EFTA01392666

ATM/Debit Service You agree that the retention or use of the ATM/Debit card constitutes acceptance of the terms and conditions of the Cardholder Agreement contained in the Terms and Conditions of Deposit Accounts. Internet Banking Service If you have selected to receive Internet Banking Services, you understand that you will be required to enter into a separate Internet Banking Services Agreement with DBTCA before you can access the Internet Banking Service. Acknowledgement of Receipt of Privacy Notice By signing below, you acknowledge receipt of 0BTCA's Privacy Notice included in the Application Package. Non-US Individuals: Confirmation of Tax and Compliance Responsibilities. You confirm that it is your responsibility to fulfill any tax obligations and any other regulatory reporting duties applicable to you in any relevant jurisdictions that may arise in connection with assets. income or transactions In your account(s) and your business relationship with 0BTCA. Non-US Organizations: Confirmation of Tax and Compliance Responsibilities. You confirm that h is your responsibility to fulfill any tax ebligations and any other regulatory reporting duties applicable to it in any relevant jurisdictions that may arise in connection with assets, income or transactions in your accountls) and your business relationship with DIITCA. Furthermore. you confirm that the necessary information (to the best of your knowledge and capabilities) is made available no less than annually to the relevant beneficial owner(s), settlor(s), beneficiarybes), partner(s). etc. to enable hirrJher/ them to fulfill any respective tax obligations that may arise for himrher/ them in connection with your business relationship with DBTCA. Please complete and attach separate W-8 or W-9 documentation as applicable. Terms and Conditions and Representations By signing below, you acknowledge receipt of the Terms and Conditions for Deposit Accounts attached to this Application and agree to be bound by them. In addition, you agree to notify us immediately of any material change to the information provided by you on this Application. You represent and warrant that all of the information provi ed-byTaiiiii on this Application is accurate! The Terms and Co Acceptance You understand r Deposit Acc subject to change by DBTCA cunt Holders Signatu Joint Account Holder's Signature 9/r4, Oate Date P pry. ifoe.Bat n 41evuritiedrby: .'" Petlg Cx{ r: -,x ../ag liscs, Pcr — r i a e41 . l• ?T`F% I; (TA WANa b s47^ ,atei• 17Nik t • Wes Mtattgeteraity -1:44 FP' iti.fl.t•ertt•••511;Taratir`"tafAssn'if•rgria. `i• cilab ktiii rte.•• aci'SSZ v. a;kir -• a • c a • • • ce re g . IF %V; • (7', 3% “).••$ ;It? g lineM eWa4_';*1 ll tn. cie, .‘$" • at . AZ:Wa 4o, 7.41%,IVin'A CCS t c:MbiV 7'4" 4.ttg, /.• • r :al.'. • PaaTiatetiti: m- •rztv.--mrag0,.4 mcnr*.- sayzwima WIDC ;•izs:1:4.1r.0,e.±:Pefir # tit5f&a 3 13AWa4.0101 013959032613 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0097927 SDNY_GM_00244111 EFTA01392666