Case File
efta-01392757DOJ Data Set 10OtherEFTA01392757
Date
Unknown
Source
DOJ Data Set 10
Reference
efta-01392757
Pages
1
Persons
0
Integrity
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Text extracted via OCR from the original document. May contain errors from the scanning process.
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 inn 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 OBTCA'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 lax 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 DBTCA.
Non-US Organizations: 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 it in any relevant jurisdictions that may arise in connection with assets, income or transactions in your attount(s) and
your business relationship with DBTCA. 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), sentons).
beneficiary(ies), permi(s), etc. to enable him/her/ them to fulfill any respective tax obligations that may arise for him/hod
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
immediately of any material change to
the information provided by you on this Application.
You represent and variant' et all of the info,
tO provided by you on this Application is accurate.
The Terms and Conditions for
ositAcca
t to change.
Acceptance
You
i understand that this ap rication is subject to acceptanCe by OBTCA.
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Joint Account Holder's Signature
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CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
CONFIDENTIAL
DB-SDNY-0098025
SDNY_GM_00244209
EFTA01392757
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