Case File
efta-01450291DOJ Data Set 10OtherEFTA01450291
Date
Unknown
Source
DOJ Data Set 10
Reference
efta-01450291
Pages
1
Persons
0
Integrity
Extracted Text (OCR)
Text extracted via OCR from the original document. May contain errors from the scanning process.
BY SIGNING BELOW CLIENT ACKNOWLEDGES THAT: (1) CLIENT HAS RECEIVED, READ, AND AGREES TO THE TERMS AND CONDITIONS OF THIS
ACCOUNT AGREEMENT, INCLUDING THE APPENDIX WHICH CONTAINS IMPORTANT INFORMATION; AND 12) THE INFORMATION CONTAINED IN THIS
ACCOUNT APPLICATION IS ACCURATE.
'CLIENT ACKNOWI EDGES THAT THIS ACCOUNT AGREtti4
A
E ARRITRATiONCLAIJSE AT SECTION It PAGE &AND CLIENT
.
.
9KOREES TO ITS TERMS (ALL ACCOUNT AGREEMENT Si.
THE INTERNAL REVENUE SERVICE DOES NOT REQUIRE CLIENT'S CONSENT TO ANY PROVISION OF THIS DOCUMENT OTHER THAN THE CERTIFICATION
REQUIRED TO AVOID BACKUP WITHHOLDING. AND. IF APPLICABLE, THE CERTIFICATION REQUIRED TO ESTABLISH CUBIT'S STATUS AS A NON-US.
PERSON MID OBTAIN A REDUCED RATE OF WITHHOLDING.
Important Information for ERISA employee benefit plan clients: U.S. Department of labor regulations require DBSI to disclose to a responsible plan fiduciary
certain information in connection with the services that DB& provides to a plan, to assist the fiduciary in evaluating the reasonableness of DBSI's services and
related compensation. The disclosure is available online, at http://www.pwm.db.com/amerkas/enterisa_discknurejxs.html. 8y signing below, you acknowledge
that you are a fiduciary responsible for the procurement of DBSI's services to the plan, you have read the disclosure and you understand the disclosure.
Individual or Joint account (IF THIS IS A JOINT ACCOUNT, ALL ACCOUNT OWNERS MUST SIGN):
CONFIRMATION OF TAX AND COMPLIANCE RESPONSIBILITIES
Client acknowledges having sole responsibility to fulfill any tax obligations and any other regulatory reporting duties applicable in any relevant jurisdictions that
may arise In connection with assets. Income or transactions in Client's account(s) and business relationship with DBS1.
CHECK A BOX ISELOWONLY
CLIENISDONOT WANT JOINT TENANT
EINTS
SURVWORStliP OR TENANTS BY.111E ENTIRETIES.
CLIENTSSPECIETINSIEAC9
O Tenants in common; Dv
ElCommunity
for marled couples
oaths; each spouse retains SO%
erest in the community property upon death of the first spouse).
-://71$
Signature
Data
Print Namej •
Entehl
SSN/EIN
Signature:
Date
Print Name
SSN/EIN
Signature
Date
Print Name
SSIWEIN
Corporation, partnership, must or other entity:
CONFIRMATION OF TAX AND COMPLIANCE RESPONSIBILITIES
Client acknowledges having sole responsibility to fulfill any tax obligations and any other regulatory reporting duties applicable to in any relevant Jurisdictions
that may arise In connection with assets. income or transactions In Client's accountisl and business relationship with DBSI. Furthermore, Client confirms that the
necessary Information (to the best of C€ient's knowledge and capabilities) is made available no loss than annually to the relevant beneficial owner(s). settiorls).
beneficiary(ies). partner(s). etc. to enable such person(s) to fulfill any respective tax obligations that may arise for such person(s) in connection with Client's
business relationship with OBSI.
Name of Entity
Employer ID No.
Signature of Officer. Partner. Trustee, Authorized Party
Date
Print Namenitio
Signature of Officer. Partner. Trustee, Authorized Party
Dm°
Print Name/Tato
Signature of Officer. Partner, Trustee, Authorized Party
Oslo
Print Nameflitle
12.PWM-0573
7
012146 011113
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
DB-SDNY-0105843
CONFIDENTIAL
SONY GM_00252027
EFTA01450291
Technical Artifacts (6)
View in Artifacts BrowserEmail addresses, URLs, phone numbers, and other technical indicators extracted from this document.
SWIFT/BIC
ACCURATESWIFT/BIC
APPENDIXSWIFT/BIC
APPLICATIONSWIFT/BIC
CONTAINSSWIFT/BIC
INFORMATIONURL
http://www.pwm.db.com/amerkas/enterisa_discknurejxs.htmlForum Discussions
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