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sd-10-EFTA01356685Dept. of Justice

EFTA Document EFTA01356685

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KYC Print Page 8 of 43 One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summa 3A. Individual Details (for all part es) Individual's Name: Karyna Shuliak - Date of Birth: Country of Residence: United States Country of Citizenship: Belarus Address of primary residence: Has client resided outside of his/her country of nationality for 5 years or more? Li Yes W No Profession/Occupation: Interior Decorator Tax ID / SSN: Current Employer: JSC I

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Dept. of Justice
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sd-10-EFTA01356685
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