EFTA Document EFTA01362418

KYC Print Page II of 34 One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summary 3A. Individual Details (for all parties) Individual's Name: Darren Indyke - 00000486405 Date of Birth: 2/19/1965 Country of Residence: USA Country of Citizenship: USA Address of primary residence: 2 Kean Court Livingston 07039 United States Has client resided outside of his/her O country of nationality for 5 years or more? Yes b1 No Profession/Occupation: L