EFTA Document EFTA01365763

BY SIGNING BELOW CUENT ACKNOWLEDGES THAT: II) CLIENT HAS RECEIVED. READ AND AGREES TO THE TERMS AND CONDITIONS OF THIS ACCOUNT AGREEMENT, INCLUDING THE APPENDIX WHICH CONTAINS IMPORTANT INFORMATION: AND (2) THE INFORMATION CONTAINED IN THIS ' ACCOUNT APPLICATION IS ACCURATE. CUENT ACKNOWLEDGES THAT THIS ACCOUNT AGREEMENT CONTAINS A PRE-DISPUTE ARBITRATION CLAUSE AT SECTION III, PAGE E AND CUENT AGREES TO IT TERMS (AU. ACCOUNT AGREEMENT SIGNATORIES MUST INITIAL). INITIAL HEllth.-.. 5 z -../.. 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 REOUIRED TO ESTABLISH CLIENTS STATUS AS A NON-U.S. PERSON AND OBTAIN A REDUCED RATE OF WITHHOLDING. Important Information for ERISA employee benefit plan clients: U.S. Department of tabor regulation. require DBSI to disclose to a responsible plan liducisry certain Information In connection with the serykes that 08.51 provides to a plan, to assist the fiduciary In evaluating the reasonableness of MST, services and rotated canperisatIon. The disclosure is visitable online, at Mtp://www.pwm.db.coirdamorical/eNerbiluiledosure_pcs.htnil. By aignitg below, you acknowledge that you are • fiduciary responsible for the procurement of DBSI's services to the plan, you have read the dndosure and you understand the disclosure. Individual or loin account (IF THIS IS A JOINT ACCOUNT, ALL ACCOUNT OWNERS MUST SIGNI: CONFIRMATION OF TAX AND COMPLIANCE RESPONSIBILITIES Client acknowledges having sole responsibility to fund any tax obligations and eny other regulatory reporting dudes applicable In any relevant jurisdictions that may arise in connection with assets, Income or transactions In Client's scrounge) and business Walk:nal* with DBSI. CHECK A BOX BELOW ONLY IF CLIENTS DO NOT WANT JOINT TENANTS WITH RIGHTS OF SURVIVORSHIP OR TENANTS BY THE ENTIRETIES. CLIENTS SPECIFY INSTEAD: O Tenants In common: Cornrnundy Pro or mar couPle* In cod Signature Print Name Signature Print Name Signature Print Name _spouse retains SO% Interest In the community property upon death of the first spouse). • Dale a t4 SSNIEIN Date SSNIEIN Date SSNIEIN Ccwporefron. partnership, trust or other entity: CONFIRMATION OF TAX AND COMPLIANCE RESPONSIBILITIES Client acknowledges having sole responsibility to fulfill any tax obligations and any other niElitleiY reporting duties applicable to In any relevant jurisdictions that may raise in connection with assets, Income or transactions In Client's ittcountle) and business relationship with OBSI. Furthermore, Client confirms that the necessary kW crimailon Ito the best of Client's knowledge and capabilities, is made available no less than annually to the relevant beneficial ownerld. settions). benelkisryllesL Pertrierls), etc. to enable such presents) to fulfill any respective tax obligations that may arise for such personts) in connection with Client's business relationship with MISS. Nunn of Entity Southern Financial LI-C Signature of Off Ira Parma., Trustee. Authorized Par J•rfliT EPH•in Print Name/Title B6 Employer ID No -0199192 Date 7_—.RC --C3 Signature of Officer, Partner. Trustee. Authorised Party Date Print Namarfille Signature of Officer. Partner. Trustee. Authorized Party Date PAM Name/Thle 19.AWM.0196 7 012146.032813 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0056837 CONFIDENTIAL SDNY_GM_00203021 EFTA01365763