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7/15:2019
KYC Print
One sheet must be established for EACH INDIVIDUAL PARTY In Section 2. Account Ownership Summary
3A. Individual Details (for all parties)
Individual's Name:
Date of Birth:
Country of Residence:
USA
Country of Citizenship:
LISA
Address of primary residence:
Boynton Beach Ft. 33436 United
States
Has client resided outside of
his her country of nationality for
5 years or more>
yes 49 No
Profession/Occupation:
Tax ID / SSN:
Current Employer:
Position/Title/Rank:
Address of employer:
Does the person work as senior executive of a DB recognbed regulated entity in the financial
ndusby> or an entity fisted on a DO-recognised exchange> (Not applicable for operating entities
.
Yes I
No
Is the intividual a Politically Exposed Person (PEP)?(//11% dersato)
Yes
I
No
To the best of your knowledge, Is the individual related to an employee of the DB grouplinsmifY
a - Friendship, *sate)
1 Family
i : Friendship
::, None
To the best of your knowledge, is the individual party to a noffibanking relationship wei Deutsche
Bank (e.g., external legal counsel, client referral source, supplier of goods or sentices)70/
Yesdesolbe)
u Yes
is6 No
If applicable, indicate which bank officers have met the person:
Indicate where and when the dent meeting(s) took place:
Bank Officer Name(s)
Bank Office:
Client Private
pomkile:
Client Place of
Business:
Other Location (specify):
Date:
(3
1.3
Wealth Details for this Individual are not filled in, because they are the same as for the following person:
38. Wealth Details (Only for parties requiring source of wealth description as indicated in Secton 2)
Nature of the Individual's Business:
Primary Country of source of wealth/source of Funds>
Primary industry of source of Wealth; Source of Funds>
Summarize Source of Wealth:
•
. Business Owner
Salary/F-amings
. Investment
• Inheritance/Gifts
Other:
Further Describe Source of Wealth /Detail the history of wealth for each of the sources: (e.g. For trusts, how did settlor accumulate wealth> For inheritance, how did
family accumulate wealth>For business owners, how long in business, how many employees, level of profitability> Indicate type of business, countries of major
activities, important business partners.)
Estimated Annual Income(S):
Estimated amount of investable assets(f):
Estimated Net Worth(f):
Other Known F, ancial Institutions:
Amount of asses planned to invest wth PWM(f):
Institution:
Country:
Est. Assets Under Mgt:
Institution:
Country:
Est. Assets Under Mgt:
Institution:
Country:
Est. Assets Under Mgt:
https:ildbforcepb.my.salesforce.comiservietiservlet integration2lid=0 I N30000000D9D4eidx5003200001EHPpb&ict l&linkTokenWmpFPSxNakF4T
20.43
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
CONFIDENTIAL
DB-SDNY-0066806
SDNY GM_00212990
EFTA01372900