EFTA Document EFTA01387278

One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summar 3A. Individual Details (for all p flies) Individual's Name: Wallace, Daphne - Date of Birth Country of Residence' USVI Country of Otizensh 0 USV Address of primary residence- United States Has client rescleo ou:sioe of luSrher country of O nationality for 5 years or more? yes .i. No Professon, Occupation: Finance Tax ;D SSN Current Employer: Southern Trust Company Inc Position/Title/Rank: controller Address of employer: 6100 Red Hook Quarter St Thomas United Sates 00802 Does the person work as senior executive of a DB-recognized regulated entity in he financial Industry? or an entity listed on a OB-recognised exchange? (Not pplicable for operating entities Oyes tri No Is the individual a Politically Exposed Person (F£P)?(If Yes, describe) O Yes wr Lali No To the best of your knowledge, lathe individual related to an employee of the DB groupWif Family or Friendship, describe ) D Family O Friendship g None To the best of your knowledge, is the Individual party to a non-banking relationship with Deutsche Bank (e.g., external legal counsel, client referral source, supplier of goods or services)7(if Yes,describe ) ❑O Yes 10 No If applicable. indicate which bank officers have met the person. Indicate where and when the client meetings) took place Bank Officer Name(s) Bank Office Client Private Domicile Client Place of Business Other Location (soecify! Dare D O • O O • D O O L....iWealth Derails for this individual are not (pled ri because they are :he same as for :he following person. 38. Wealth Details (Only for parties reowr ng source of wea :h oesc-pcion as tad ceed in Section 2) Nature of the Individual's Business: Primary Country of source of wealth/source of Funds? Primary rdustry of source of Wealth/Source of Funds? Summarize Source of Wealth: O Budness Owner O Salary/Earnings O Other: • Investment LI Inheritance/Offs CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0089539 SDNY GM_00235723 EFTA01387278