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/Titl