EFTA Document EFTA01387280

One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summar 3A. Individual Details (for all parties) Individual's Name: Groff, Lesley - Date of Birth Country of Residence. USA Country of Otizer•sh 0 USA Address of primary residence- United Rates Has client resdeo ou:sioe of his/her country of nationality for 5 years or more? 0 Yes ,V. No Profession' Occupation. Attorney Tax ID: SSN Current Employer: Darren K lndyke PLLC Position: Title' Rank Attorney Address of employer: new york NY United Sates 10022 Does the person work as senior executive of a DB-recognized regulated entity in he financial Industry? or an entity listed on a 0B-recognised exchange? (Not callable for operating entities 0Yes tri No Is the individual a Politically Exposed Person (F£P)?(If Yes, describe) 0 Yes Ns' h.4 No To the best of your knowledge, is the individual related to an employee of the DB groupWif Family or Friendship, describe ) D Family 0 Friendship g None To the best of your knowledge, lathe Individual party to a non-banking relationship with Deutsche Bank (e.g., external legal counsel, client referral source, supplier of goods or services)?(if Yes,describe ) ❑0 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 (soecilyi Dare o 0 • 0 0 • D 0 0 L....iWealth Derails for this individual are not filed ri because they are :he same as for :he following person. 3B. Wealth Details (Only for parties recur, ng source of wea :h oescription 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: 0 Budness Owner 0 Salary/Earnings 0 Other • Investment 0 Inhentance/Gfts CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0089541 SDNY GM_00235725 EFTA01387280