EFTA Document EFTA01387980

One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summar 30. Individual Details (for all parties) Individual's Name: Date of Birth. Country of Residence' Country of Citizenship Has client resided outsice of ha/her country of Address of primary nationality for 5 years or residence- more? 0 yes .i. No Profession, Occupation: Tax ;D SSN Current Employer: N/A Position/Title/Rank: N A Address of employer: N/A Does the person work as senior executive of a DB-recognized regulated entity in he financial Industry? or an entity bated on a 0B-recognised exchange? (Not pplicable for operating entities ales kw/. No Is the individual a Politically Exposed Person (F£P)?(11 Yes, desaibe) N/A 0 Yes ...4 r No To the best of your knowledge, is the individual related to an employee of the DB groupyd Family or Friendship, dewily) NIA 0 Family 0 Friendship Vi 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(d Yes,deseribe ) N/A 0 Yes 10 No If applicable. indicate which bank officers have met the person' Indicate where and when the client meeting(s) took place Bank Officer Name(s) Bank Office Client Private Domicile Client Place of Business Other Location (soecify! Dare 0 • 0 • 0 0 D 0 El L....iWealth Details for this individual are not filled xi because they are the same as for the following person. 3S. Wealth Details (Only for parties requiring source of wealth description as indicated in Section 2) Nature of the Individual's Business: Homemaker Solely relies on income from her wife who is a Interior Designe, Primary Country of source of wealth/source of Funds? united Sates Primary industry of source of Wealth/Source of Funds? Other Summarize Source of Wealth: D Bulimia Owner ga Salary/Earnings • Investment 0 Inhentance/Gifts Other: Further Desaibe 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 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0091278 SONY GM_00237482 EFTA01387980