EFTA Document EFTA01387987

One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summary 3A. Individual Details 'or all part es. Individual's Name: Date of Binh: Country of Residence Country of Citizenship: Address of primary residence- s client resided outside f his/her country of ationality for 5 years or ore? O yes :hi No Professon, Occupation N A Tax ID I SSN Current Employer: N A Position/Title: Rank 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 listed on a OB-ratogn ised exchange? (Not pplicable for operating entities ElYes kw/. No Is the individual a Politically Exposed Person (F£P)?(If Yes, describe) N/A O Yes ...4r No To the best of your knowledge, is the individual related to an employee of the DB groupWit Family or Friendship, describe) NIA O 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)?(if Yes,describe ) NIA IDYes . w" 4 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: Oient Place of Business Other Location (soecityi Date O K O • O O D O O nWealth Details for this individual are rot Mel ri because they are the Sate as for the following person. 38. Wealth Details (Only for parties recur, ng source of weaTh oesc—ptsr as rad need in Section 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: DEtuartess Owner O Salary/Earnings • Investment Li Inhentance/Gifts JOther. CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0091288 SDNY GM_00237472 EFTA01387987