EFTA Document EFTA01387991

One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summar 3A. Individual Details . 'a' , oc': es, ndividual's Name Date of Birth: Country of Residence Country of Citizenship' Address of primary residence- -4as C ert rescec c.aside of hisiber country of nationality for 5 years or more? Yes t No Profession, Occupation N A Tax ID: SSN Current Employer: N A Position/Title( Rank NSA Address of employer: N A Does the person work as senior executive of a DB-recognized regulated entity in the financial Industry? or a entity listed on a OB-recognised exchange? (Not applicable for operating entities OYes ri No Is the individual a Politically Exposed Person (PEP)7(i( Yes. describe) N/A Yes .4 No To the best of your knowledge, lathe individual related to an employee of the DB groupWif Family or Friendship, describe) N/A I,,,,) 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 Yam/nate ) WA OYes RN° If applicable. indicate which bank officers have met the person. Indicate where and when the client meeting(s) took place Bank Officer Narne(s) Bank Office Client Private Domicile. Client Place of Business Other Location (soecityt Dare o O iii O O • D O 0 nWealth Details for this individual are rot fi led o because they are :he same as for the following person. 3B. Wealth Details (Only for parties recur ng source of wea':h descrIption as Ind cated in Section 2) Nature of the Individual's Business: Primary Country of source of wealth/source of Funds? Primary Mdustry of source of Wealth/Source of Funds? Summarize Source of Wealth: 11 Business Coen., O Salary/Earnings • Investment O I nhentance/Glts J Other: CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0091296 SDNY GM_00237480 EFTA01387991