EPSTEIN
page 3 / 275 . OCR, unverified
Skip Part 2 and proceed to Part 3 in this questionnaire.
"Family Truer includes trusts with the name of the natural person(s) or family grantors. or the words. spousal. marital, testamentary,
family, revocable. irrevocable, estate, living. charitable. residuary. dynasty, FBO, under •veal. supplemental needs. special needs, credit
shelter. bypass. GST exempt or non-exempt. grantor. ORAT. CRUT, etc. where there are multiple family members who are grantors.
including where the grantor-beneficiary relationship is either lineal or non-lineal (i.e.. outside the lines of parents and issue).
"Family Member" includes any family member (all lineal descendants (including by adoption. shipcniidnin, foster children, and individuals
that were a minor when another family member became a legal guardian of that individual) of a common ancestor (who may be living or
deceased), and such lineal descendants' spouses or spousal equivalents: provided that the common ancestor is no more than 10
generations removed from the youngest generation of family members), including former family members.
wirrimi57 022673.i 201 i5 Page 1 on 3
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
DB-WNW-0031319
CONFIDENTIAL
SONY GM_00177503
EFTA01345153
--- SOURCE: IMAGES__0015__EFTA01345154.txt ---
METADATA_SOURCE: IMAGES0015
METADATA_FILENAME: EFTA01345154.pdf
----------------------------------------
Part 2
ta the vehicle an operating company which does not own or propose to acquire securities° having a value of 40% or more
of the value of its total assets° on an unconsolidated basis? (Please note that the attached client certifications needs to
be provided.)
Yes, the entity is an operating company engaged in the business of
and a client certification is attached
No
Part 3
Please con
— Did not check any box in Section 1. or
— Checked -no' in Section 2.
olcker onboarding approval of this vehicle If you
If you either checked any box in Section 1 or checked -yes' in Section 2 and have obtained a client certification, please
attest and sign as follows:
I attest that the above information is accurate and current and based on information provided to me by
t Ur.• flA
Kc tn t.
as contact for
OM
Sgnimum of Clem
Cynthia Rodriguez
Name of Chen! Representative
Oat*
(
( Liz
The meaning of 'security in this context is broadly construed and includes, but is not limited to, stocks, bond
security futures. as well as any put, call or other option on any security.
a Value to total assets is excluding U.S. government securities and cash items.
a See end of document for Certification.
other debt instruments,
whilS71 7 022673.120115 Page 2 o13
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
DB-SDNY-0031320
CONFIDENTIAL
SDNY_GM_00177504
EFTA01345154
--- SOURCE: IMAGES__0015__EFTA01345155.txt ---
METADATA_SOURCE: IMAGES0015
METADATA_FILENAME: EFTA01345155.pdf
----------------------------------------
Deutsche Bank
Wealth Management
Certification Regarding Beneficial Owners Of Legal
Entity Customers
I. General instructions
What is this form?
To help the government fight financial crime, Federal regulation requires certain financial institutions to obtain, verify,
and record information about the beneficial owners of legal entity customers. Legal entities can be abused to disguise
involvement in terrorist financing, money laundering, tax evasion, corruption, fraud, and other financial crimes. Requiring the
disclosure of key individuals who own or control a legal entity (i.e., the beneficial owners) helps law enforcement investigate
and prosecute these crimes.
Who has to complete this form?
This form must be completed by the person opening a new account on behalt of a legal entity with any of the following U.S.
financial institutions: (i) a bank or credit union; (ii) a broker or dealer in securities; (iii) a mutual fund; (iv) a futures commission
merchant or (v) an introducing broker in commodities.
For the purposes of this form, a legal entity includes a corporation, limited liability company, or other entity that is created
by a filing of a public document with a Secretary of State or similar office, a general partnership, and any similar business
entity formed in the United States or a foreign country. Legal entity does not include sole proprietorships, unincorporated
associations, or natural persons opening accounts on their own behalf.
What information do I have to provide?
This form requires you to provide the name, address, date of birth and Social Security number (or passport number or other
similar information, in the case of Non-U.S. Persons) for the following individuals (i.e., the beneficial owners):
• Each individual, if any, who owns, directly or indirectly, 25 percent or mare of the equity interests ofthe legal entity customer
(e.g.. each natural person that owns 25 percent or more of the shares of a corporation); and
• An individual with significant responsibility for managing the legal entity customer (e.g., a Chief Executive Officer,