EFTA00169427.pdf

Structured Products Agreement and Approval Form Please Complete All Sections Accoutki Account Ham; WIG - o 2 33,c)li sfx, ilerS-t K) N A/Qc AL LL c_. Account Type arin.v•Phil !aMtivilltital.:yetroluity I.w loralion ($9004). NOTE: IRA and ERISA accounts are prohibited from purchasing Structured Products. Account and Owner Information: Provide requested inhumation for each beneticial account owner (tong. If more than one owner exists. !ha Structured Products Agreement and AppiovaiSuroontentary Form to this Agreement may be tequired. loot; Nanµ. Malelle. Lan Name nl IntImdua Teu.iev el El.:cuInt -re--CP2.€-_•`1 G9 51-6-I JJ ndtven I cic) Rco 1-V ic) \< c&k\ONet 132 s-r - rNotAAS CnUntrY Ilvil•Uni nt 0rpendetitc US VW..G‘s. MA, nal Sialirs - MfaCOlrf vv CmCgOvN Pus. Pngiv• S\)/ of SGL4 Invest Dann> Pennon VoNS I tell 410 pcovccrics owNet (0* l ioatal S) a! Ira , aa(S) atlag !Km httatial OWlia, (51 MilltDoitd to Pl3C0 Orders los t he account L "kR2Y-C--1-1- 5 DAR.Leic.) Client(s) Financial Information Approximate. Aggregate Sources of Income Approgimate Net Worth ApproLimate Liquid Nat Annual Income of Account (Approximate) Worth Excluding Principal Owner(s) from All Sources Residence Less than $50,000 Salary/Bonus Less than S50,000 Less than $50,000 550,000 - 599.999 550.000 - 599.999 S50.000 - 599.999 Interest s 193 5100,000 - 5249.999 5100,000 - S249,999 5100.000 - 5249.999 5250.000 -5499,399 Other (specify): $250,000 -$499.999 5250.000 - S499,999 `,500.000- 5999.999 ya S500.000- S999.999 5500.000 - $999.999 IMEe tee :".1.000,000 - Y2,499.999 91,000.000 - 82.499,999 51.000.000- 52.499.999 ::,2.500.000 - $4,999,999 52,500.000 34.999.999 52.500.000 - 54,999.99s .5.000,000 and over 7 ( S5.000,000 and ovl 11 1n! !aim nest o O017.3330n paw oi 5 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) aA9349-30830 EFTA_000 19700 EFTA00169427  Investment Experience of Account Owner(s) Year First Average it Trades Average Sim of Types of Previous Option Traded Per Year Trades In :r Experience Options 19 'KJ k Covered Cali Wriiing Equities 4( Purchased Options Fixed Income I115' 4. Option Spreads Commodities and Futures 0/0 Uncovered Put Writing Structured Products aoOc) d Uncovered Call Writing DR; Derivatives None Foreign Currency Alternative Investments (Hedge Funds. Private Equity) Investment Objectives for the Client Account (Select up to :my° adjacent objeCtivas): Capital Preservation Income Growth ik Aggressive Gi•—qh Representations Relating to Qualification of the Client Check all that apply. At least one category must o:' theck2d. I represent that Client qualifies as an 'Accredited Investor' as defined in Regulation 0 under the Seciesiies AN of 1933 because Client is: • a natural ;arson with incividital income exceeding 5200.000 in each o: the two roost rectal', years or joint income with x spouse exceeding 5300,000 in each of those years and a r easonable expectation of the same income level in the current year: a natural person With individual net worth, or joint net worth with a spouse. over S1.000.000. excluding pi Utterly residence: a ;rust with assets in excess of 55.000.000. not formed fa the SpeedKt pi II 1)O:411 of acquiring the sect,' inert °Heratwhose purchases are directed by a sophisticated person: a revocable trust that nay be amended or revoked at any time by tit! tar int tii s end where MI of the grantor::urn accredited investors: a charitable organization. Corporation or partnership wills assets exceeding 55.000.000; 1.4 a business in which all the equity owners are accredited investors: a bank, savings and loan association, registered broker or dealer, InSUF Wire company, registered investment company, business development company or licensed small business investment Company; an erriptoyee beneii, plan. within the meaning of ERISA, if a plan irduciaty Mai is a bank. insurance company or registered investment adviser makes the investment decisions, or if the plan has over :E.go0.000 in total assets or a sell-direried plan with investment decisions made solely by accredited investors: a plan established and maintained by a state, its political subdivisions a any agency or instrumentality tliereni. for the benefit of its employees with total assets in excess of "5.00omoo; rn a director. CueCulive officer or general partner of the issue. of tile setae leS huarg &loud. V•MI /MIR 'PM I/SWIM vr4 "tom i Pas •e CONFIDENTIAL — PURSUANT TO FED. R. GRIM. P. 6(e) spat x6831 EFTA_00019701 EFTA00169428  Representations Relating to Qualification of the Client (Continued I .-t:preseet ;net Client qualifies as a "Qualif ) ied Purchaser` as defence] to, the Investment Cuinimay Act of 1940. lxicaukt Olefins a natural person (including any person who holds a joint. consenter any : ' propeaty, or other similar shined owne, ship antenna in on issuer that is excepted under section 3(e)(7) with Thai panne i's qualified purchaser snouted who owi, not tete: than SS.000.000 in investments: any person. &cling i or its own account or the accounts of other on a dlScrationary basis, not less Than $25.000.000 in ritirtificsi putchase, t.. who in the agent(Jate twee: anti u.vv.ts investments. V a company that owns not less than $5,000,000 in investm ents runt that is owlet() directly or indirectly by or for 2 or ;nth,: natural persons who are related as siblings or spouse (includ ing framer spouses). ur deed fit lent descendant sine WU, or adoption. spouses of such persons. the estates of such nelsons . or foundations, charitable organizations. or trusts established by or for the benefit of such persons: our a trust that is not covered by any definition above, and that was lin., torment Ira the specific purpose of acqui,mg Itue securities offered, as to which the trustee or otter person authon...st to make decisions with resi ft:et to Mc settle or other person who has contributed assets to trust en, i eacti the trust. is . person closet abed Many definitions above. Client(S) Strategy Requests. Please check as many of the following smitegies ("Sinchafed Pt oducasi as may apply. Well MI SVOCIUreid Products, in the event of early liquidation. there may not I '• .t liquid market, and the invest in may r. qml ier,ce a IcKs, dire to costs involved with unwinding the investment. Further more. ins:slues aro imposed to the credit risk of the .smog which in the case of a default. may result in a significant, entity. or total. loss in the investor. 1)( 1. Principal Protected Structured Notes and Certific ates of Deposit-. 90%-10054 Principal Protection which may resin in returns than a direct investment in the underlying. Investo lowei r uncimstands that principal is protected only if held le maturity anti that FDIC insurance applies only to Marie:Winked Certific ates of Deposit up to the stdttitory limits. y' 2. Buffered Notes—Patna' principal pioiect ion (usually protection from the lust 10::.•204, decline in the as a belie; to loss. Investors participate in cite downside. either omit:Ilying) when Sc' .tes on a 1.-fon1ix lewiragecl basis,in the womanlike declines beyond the predelonnined boiler level. Upsacitt partici:A undene lio+ the taxleilying May belcvaagerland Is sem:Inns9 capers& ttc 3. Contingently Protected (including Reverse Conver tible and Callable Yield) Notes—Full Principal PrOtectinit only if a e.sei hairier is not breached. If a barrier is breached. investo would pi rs lose the level of peotection and paiticipate in am :Iodine in the underlying, it any, at maturity. Structures include but payment, participation in upside if the underlying perform arc rant limited to those that pay investors a fixed eounan s positively. oi both. The investor acknowledge,; that at maturity maybe in the term of cash or physical delivery settlement of the underlying. K 4. Market Participation Notes and Warrants—Zero principal protection. Full downsi one O; mote underlyingS in the form of a weighted basket de participation. MPNs may be linked to varying degrees of upside participation, leverag or overlay and may be customized to octet siteight I fob 1, or e or a fixed coupon. Investors in MPNs seek access to an underly is generally complex and which may be inaccessible to them ing which in the nun kat. DB and third pat iy erOprretary indices are typically used as an underlying. Warrants may be linked to hedge funds, mutual funds, basket of funds as well stocks and may lose lull value or a premium paid if the as side/actual price et the underlying asset tln,^S riot list:. The following representations are applicable lot an individu al account. II this is a joant, trust. partnership, limited company. corporate or other type of account, the word T m (he liability joint accost or the authorized signatory making following paragraphs shall mean each owner in the case represent:Akins on ',Alai' of the bust, parInvship, limited liability of a other entity in the case of such account type• company te as the Case may be. I represent that the purchase of Structured Products is suitable for my account in fight of my investm experience, financial situation and risk ent objectives and based upon my own judgment, adequatoleran ce. I have made my own decision to utilize Structu te information I have independently obtained (loom red Products foe my arxotint regarding Structured Products and consul sources other than Deutsche Bank) tation with my own advisors to me extent I have regulatory. tax. business, financial, accounting and deemed necessary as to the tepee. related aspects of lily put chase of Ste uctured Produc Structured Products may contain a derivat ts I understand that ive component in the form of one o more embed may have the result of reducing the glans Or interes ded options, and that such option(s) t income, or increasing the losses (wheel) may include the Scrucitued Products. whether held to maturit a loss of principal) on y or sold prior to maturity, to a °reales extent than Structured Products did not contain such a derivat would be the case if the ive component. I also understand that Structured capital preservation features if sold prior to Products may lose then maturity. Finally, I understand the investment iisksas Products. including but not limited to Metier credit risk, sociateci with SiflICinred market risk and liquidity risk. to hie extent peinulted by applicable law and rules. I inithoitze Deutsche Bank to acquire for my Account. I acknowledge and agree and dispose DI Struclui et! Pioduee, In ;horn• m.' that when Structured Produces ant iitaized for :in I In Ilip• L. : t tin ri ;the re.:4 h, :4Attbn• um: Any :e'parmy account Deutsche Sank Ohly i mint: •••it. 'ann. ..In poi nolo eine on ...WI Iii) I. • nit, • ...timid •.! •fliostorcii/ti 'AM.' r. a • nem.innel 1Y ,.kk,l it •Atlk.mi-•. awl , ..Y.• loans. in ' his. Owe 1.4 which a 4•ri 4 lir I . t.+.lu•.w niii..11119 .!.. min i.i boo • . .Id' • ''.1 •••••• .h• ail.. 4.1 ' h. - ••• rd .d . r.r 10..1-41/711.1 /tr. CONFIDENTIAL — PURSUANT TO FED. R. GRIM. P. 6(e) ii/V)& 711832 EFTA_00019702 EFTA00169429  I agtee that I wilt mad cm etutly any prospectus. term sheet and any mike olio' mg ch v It (any ..mcli inospectus. torn shed) or afterlife docinfient, an 'Offering Docurneilr) that I may iet: me at corawction with die ar.quisitimi oi .iny Structured Product for my Account. including disclosures in any such Of/rim r.krument desailfing the lees I may pay u i conoeciion will) the Structured Product as well as representations and warranties tiLI, I yell be deemal to have made in coniiectior. wait :he acquisition of the Structured Product. Qualified Institutional Buyer I rep &sent that qualifies as a "Qualified Institutional Buyei" as defined below. R(i) Any of the following entities, acting to. its own account or the nrcnunls of other qi eddied institutional lanyais. Mal in die aggregate owns and invests on a discretionary basis at least hi O0 Ammon in securities of issuers that are nut affiliated ranth the entity: A• (A) Corporation, etc. A corporation (other than 4 hank. savings if ni loan ur simile; if istitounii whored io in (d) belcw/). partnership, Massachusetts or similar business trust, organizzitnit descried in Scallop' S01(c)(3) of the Internal Revenue Code, &wall Business Development Company licensed by the ; S. Small Business Administration under Section 301(c) ur (d) of the Small Business Investment Act of 1958, or business durelopinimi conetaw as deli: led in Seclioit ?02(x)(22) of the Investment Advisois Act of 1940: or (B) Insurance Company. An Insurance Company as defined in :crown 7(13) of the Act; or (C) ERISA Plan. An employee benefit plan within the meaning of frale I of the Employee Retirement Income Security Act of 1974: Or (0) State or Local Plan. A plan established and maintained law n :.eats. 4s poldical subdivisions,. or any agency instrumentality of a staled its political subdivisions. for the bent fit oi its eintraleest (El Trust Fund. A trust fund, whose trustee is a bank or trust. whose particemnis ate wick isively plans specified in subpar asyaph (C) or (0) above (but not includeig trust funds nevem IRAs or Keogh plans as pat racipaiits). (F) Investment Company. An imvesbmdne company registered under the Investment Company Act of 1940m any Isomers development company as defined in Section 21eX40) of that Au: Of (Q) Investment Advisor. An investment advisor registered uncle, the Investment Advisors Act of 1940 Bank or Savings and Loan. We area bank defined in Section 3(a)(2) of the Act. a savings and loan association OF other institution relo aced in Section 3(0X5XA) of the Act. or a foreign bard. in savings and loan association of equivalent institution that in the aggregate owned and invested on a discietiona y basis, for as own account and the accounts of °Mei persons. at leas; the amount of securities specilied below Mot less duel ≥100 million). calculated as provided in Rule 144A. as of the date specified below and had an audited net worth of at least $25 million as of the end of rim most recent fiscal year. (This paragraph does not include bank commingled funds, ;nowt as noted in ('XE) above.) (iii) One of a Family of Investment Companies. We are an investment company registered under the Investment Company Act of 1940 that is pan of a "family of investment companies", as defined in Rule 14i1A, that owned in the aggregate at least the amount 01 securities specifier:, below (not less than S100 million). cakulated as provided in Rule 144A. as of the date specified below. (iv) We are a dealer registered tinder Section 15 of the Securities Ef.chtinge Act at 1934, and we are one of the following (A) Dealer/QM. We owned or invested on a discretionary basis. fur our own account and the accounts of other persons, at least the amount of securities metalled below (not less than S10 million). calculated as provided in (bile 144A. as ol the date specified below. (B) Dealer/RisklesS Principal or Agent. We are acting either on a runless principal basis lot simultaneous resale toe qualified institutional buyer Or as agent for one or more qualified institutional buyers. (v) Entity owned by Qualified Buyers. We are an entity. all of the equity owners of which ate qualified institutional buyers (cacti satisfying one of (t) thimgh qv) above including as ape:lcale the 1.100 nudtou In calculating the amount of securities owned or invested:. . n._n /r0711 51,44 OOSI ultrio Oe1017 Il..p• ••• CONFIDENTIAL — PURSUANT TO FED. R. CRIM. P. 6(e) 6V661stba;833 EFTA_000 19703 EFTA00169430  By signing below, I hereby confirm that the representations made in this Structured Products Agreement and Approval Form are true to the best of my knowledge. Client signature block:' 14a al accaaa S‘gaatzaa Sayan!~ Nam° Nark, Daa Jau •It this Is a d..1irif account a jånt account holders must The following signature block should be used fora Trust Partnership, limited liability Company or Corporate client. Tab yeAccam: sou-t\-w2(Lk) Fu‘H.)- N)c-‘ I-- Dote C fi ("q-. N, Wr rri2-6--\ \ sref•) If this is a trust account check as anpropriale Trustee CoTrustee For Deutsche B#ik Office Use Only ems ka »wry Oete I 0(2-34 -"+" , t\` \N VQ(I nit imestmantSilatiaaa Nana. 'So s FluttA 5 timSNAM Lbriaitai AI9caI S.naute Data Pry! Manarar ria:ntt Please submit el completed and fully executed forms to Compliance via NetX360. "Deutsche Sank' means Dutitsche Bank AG and its alfiriated companies. De utsci le Bonk. Wealth Management represents Ise, irealdi crtarelgement activities conducteu by Deutsche Bank AG or its r.t.b.SidrariM.. Brokerage services are altered through DeursChe Bank SDICAlli:WS Inc.. a broker-dealer and registered investment adviser, tvhich corttlucts itwesement hankie() sod seutrieeg activities in the Waned States. Deutsche Bank Securities Inc isa member of n NRA, NYSE and SIPC. 2.N; c.y~a Balk M ',naval. WM: )aria ;Waft CAPJ; ClaiDaatzel 7 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) 11M1W0M834 EFTA300 19704 EFTA00169431