EFTA01291941.pdf

WARNING: PRINTED VERSIONS OF THE BSA E-FILING FORMS ARE NOT FOR SUBMISSION AND WILL NOT BE PROCESSED BY FINCEN. Currency Transaction Report Version Number 1.1 OMB No. 1506-0064 Filing Name (62.6266 '1 Type of filing Minitel report ❑ Correctiamend prior report ❑ FunCEN directed Backfiling Document Control Number / BSA Identifier Save Validate Print Under penalties of perjury. I declare that I have examined this transmittal, including accompanying documents, and to the best of my knowledge and belief it is correct and complete. In the case of documents without recipients identifying numbers, I have complied with the requirements of the law in attempting to secure such numbers from the receipts. I declare that this filing represents all Documents filed during this reporting period except for those transactions reported on paper. Sign with PIN SDNY_GM_00049867 CONFIDENTIAL - PURSUANT TO FED. R.CON(F IDENTIAL DB-SDNY-0012691 EFTA_00160475 EFTA01291941  WARNING: PRINTED VERSIONS OF THE BSA E-FILING FORMS ARE NOT FOR SUBMISSION AND WILL NOT BE PROCESSED BY FINCEN. Part I Person Involved in Transaction 1 of 2 00 ri Person conducting Person conducting Person on whose behalf b (private) .2 8 transaction on own behalf transaction for another c ❑transaction was conducted O Cmiller Service 3 O Multiple transactions Check O If entity '4 Indwiduars last name O Unknown Indyke or entity's legal name •5 First name O Unknown Darren 6 Middle name K. Suffix 7 Gender Male 8 Alternate Name 9 Occupation or type of business Attorney; owner of law arm 9a NAICS Code '10 Address O Unknown •11 City ❑ Unknown •12 State '14 Country O Unknown [ O Unknown NJ US '13 ZIP/Postal Code 0 Unknown • '15 TIN 0 Unknown le TIN type SSN.ITIN •17 Date of birth El Unknown 18 Contact phone number Ext. 19 E-mail address '20 Form of identification used to verify identity OUnknown cg Drivers scene/Stale ID O Passport O Alien Registration ❑ Other Number Country US Issuing State NJ 21 Cash In amount for individual or entity listed in Item 4 Account number 0 0 22 Cash out amount for Individual or entity listed in Item 4 $ 40.000 Account number) 10 • Page 2 of 5 SDNY_GM_00049868 CONFIDENTIAL - PURSUANT TO FED. R.CONIF IDENTIAL DB-SONY-0012692 EFTA_00160476 EFTA01291942  WARNING: PRINTED VERSIONS OF THE BSA E-FILING FORMS ARE NOT FOR SUBMISSION AND WILL NOT BE PROCESSED BY FINCEN. Part I Person Involved in Transaction 2 of 2 0 0 '2 Person conducting Person conducting Person on whose behalf d O E a Courier ❑ transaction on own behalf - 11 I—I transaction for another c transaction was conducted Service (Private) 3 O Multiple transactions Check El If entity '4 Individual's last name or entity's legal name O Unknown Darren K. Indyke PLLC •5 First name ❑ Unknown 6 Middle name Suffix 7 Gender 8 Alternate Name 9 Occupation or type of business 9a NAICS Code '10 Address O Unknown '11 City O Unknown New York •12 State O Unknown NY '13 ZIP/Postal Code 0 Unknown 10022 '14 Country O Unknown US •15 TIN D Unknown 16 TIN type E1N •17 Date of birth 0 Unknown 18 Contact phone number I Ext. 19 E-mail address '20 Form of identification used to verify identity Unknown O Drivers scene/Stale II) O Passport ❑ Mien Registration D Other Number Country Issuing State 21 Cash In amount for individual or entity listed in Item 4 Account number 0 0 22 Cash out amount for Individual or entity fisted in Item 4 40.000 Account number [ Page 3 of 5 SDNY_GM_00049869 CONFIDENTIAL - PURSUANT TO FED. R.CON(F IDENTIAL DB-SONY-0012693 EFTA_00160477 EFTA01291943  WARNING: PRINTED VERSIONS OF THE BSA E-FILING FORMS ARE NOT FOR SUBMISSION AND WILL NOT BE PROCESSED BY FINCEN. Part II Amount and Type of Transaction(s). Check all boxes that apply. '23 Date of transaction [e6/27/2014 24 ❑ Armored car (FI Contract) ❑ ATM ❑ Mail Deposit or Shipment ❑ Night Deposit ❑ Aggregated traneadions 15 CASH IN: (in U.S. dollar equivalent) '27 CASH OUT: (In U.S. dollar equivalent) a Deposit(s) a Wilhdravraes) 00 b Paymenes) .00 b Advance(s) on credit (Including markers) .00 c Currency received for funds transter(s) out .00 c Currency pad horn lunds transients/ In .00 0 Purchase of negotiable instrument (s) .00 d Negotiable instrument(s) cashed 40,000,00 e Currency exchangers) 00 e Currency exchangers) .00 Currency to prepaid access .00 f Currency from prepaid access .00 Purchases of casinos chips. tokens Redemphonee of casino chips. tokens. and other gaming Instruments 00 TITO tickets end other gaming instruments 00 h Currency wagergt) including h Payment(s) on wagen(s) (including root mane/ *Ts .00 and OTB or sports pool) .00 Travel and congernentary expenses and I Bills inserted kite craning devices .00 took gaffing Incentives .00 Payment la tournament. contest or other a Other (specify): promotions 00 .00 a Other (specify) Total Cash in ._..._._•00 Total Cash out 40,000.00 26 Foreign Cash in Foreign Country 0 0 28 Foreign Cash out Foreign Count!). 0 0 Page 4 of 5 SDNY_GM_00049870 CONFIDENTIAL - PURSUANT TO FED. R.CON(F IDENTIAL DB-SONY-0012694 EFTA_00160478 EFTA01291944  WARNING: PRINTED VERSIONS OF THE BSA E-FILING FORMS ARE NOT FOR SUBMISSION AND WILL NOT BE PROCESSED BY FINCEN. Part III Financial Institution Where Transaction(s) Takes Place 1 of 1 0 0 17 Type of financial institution Depository institution Other (specify) '29 Primary federal regulator I Federal Reserve Board (FRB) 38 If 37a - Casino/Card Club is checked, indicate type (child( only one) ❑ State licensed casino 0 Tribal authorized casino ❑ Card club ❑ Other '30 Legal name of financial institution I Deutsche Bank Trust Company Americas 31 Alternate name, e.g. trade name, DBA '32 EIN *33 Address '34 City New York '35 State NY '36 2IP Code j10154 39 Financial institution ID type ID number '40 Contact offite DB PB AML '41 Phone number '42 Date Filed (Dale filed will be auto -populated when Ihe form is signed.) Page 5 of 5 SDNY_GM_00049871 CONFIDENTIAL - PURSUANT TO FED. R.QQN(F IDENTIAL DB-SONY-0012695 EFTA_00160479 EFTA01291945