EFTA01368296.pdf

BY SIGNING BELOW CUENT ACKNOWLEDGES THAT: (1) CUENT HAS RECEIVED, READ AND AGREES TO THE TERMS AND CONDITIONS OF THIS ACCOUNT AGREEMENT, INCLUDING THE APPENDIX WHICH CONTAINS IMPORTANT INFORMATION: AND (2) THE INFORMATION CONTAINED IN THIS ACCOUNT APPLICATION IS ACCURATE. CLIENT ACKNOWLEDGES THAT THIS ACCOUNT AGREEMENT CONTAINS A PRE-DISPUTE ARBITRATION CLAUSE AT SECTION III, PAGE 5. AND CLIENT AGREES TO TERMS (ALI. ACCOUNT AGREEMENT SIGNATORIES MUST INITIAL. INITIAL HERE: THE INTERNAL REVENUE SERVICE DOES NOT REOUIRE CUENTS CONSENT TO ANY PROVISION OF THIS DOCUMENT OTHER THAN THE CERTIRCATION REQUIRED TO AVOID BACKUP WITHHOLDING. AND, IF APPLICABLE. THE CERTIFICATION REQUIRED TO ESTABLISH CLIENT'S STATUS AS A NON-U.S. PERSON AND OBTAIN A REDUCED RATE OF WITHHOLDING. Important Information for ERISA employee benefit plan clients: U.S. Department of labor regulations require DBSI to disclose to a responsible plan fiduciary certain information in connection with the services that DBSI provides to a plan, to assist the fiduciary in evaluating the reasonableness of ()BSI's services and related compensation. The disclosure Is available online, at httplewswg.pwrn.db.conVamericasien/erisa_disciosure_pcs.html By signing below, you acknowledge that you are a fiduciary responsible for the procurement of DBSI's services to the plan, you have read the disclosure and you understand the disclosure. Individual or joint account (IF THIS IS A JOINT ACCOUNT, ALL ACCOUNT OWNERS MUST SIGN): CONFIRMATION OF TAX AND COMPLIANCE RESPONSIBILITIES Client acknowledges having sole responsibility to fulfill any tax obligations and any other regulatory reporting duties applicable in any relevant jurisdictions that may arise in connection with assets. Income or transactions in Client's account(s) and business relationship with DBSI. CHECK A BOX BELOW ONLY IF CLIENTS DO NOT WANT JOINT TENANTS WITH RIGHTS OF SURVIVORSHIP OR TENANTS BY THE ENTIRETIES. CUENTS SPECIFY INSTEAD: O Tenants in cornmon: retains 50% interest in the community property upon death of the first spouse). Community ?i3c!! Signature 2 Date (- a - Print Name 7:arid-I SSNiE IN Signature Date Print Name SSN/EIN Signature Date Print Name SSWEIN Corporation, partnership, twat or other entry: CONFIRMATION OF TAX AND COMPLIANCE RESPONSIBILITIES Client acknowledges having sole responsibility to fulfill any tax obligations and any other regulatory reporting duties applicable to in any relevant jurisdictions that may arise in connection with assets. income or transactions in Client's account(s) and business relationship with OBSI. Furthermore. Client confirms that the necessary information Ito the best of Client's knowledge and capabilities) is made available no less than annually to the relevant beneficial owneffsl, settlorts). beneficiery(oes), partner-Is), etc. to enable such person(sl to fulfill any respective tax obligations that may ariso for such porsonls) in connection with Client's business relationship with DBSI. Southem Financial US 66-0799192 Name of Entity Employer ID No Signature of Officer, Partner. Trustee. Authorized Party Data 7 Jeffrey Epstein Print Name /ills Signature of Officer. Partner. Trustee. Authorized Party Date Print Name/Title Signature of Officer, Partner, Trustee, Authorized Party Date Print Name/Title 13-AWM-0196 7 012145.0321113 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0059992 CONFIDENTIAL SDNY GM_00206176 EFTA01368296