EFTA01282889.pdf

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SDNY_GM_00038484
CONFIDENTIAL
CONFIDENTIAL - PURSUANT TO FED R. CRIM. P. 6(e) DB-SDNY-0001308
EFTA_00149093
EFTA01282889

Account Title and Joint ApplijiatienInfontifitizin
Southern Financial LLC • • •
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Name of -AcCoioulide 1:NintAfilfijr*l
last name, lest name. middle Satialor Business 'fisetteme, first name. middle initial)
• • •
Social Socunty Menem a taxpayer ID Sturntrat Social Security NuMbir or Thspayet ID NOMIS
_6100490-SPICSIINIthl-P-4.. • • •
Addresi Address'
. • .
Cnv. Slate OM• • • • • • Clly:StillObild Zip Coda'
Home lele DOOM, Manlier Tekptgne
Elvsinssa Telephone Mimeo:eh
2SITEIVa013
Daticif With •
Name of Empleysr Shaff fAllano!OY".
Aetna Addteis
.
City; State and-ZTip Cede- •Caty, State and Code " '
Noticeof Customer Identification Policy
Important Information
To help th-egovernment fight Milfunding of ternsiiimend Monet; launderifwg activities, Federal law imitates an financial
institutions. obtain, Wirityzind- record infwmbtion that identifies each persOnWho establishes'a n. or
other biisiness relationship with a finartciat institution. This means that we will salt for your name, address: and other
'information that with allow we to identity you: We may also ask-to see identifying docureents such as a certificate of:
formation Of good standing (ledal. entities) or a passport or. otha! photo identification juidieldnals).
'3rd-EU Notice
•
Governmental rules have also broadened the scope'Of the Bank-sobtigations io the fight against:money letindedep
and teircaristlitien6ng;:these rules call loran activelninsivernent of both asset management lima and their clients. For
new and existing clients we currentlyh ave a -legal obligation to: ask ow customers questions regarding their identities;
addresses. source of funds and. if necessary, legal representatitres, authorized:s ignatories, beneficial owners or control
structures and to collect requisite documentation te.ehtelantiate.the information: Also, enhanced anti-money laundering
reqUirementi require that ehquid any of, the aboiie persona! Or institutionalinformation Ahanpk OWteams would b..e .
°Wiped so immediately notify the dflantle(1) endpreyideps 4yitlYreilayantdocuriMmetlaeto Verillifho.so changes.
Telephone, Facsimile-or Email InstructiOnS
By Sighing-L*6w: you agree that from erne to time you may give instnictioni by ielephone, facsimile a emailr egarding
the above OW-foiled eccourfitil (defined herein as "Verbal Instructions'). his understood that the risk of Verbal
InStruetions being given chi person of persons purported lobe youi s-yOtir own. Absent the gross negligence-or willful
misconduct of.Deusche.Bank Trust Company Americas (OBTCA),.y Oujagroi to indemnify and hold harmless OBTCA for
any:claim's, lases, expenses; cdits-or attorneys' fees resulting treatO BTCA's acting upciA such misunderstood 'end
unauthorized Verbal Instructions. You understand that DBTCA.Mate. but stallnot be' requited.! teak verifieetierief your •
verbal, facsimile or email instructions Wish back. In case of doubt, OBTCA may in its sole discretion refuie to execute
your Verbal lnstructions or any part thereat without lncurrino any liabilay..DOTCA is under-no Obligation:IA*4c* your •
:Verbal Instructions to transfer funds or seCorities to any accounts) withog!*tition insfitzedonsOereing your original
signature.
Joint Account Disclosure
You have opened }clot account with OBTCA and acknovAedge receipt of: ilia lellosieTng.inforinitlon• This deposit end any
additions to the account shah become.the properly of eaChowner es joint tenants, and.DBTCJ1 may release the entire-
account to any owner during the lifetime of all owners: DEITCA may bailor checks, Ordeei or Withdrawal requests horn
any owner Owing the biotin* of allo wners. The Bank may be required by service of legal probase'fnrenlit funds held in.
the joint accoum to satisfy a judgment ehlered.against. or other valid debtincurred tiNi:ariy owner of the account. DENG\
May honer checks. orders:o r withdravial requests from. the survivors) eget the death of any owners) and may treatthe
account as the sole properly-of the survivors) alter the death-of any (wineds). Unless DBTCA receives withertnetice •
signed by any owner not to pay W. cilinjor any join; deposit or addiliwtoi acornak.D.BTCA shill not be liable to any Owner.
:for continuing lo honor checks:o rders or withdrawal requests-from any owner. After. ine.receitztof the eutice.rpfenred 10
in the previous sentence, OBTCA-mayrequint the Written euthorization.ol any or atiorni °Whirs:fin lig:hefted' PSYMehea
or deliveries.
2 13.0040101
0i3S59.0326t3
SDNY_GM_00038485
CONFIDENTIAL
CONFIDENTIAL — PURSUANT TO FED R GRIM. P. 6(e) DB-SDNY-0001309
EF1'A_00149094
EFTA01282890

ATM/Debit:$ eMce
ir 'Matadi& 'Illgtil*letentioneuOtti Ctl.dwATIvlaibit card conetistis 4e:enplanes oftOterms and conditions of the
AgreamentiOgriteinsidlit'llie TOSiiiand COnditioni.ed. DepOsit -
Internet Barlking.SerViCe.
Ityou haw selected to receive Internet flanking:Services. You understand that you will be reisuliad to error into a
lapareie:Mtemet•ganIdng.Senrices Agreement with DBTCA before you can access the Internet Banking Service.
Acknowledgement Of:Receipt of NO./icy Ncitice
By signing biknie, you adknoWledge receipt of iNfTeks Pii6aCy Notice included in the ApPlii-aV0.9 Package.
Non-US Individuals: Confirmation of*Te?tancl•CornplianoefiesponSibilities,
You confirm that it is youi teipptiSibility-to fulfill any tax tibikkitions and any other.• regulifory reporling duties applicable.
Is you ;II any relevant juriauticete :Set may arise in Canitiotl6h:With assets; income or tranaSetionsksyoui itecciss(s).
and yOur business bilgibbshib-wo DBTC,A.
.. • .. •
Non-US OtoanizatiOnt:-.Confiernation'of Tajc:and Compliance Responsibilities.
Yinknotifilm that it is Youi resiionlibilitY.tolunili any lug ohligeiioria and any other regulatory reporting Duties applicable
CO it in' nyTrelevantjulisdintions that may arise' in connection with assets; iricorrieottiatisections juyourtitecising(s) and
Yout bOilneas relationship with 001CA. Eurtherrignu.yeni cOnfirth thatthe n.ecasearyInforriiationAto the best Oil SOO/.
knowledge and capabilities) is madea vailable no re.“ than annually to. the relevant beneficial tie/Sale). tuitikSe(11:
benefielitry(ies),,panniy(t),:et to enabletiithater/ them to (OM any respobtiva Uli Obligalkins that may arise far hirii/hari.
*OM Ucconnection your busin'e'ss relatiOnship With:DEiTCA.
• .
Please complete and attach separate W:78 et W:P clothirpeptetiphas 106dd/ie..
Term.s. . and Conditions a nd .R. epresentations. .. .. .. .. . . .
By Mining below you acknoWleilge receipt of the:Ternis end Conditions ki.OUSIOWASIourits attached to this
APPlicatIcin and agree to Si bOun0 bythern: Intiddition:YoUattietto notify us inwriedlaiely of anymateriel changeUS
die information provided by you on this AppliCatiOn.
You represent and that all of the infoiinatlisn Provided by you On thiS Aeolic:Won illaiaisid.
The Terms and Conditions for Deposit Acceuntsam so •jectio change.
Athapta
YOu *triad by. oerrcA.
Saint .t fleasect stratus—
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Far Onlir Reviewed by.
Na
"•":.
uato
btu
Date
At • by DATCA:
-71/1A-JEC-7CAC
(.".410C
.Date
1S AWM-010I
013959 032013
SDNY_GM_00038486
CONFIDENTIAL
CONFIDENTIAL — PURSUANT TO FED R. GRIM. P. 6(e) DB-SDNY-0001310
EFTA 00149095
EFTA01282891