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 q Correctiamend prior report q 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
IDENTIAL
CONFIDENTIAL - PURSUANT TO FED. R.CON(F DB-SDNY-0012691
EFTA_0016 0475
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
or entity's legal name O Unknown Indyke
•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 q Unknown
•
•12 State O Unknown [ NJ '13 ZIP/Postal Code 0 Unknown
'14 Country O Unknown US
'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 q Other
Number Country US Issuing State NJ
21 Cash In amount for individual or entity listed in Item 4
0 0
Account number
22 Cash out amount for Individual or entity listed in Item 4 $ 40.000
1 0 •
Account number)
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SDNY_GM_00049868
IDENTIAL
CONFIDENTIAL - PURSUANT TO FED. R.CONIF DB-SONY-0012692
EFTA_00 160476
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 a - 1q 1 t P ra e n rs s o a n c t c io o n n d o u n c o ti w ng n behalf I—I t P ra e n rs s o a n c t c io o n n d fo u r c a ti n n o g t her c P tra e n rs s o a n c t o io n n w w h a o s s e co b n e d h u a c l t f e d d O ECourier Service (Private)
O
3 Multiple transactions
El
Check If entity
'4 Individual's last name O
Unknown Darren K. Indyke PLLC
or entity's legal name
•5 First name q Unknown
6 Middle name
Suffix
7 Gender
8 Alternate Name
9 Occupation or type of business
9a NAICS Code
'10 Address O Unknown
O
'11 City 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 q Mien Registration D Other
Number Country Issuing State
21 Cash In amount for individual or entity listed in Item 4
0 0
Account number
22 Cash out amount for Individual or entity fisted in Item 4 40.000
Account number [
Page 3 of 5
SDNY_GM_00049869
IDENTIAL
CONFIDENTIAL - PURSUANT TO FED. R.CON(F DB-SONY-00 12693
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 q Armored car (FI Contract) q ATM q Mail Deposit or Shipment q Night Deposit q Aggregated traneadions
15 CASH IN: (in U.S. dollar equivalent) '27 CASH OUT: (In U.S. dollar equivalent)
a Deposit(s) a Wilhdravraes) 00
.00
b Paymenes) .00 b Advance(s) on credit (Including markers)
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
a Other (specify)
.00
Total Cash in ._..._._•00 Total Cash out 40,000.00
0 0
26 Foreign Cash in Foreign Country
0 0
28 Foreign Cash out Foreign Count!).
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SDNY_GM_00049870
IDENTIAL
CONFIDENTIAL - PURSUANT TO FED. R.CON(F DB-SONY-00 12694
EFTA_00 160478
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)
q State licensed casino 0 Tribal authorized casino q Card club q Other
I
'30 Legal name of financial institution 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 aut-opopulated when Ihe form is signed.)
Page 5 of 5
SDNY_GM_00049871
IDENTIAL
CONFIDENTIAL - PURSUANT TO FED. R.QQN(F DB-SONY-00 12695
EFTA_00 160479
EFTA01291945