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EFTA01279592.pdf
AI Summary
This is a Wells Fargo bank account application form from October 7, 2014, for opening Premier Checking and High Yield Savings accounts. The document appears to be part of Epstein case disclosure files but contains redacted customer information, making the specific account holder's identity unclear. [Rating: 5/10 - Standard bank account application with case-specific relevance due to inclusion in Epstein files, but customer information is redacted limiting insights]
Flags
financial_transactions
redacted_content
Extracted Entities
| Name | Type | Context |
|---|---|---|
| Thomasville Main | location | Wells Fargo store location where accounts were opened |
| Wells Fargo Bank, N.A. | organization | Financial institution where accounts were opened |
| Stephanie T. Varner | person | Wells Fargo banker who processed the account application |
Full Text
Consumer Account Application WELLS FARGO Bank Name: Store Name: 'WELLS FARGO BANK, N.A. THOMASVILLE MAIN Banker Name: OfficetePottlolio Number: Date [STEPHANIE T. VARNER 10/07/2014 Banker Phone: Store Number Bat AU: Banker MAC 110329 ;0067237 iD0133-010 To help the government fight the funding of terrorism and money laundering actvities,U.S. Federal taw requires financial institutions to obtain, verify, and record Infounadon that identifies each person (individuals and businesses) who opem an account What this means for you: When you open an account, we will ask for your name, addiess. date of birth and other information that will allowus to identify you. We may also ask to see your driver's license or other identifying documents. New Account Information Product Name Account Number: Product: IFMA Premier Checking ,DDA Purpose of Account. Minor (CAB IFersonal/Household 1338 Product Name: Aaount Hunter: Newt: (Wells Fargo High Yield Savings DDA Purpose of Account Moor COW: Personal/Household 1338 flewAaouni Checking/Savings Bonus Offer Available: Printed NO Related Customers Customer Name. Account Relationship: Sole Owner Statement Mailing Information Customer(s) I isted on Statement Statement Mailing Address. Address line City State IIP/Pottal Code COU try. Page 1 of 3 0%8921 (5.14 SW:1 2W02-000650149785-01 Wells Fargo Confidential CONFIDENTIAL SDNY_GM_00028591 EFTA_00139211 EFTA01279592 Consumer Account Application Customer 1I nformation Street Address: Customer Number (ECN): Address Line Account Relationship: Address line 3. (Sole Owner Taxpayer Identification Number (TIN) TIN Type: Date of Birth: City: State: ISSN Primary. Type: Primary ID Desorption. ZIP/PostalCode Country. Treat thn address: IDLIC Tear(s) Month(s) PrimarylOSUCtry/Prov. Primary ID Issue Date: Primary. Expiration Date Directional Address' (Document alien no physical tesidence, business oraltemate meet address.) SecondaryIDType: Second ID Description: Secondary IDState/Country.. Secondary ID Issue Date: Secondary IDExpiration Date. Previous Street Address: Home Phone: Business Phone. City State. Current Employer. /IP/PostalCode Country: Time at this address [Unemployed Yearrsi 'stand*) Check Reporting. Country of Citizenship. NO RECORD US Request for Taxpayer Identification Number and Certification (Substitute form W.9) Under penalties of perjury. I certify that. 1 The number shown on this form is my correct taxpayer identification number for l am waiting for a number to be issued tome), and I UNLESS I HAW CHECKEDONEDE Itt BOAS 80.0%clern not subject to backup withholding either because I haw not been notified by the InWnal Revenue Service ORS) that l am subject to backup withholding as a result of a failure to report all interest or dividends, a the IRS has notified me that I am no longer subject to backup withholding (does not apply to real estate transactions, mortgage interest paid, the acquisrtiono abandonment of secured property, contributions to an Individual Retirement Arrangement (IRALand payment other than interest and dividends). 3 lama U.S. citizen or other U S. person. q I am subject to backup withholding I am exempt horn backup withholding 4.1 am exempt from Foreign Account Tax Compliance Act (FATCA) reporting. fax Resiinsible Customer Name: Ta a er bknbfdation Number am). TINCenikation Signature tAIVOILltlair Submit manually Due. p Signature not required 10/07/2014 Customer Signatures Everything I have stated in this application is correct. You are authorized to make any inquiries that you consider appropriate to determine if you should open or maintain the account. This may include ordering a credit report or other report (i.e. information from any motor vehicle department or other state agency) on me. I have received a copy of the applicabk account agreement and the privacy policy leach may be amended from time to time) and agree to be bound by their terms. I also agree to the terms of the dispute resolution program described in the foregoing agreements. Under the dbpute resolution program, our disputes will be decided before one or more neutral persons in an arbitration proceeding and not by a jury trial or a trial before a judge. Page 2 of 3 DSG8921 (5-14 SVP) 2[402-000650149- 85-02 Wells Fargo Confidential CONFIDENTIAL SDNY_GM_00028592 EFTA_00139212 EFTA01279593 Consumer Account Application Customer 1 Name Customer 1 Signature ▪ Submit manually Date: q Signature not required 10/07/2014 Page 3 of 3 DSG8921 (5.14 SW) 2W02-000650149785-03 Wells Fargo Confidential CONFIDENTIAL SDNY_GM_00028593 EFTA_00 I 39213 EFTA01279594