SWAP ADDENDUM ANNEX
CLIENT INFORMATION FORM
I. Please provide the following information regarding Client.
Legal_Name of Client Swap Vehicle: SL)tj•kketc C. eaktaf fraftt_
Legal Address: 4.21sa 'a OO%O
Email Address:
Principal Occupation / Business:
CFTC Interim Compliant Identifier or Legal Entity Identifier': 541Accs Ali:sox L NAN IC•81
2. Does Client have a Swap Agent?
El YES [NO
If yes, then please provide the following information regarding the Swap Agent.
Name:
Address.
Email:
Phone:
Each Swap Agent must also complete the Swap Agent Statement provided in Pan 4 of this Protocol
and return the completed Statement to DB.
3. Will Client's swaps be guaranteed by another entity?
El YES viNO
If yes, then please provide the following information regarding Client's guarantor.
Legal Name:
Legal Address-
Each Guarantor must also complete the ECP Questionnaire for Guarantors provided in Part Sot
this Protocol and return the completed Questionnaire to DB.
I The CFTC Interim Compliant Identifier (or "ClCE), which will ultimately be replaced by a Legal Entity Identifier (or "LEV),
is a unique customer identification number used by swap dealers as pan of their repotting obligations under the CFTC
Regulations.
A-1 6395993
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0060156
CONFIDENTIAL SDNY_GM_00206340
EFTA01368423