This Account Agreement contains a pre-dispute arbitration clause at Section III, page 7.
Signature Date
Pant Name SSN/EIN
Signature Date
Print Name SSN/EIN
Signature Date
Print Nome SSNIEIN
Corporation, partnership, trust or other entity:
Confirmation of tax and compliance responsibilities
Client acknowledges having sole responsibility to fulfill any tax obligations and any other regulatory reporting duties
applicable to Client in any relevant jurisdictions that may arise in connection with assets, income or transactions in Client's
account(s) and business relationship with 0BSI. Furthermore, Client confirms that the necessary information (to the best
of Client's knowledge and capabilities) is made available no less than annually to the relevant beneficial owner(s). settior(s),
beneficiary(ies), partner(s), etc. to enable such person(s) to fulfill any respective tax obligations that may arise for such
person(s) in connection with Client's business relationship with DBSI.
26-6639711
Employe/ ly No.
its, )Wi
Date
Harry I Seller f Trustee
Pint NamerTide
Signature UtliErPartner, Trustee, Au , orlatd Pany
ifrzais
Erika A Kellerhals/ Trustee
Print Namara,.
Signature of Odir.er, Panne, Trustee. Authorized Party Date
Print Name/Title
wM ta9778 015584 WTI IC, Page 9 of 16
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0076233
CONFIDENTIAL SDNY GM_00222417
EFTA01378952