EXHIBIT A
In connection with authorization provided in the DB InSight Agreement for On-Line Statements, the following are additional current
and future custody accounts of Account Holder(s) requested to be available through the DB InSight service:
Legal Entity Name: Account Number(s):
Authorized this day of . 200
Customer Name: Jeffrey Epstein Customer Name:
Signature: Signature:
Title flf App.): Title of App.):
Email Address REQUIRED): Email Address REQUIRED):
[Executed also on behalf of the Associated Account Holders as defined in the Terms and Conditions, if any)
CONFIDENTIAL — PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0 103805
CONFIDENTIAL SDNY_GM_00249989
EFTA01448705