EFTA01282339
Dataset 10 · 6 pages · 578 KB · 1,562 words
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Wealth Manager Services Custody New Account Opening Form Deutsche Bank STATE STREET Private Wealth Management lot I vervIliant You limn! In - Account # 0 Is Owner a US Tax Payer? 0 External Custody 0 Federal Tax ID (SSN/TIN/EIN) 0 Account MIA Type 8701 PERSONAL CUSTODY 0 Acct Short/Long Name Jeffrey Epstein Enter Name for Sorting: Jeffrey Epstein Date Opened 4/10/2014 0 Branch 38: DB NY DOMESTIC - CUSTODY ACCT [E214730 0 State Domicile 54 U.S. Virgin Islands 0 Administrative Law 132 New York Acct Legal Name Jeffrey Epstein Next Fiscal 12/31 of the current year OR If ERISA Account Enter Plan Year End For Client Service Use Only Tax Prep Service Tax Servicer 2 Production Group 5 OCountry of Residency 209 United States 0 Acquired by 0 Account Capacity 20 CUSTODIAN Fee Agrmt Date 4/10/14 0 Date of Agreement 4/9/14 0 Date of Apptment 419/14 0 Group Code 0 Team Code 0 Base Currency 1 1 DEUTSCHE BANK TR CO AMERICAS 5 DOMESTIC CUSTODY 22 US DOLLAR 0 Premium Tax Service Client? Yes 0 If an ERISA Account is 5500 Reporting Required? No 0 Is account owner a tax exempt recipient? No 0 Is this an IRA Account? No Tax Record 0 US Tax Class 1 US RESIDENT (TAX DUTY) Foreign Tax Class 0 Country Situs 0 State Situs Valid Forms 209 United States 54 U.S. Virgin Islands 0 Status 0 Start Date I W-9 2 certified 4/10/2014 (mm/dd/yyyy) w-8 (mm/dd/yyyy) Form 1001 (mrnMd/yyy-y) Treaty Eligible Field 6 Special Withholding Instruction field should only be used for NRA clients submitting W-8Ben forms Treaty Eligible? INo Withholding Special Instructions if Not Using Treaty Eligible Rates JUIN T.:JAW-KA/Jr /RC CONFIDENTIAL — PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SONY-0000566 EFTA_00I 48351 EFTA01282339 Tax Record Address The following address must be added to Global Plus for the official mailing address of the client If the account owner is a non US taxpayer, enter the address to which the 1099, 1042 or other mailings should be sent. For US taxpayers this may or may not be the same as the owner affiliation address. 0 Client Name JEFFREY E. EPSTEIN 0 Street Number 6100 Street Name Red Hook Quarter, B3 0 City St. Thomas 0 State 54 U.S. Virgin Islands 0 Zip Code 00802 0 Country 209 United States 0 IRS Control Name EPST Affiliation - Owner If owner has an existing client record on Global Plus select Yes in the option below and provide the existing Internal client #. No other Information Is required. If No Is selected owner Information will populate based on tax recordInformation provided. This address Information below should reflect the legal/permanent address of the account owner. May be different than mailing address above. 0 Is the owner an existing client record on Global Plus No Internal Client # If new client complete the appropriate information for the owner affiliation: Client Title First Name Last Name Individual Client Name JEFFREY 'EPSTEIN Name Extension Field or Corporate Name Street # 6100 I Street NamelRed Hook Quarter, B3 Address Line 2 Mailing Info City St. Thomas 'state 54 U.S. Virgin Islands Zip Code 00802 I Country 209 United States Name Type 7 individual SSN or TIN Date of Birth 0 Mandatory for IRA Account 0 Select Yes to also use this owner for the following account affiliation types. These are mandatory affiliation setups except for Daily Advice Recipient If not the owner, complete the additional affiliation setup section. These affiliations types will be setup using the tax record address/mailing address. If that address should not be used select No here and setup in the affiliation section. If Daily Advice is to be setup, select which type: Yes Yes 56 - Proxy Voter 137 TAX LETTER RECIPIENT J 36 - Advice Recipient r #N/A No 1042S Recipient (applicable to non-domestic accounts only) Account Affiliations - Internal 0 Affiliation Type 152 - Corporate Action Representative ClienVEE Number Arthur Tendler EMP #01001.1 Affiliation Type 200 - Strategic Wealth Advisor Client/EE Number Paul Morris EMP# 0 Affiliation Type 228 - Custody Officer ClienVEE Number Arthur Tendler EMP # 0 Affiliation Type 2 - Investment Officer Client/EE Number Arthur Tendler EMP # 0 Affiliation Type 4 - Account Assistant ClienVEE Number Katy cheng EMPIRE. SDNY_GM_00037743 CONFIDENTIAL CONFIDENTIAL — PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0000567 EFTA_00148352 EFTA01282340 0 Affiliation Type 23 - Tax Officer Client/EE Number State Street [E:TAXST] Affiliation Type 218 - Employee Account I Client/EE Number Affiliation Type 260 - Interested Party I CiienVEE Number Affiliation Type 270 Hirtle Callahan Affiliation 'Mandatory if opening a Hirtle Account Client/EE Number Affiliation Type Client/EE Number Currency 22 USD US DOLLAR Type of Portfolio Principal Portfolio Name Jeffrey Epstein P CUSTODY USD Alt Portfolio # USD P 199 I Type of Portfolio N/A Portfolio Name Jeffrey Epstein N CUSTODY USD Alt Portfolio # USD N 199 I Date Opened 4/10/2014 21:21 Capacity Code 20 CUSTODIAN 0 Investment Authority 6 NO RESPONSIBILITY Acct Code Exten 0 Investment Objective 199 - CUSTODY 199 0 Voting Authority 0 Taxlot Sale Method 2 CUSTOMER VOTES 4 highest cost (maximum loss) l /f #1 selected, do not add Proxy affiliation Setup Sweep Yes 0 Sweep Strategy 143 • DWS GOVT CASH FUND [999010GC1] Affiliation Adds Affiliation Type 1251 MUTUAL FUND REPORT RECIPIENT Is the affiliation an existing client record on Global Plus INo (Internal Client # I If new client complete the appropriate information for the owner affiliation: Client Title Fist Name Last Name Individual Client Name Name Extension Field or Corporate Name SAME AS OWNER Street # I Street Name' Address Line 1 Mailing Info City I State Zip Code I Country Name Type SSN Date of Birth Mandatory for IRA Account Branch 38: DB NY DOMESTIC - CUSTODY ACCT [E214730] Identity any other affiliati n types this 231 MUTUAL FUND PROXY RECIPIENT client may be on this acc unt: 252 CORPORATE ACTION RECIPIENT CIINIV COLA IlillY177ALL CONFIDENTIAL — PURSUANT TO FED R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0000568 EFTA_00148353 EFTA01282341 Affiliation Adds Affiliation Type Is the affiliation an existing client record on Global Plus I No 'Internal Client # I If new client complete the appropriate information for the owner affiliation: Client Title Fist Name Last Name Individual Client Name Name Extension Field or Corporate Name Street # Street Name! Address Line 1 City State Zip Code Country Name Type SSN Date of Birth Mandatory for IRA Account Branch Identify any other affiliation types this client may be on this account: Affiliation Adds Affiliation Type Is the affiliation an existing client record on Global Plus I No 'Internal Client # If new client complete the appropriate information for the owner affiliation: Client Title Fist Name Last Name Individual Client Name Name Extension Field or Corporate Name Street # Street Name' Address Line 1 Mailing Info City 'State Zip Code Country Name Type SSN Date of Birth 1 Mandatory for IRA Account Branch Identify any other affiliati n types this client may be on this ac unt: Affiliation Adds Affiliation Type Is the affiliation an existing lient record on Global Plus I 'Internal Client # I If new client complete the appropriate information for the owner affiliation. Client Title Fist Name Last Name Individual Client Name (Langer Name Extension Field or Corporate Name Street # Street Namel Address Line 1 Mailing Info City State Zip Code I Country Name Type SDNY_GM_00037745 CONFIDENTIAL — PURSUANT TO FED. R. CRIM. P. 6(e) CONfrIDENTIX DB-SDNY-0000569 EFTA_00148354 EFTA01282342 Date of Birth Mandatory for IRA Account Branch Identify any other affiliation types this client may be on this account: Affiliation Type Is the affiliation an existing client record on Global Plus I "Internal Client # I If new client complete the appropriate information for the owner affiliation: Client Title Fist Name Last Name Individual Client Name Name Extension Field or Corporate Name Street # Street Name' Address Line 1 Mailing Info City State Zip Code Country Name Type SSN Date of Birth Mandatory for IRA Account Branch Identify any other affiliation types this client may be on this account: Affiliation Adds Affiliation Type Is the affiliation an existing client record on Global Plus I 'Internal Client # If new client complete the appropriate information for the owner affiliation: Client Title Fist Name Last Name Individual Client Name Name Extension Field or Corporate Name Street # Street Name' Address Line 1 Mailing Info City Zip Code I State Country Name Type SSN Date of Birth Mandatory for IRA Account Branch Identify any other affiliation types this client may be on this account: SDNY_GM_00037746 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0000570 EFTA_00I 48355 EFTA01282343 Affiliation Adds Affiliation Type Is the affiliation an existing client record on Global Plus "Internal Client If new client complete the appropriate information for the owner affiliation: Client Title Fist Name ast Name Individual Client Name Name Extension Field or Corporate Name Street # Street Name' Address Line Mailing Info City State Zip Code Country Name Type SSN Date of Birth Mandatory for IRA Account Branch Identify any other affiliation types this client may be on this account: REVIEWED By mahpras at 11:57 am, Apr 10, 2014 PRASHANT MAHENDRU • 4/10/2014 Name Date DHRUV YADAV Name APPROVED 4/10/2014 Date By yadadhr at 9:25 pm, Apr 10, 2014 SDNY_GM_00037747 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0000571 EFTA_00I 48356 EFTA01282344