KYC Print Page 12 of 43 One sheet must be established for EACH INDIVIDUAL PARTY in Section 2. Account Ownership Summa 3A. Individual Details (for all part es) Individual's Name: Harry Beller - 00000487202 Date of Birth: Country of Residence: United States Country of Citizenship: United States Address of primary residence: Monsey NY 10952 United States Has client resided outside of his/her country of nationality for 5 years or more? Li Yes g No Profession/Occupation: Accountant Tax ID / SSN: Current Employer: HBRK Associates, Inc Position/Title/Rank: Accountant Address of employer: 575 Lexington Avenue, 4th Boor Monsey NY United States 10022 Does the person work as senior executive of a DB-recognized regulated entity in the financial ndustly? or an entity listed on a DB-recognised exchange? (Not applicable for operating entities 0 Yes g No Is the individual a Politically Exposed Person (PEP)?(if Yes, describe) N/A K Yes RI No To the best of your knowledge, is the individual related to an employee of the DB group?(if Family or Fnendship, describe) N/A K Family 0 Friendship E) None To the best of your knowledge, is the individual party to a non-banking relationship with Deutsche Bank (e.g., external legal counsel, client referral source, supplier of goods or servIces)?(if Yes,deScnbe) N/A 0 Yes g No If applicable, indicate which bank officers have met the person: Indicate where and when the client meeting(s) took place: Bank Officer Name(s) Bank Office: Oient Private Domicile: Client Place of Business: Other Location (specify): Date: U 0 U r1 0 L.J Wealth Details for this individual are not filled in, because they are the same as for the following person: 38. Wealth Details (Only for parties requiring source of wealth description as indicated in Section 2) Nature of the Individual's Business: Primary Country of source of wealth/source of Funds? Primary industry of source of Wealth/Source of Funds? Summarize