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EFTA01460121

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Part 3 Declaration and Signature If Non-US Beneficiary/Non-US Beneficial Owner is an individual: 1. I hereby certify that for the purposes of taxation I am not a tax resident in any country other than the country/countries indicated above. 2. I confirm that my ownership or other interest in the Entity, if any, is appropriately disclosed in accordance with applicable laws and regulations in the countries in which I am tax resident and may be required to be reflected in my tax filings. 3. I confirm that all income or capital distributions received (or deemed to be received for tax purposes) by me from the Account(s) have been, and going forward will be, taken into account and included in my relevant tax filings if required by the laws of the country (countries) of my tax residence. If Non-US Beneficiary/Non-US Beneficial Owner is an entity: 1. I hereby certify that for the purposes of taxation the non-US Beneficiary/non-US Beneficial Owner is not a tax resident in any country other than the country/countries indicated in this self-certification. 2. I confirm that my ownership or other interest in the Entity, if any, is appropriately disclosed in accordance with applicable laws and regulations in the countries in which I am tax resident and may be required to be reflected in my tax filings. 3. I confirm that all income or capital distributions received (or deemed to be received for tax purposes) by me from the Account(s) have been, and will be, taken into account and included in the relevant tax filings if required by the laws of the country (countries) of tax residence. I agree that Deutsche Bank may cisclose this Certification and any other information related to it or the Account(s) now or in the future held with Deutsche Bank, to any relevant tax or governmental authorities of the country in which the Account(s) is/are/will be maintained or of any country in which I may be liable to pay taxes. I release Deutsche Bank from any obligations of b

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