Epstein Index›Documents›EFTA01393077
💨IMPACT LEVEL 1 — MEH

Epstein File EFTA01393077: Client and Beneficial Owner (DS10)

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This document is a compliance form confirming tax and regulatory responsibilities for a client account. It requires the client to acknowledge sole responsibility for fulfilling tax obligations and regulatory reporting duties, and confirms that necessary information is made available annually to beneficial owners, settlors, beneficiaries, and partners to enable them to meet their respective tax obligations. The form addresses fiduciary and compliance requirements for trust or entity-based accounts.

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Print Name SSN/EIN Signature Date Print Name SSN/EIN Corporation, partnership, trust or other entity: Confirmation of tax and compliance responsibilities **Client**
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acknowledges having sole responsibility to fulfill any tax obligations and any other regulatory reporting duties applicable to **Client** in any relevant
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Furthermore, **Client** confirms that the necessary information (to the best of Client's knowledge and capabilities) is made available no less than annually

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