
the Office of Foreign Assets Control
ORGANIZATIONFoundation/Association r Trust 17 Company
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Compliance immediately) client or related party have any financial or other association / interactions `'' within counties or regimes sanctioned by the Office of Foreign Assets Control (OFAC)? F Yes F No C'" H. Does the client or related party have any financial or other association/ interactions within high risk countries? r Ye
CH LEGAL ENTITY in Section 2. Account Summary 3C. Legal Entity Details (For all Legal Entities) Legal Entity Name: Mort, Inc - Type of Entity: — Foundation/Association r Trust 17 Company :— Estate F partne,ship Purpose of Entity: F Private Investment r Philanthropic/Charitable r Commercial Type of Entity Other (specify): Purpo
) the client or related party have any financial or other association / interactions r yes F No G' '''' within countries or regimes sanctioned by the Office of Foreign Assets Control (OFAC)? ' H. Does the client or related party have any financial or other association/ interactions F within high risk countries? r Yes NO I.
on 2. Account Summary 3C. Legal Entity Details (For all Legal Entities) Legal Entity Name: Darren K. Indyke PLLC - 00000487220 Type of Entity: r Foundation/Association r Trust 17 Company F Estate F Partnership Purpose of Entity: F Private Investment r Philanthropic/Charitable r Commercial Type of Entity Other (specify): Purpos
ce immediately) G. Dot the client or related party have any financial or other association / interactions "I wan countries or regimes sanctioned by the Office of Foreign Assets Control (OFAC)? F Yes F No H. Does the client or related party have any financial or other association/ interactions wan high risk counties? r yes i No I
ITY in Section 2. Account Summary 3C. Legal Entity Details (For all Legal Entities) Legal Entity Name: Mort, Inc - 00000487266 Type of Entity: r Foundation/Association r Trust 17 Company F estate F Partnership Purpose of Entity: F Private Investment r Philanthropic/Charitable r Commercial Type of Entity Other (specify): Purpos
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