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esided outside of Ns/her cony of nationality for 5 years or more? O Yes 0 No Professen/Occupation: Accountant Tax ID / SSN: Current Employer: HEIRK Associates, Inc Positen/Teg/Rank: Accountant Address of employer: 575 Ledngton Avenue, 4th Floor Homey NY United States 10022 Does the person work as senio
e Group: Same Booking Cater (Inacate account number): Existing O DB Group: Other Booking Center (indicate DB location and account details): O Other Instituter, - (Indcate name & location): O Physcal Deposits (specify cash, securities, cheques....): What is the expected sae and frequency of regular inflows
d outside of his/her comity of rationality for S years or more? O yes 0 No Professicti/Occupation: Accountant Tax ID / SSN: Current Employer: HEIRK Associates, Inc Positkinatle/Rank: Address of employer: 57S Ledngton Avenue, 4th Floor Horsey NY United States 10022 Does the person work as senior executiv
ve? 0 DB Group: Same Booking Cuter (InOcate account number): O DB Group: Other Booking Center (Indicate DB location and account details): O Other Instituter, — (Inelcate name & location): O Physcal Deposts (specify cash, secuntes, cheques....): What is the expected sae and frequency of regular inflows a
outside of hisffier country of nationality for 5 years or more? O Yes El No Profession/Occupaten: Accountant Tax ID / 55th: Current Employer: HBRK Asscoates, Inc Poution/Title/Rank: Address et employer: 575 Lexington Avenue, 4th Floor Mersey NY United States 10022 Does the person week as senior execut
imated amount of Investable assets(S): Estimated Net Worth(S): Amount of assets planned to invest with PWM(S): Other Known linancel Institutions: Instituter,: Country: Est. Asses Under Mgt: Institution: Country: Est. Asses Under Mgt: Institution: Country: Est. Assets Under Mgt: Please indicate th
Entities connected to both HBRK Associates and Instituter

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