Epstein Secrets

r (5)-(10) set forth in Part B of Section V of this Questionnaire, the Investor may skip this Section VI. Otherwise, the Investor should proceed to Pan A below. A. FINRA Rule 5131 Covered Persons Please initial either "True" or "False" to the following statement. If the Investor initials "True" to

inimis Exemption set forth in item (4) of Part B above. If this item is applicable to the Investor, please answer the applicable items set forth in Pan C below. (12) None of the above items in this Part A is applicable with respect to the Investor. If the investor did not initial item (4) or ite

Date: Temporary Medical Exemption PART B (Foe preschool children, children in day care and school childitn who are incomplete for immunizations in Pan A=l' of A-2.) Invalid without expiration date. DOE Code 2 1C0116* that the above named child har received the immunisations documented en she men* si

inical reasoning or evidence for exemption: DOE Code 3 I cestift that the physical condition of this child Lt nth that immenitatiomNat indicated in Pan C above is medically caltraindicated. Physician or Clinic Name: (flint or stamp) Address: D44 610, 1196. dada= la (4Omo (SIM Maher 574.11O:MX1106)

you (anent, are a.US person. If you are not .0 VS person, please complete this Part A and continue to Pan C ant return signed, completed copies of Pan A and Pan C to your DB representative If you are a US person, please complete this Part A and continue to. Part .8 and return signed, completed copies

N CERTIFICATION Please indicate below whether you (anent, are a.US person. If you are not .0 VS person, please complete this Part A and continue to Pan C ant return signed, completed copies of Pan A and Pan C to your DB representative If you are a US person, please complete this Part A and continue t

US PERSON CERTIFICATION Please indicate below whether you ("Client, are a US person. If you are not a US person, please complete this Pan A and continue to Part C a»dreturn signed, completed copies of Pan A and Pan C to your DB representative. If you are a US person, please complete thi

ent, are a US person. If you are not a US person, please complete this Pan A and continue to Part C a»dreturn signed, completed copies of Pan A and Pan C to your DB representative. If you are a US person, please complete this Part A and continue to Pan B and return signed, completed copies of Port A a