Pictet & Cie "form A" declaring Mike Quiel as beneficial owner

2
EXHIBIT 9 Case 2:11-cr-02385-JAT Document 180-9 Filed 02/05/13 Page 1 of 2

description

Document signed by Daniel Noser

Transcript of Pictet & Cie "form A" declaring Mike Quiel as beneficial owner

Page 1: Pictet & Cie "form A" declaring Mike Quiel as beneficial owner

EXHIBIT 9

Case 2:11-cr-02385-JAT Document 180-9 Filed 02/05/13 Page 1 of 2

Page 2: Pictet & Cie "form A" declaring Mike Quiel as beneficial owner

A Account No. : Contracting partner:

l'y~~Hq~AG

ß,.~ .(j PO t?tW q8f'1I

Establishment of the Beneficial Owner's Ide(Form A as per art. 3 and 4 CDB)

The contracting partner hereby declares:(mark with a cross where appropriate)

o that the contracting partner is the sale benefic

if that the beneficial owner/s of the assets i

Full name (or Company), Date of Birth, Nationalit ,

es to inform the bank, of his own accord, about any changes.

Wilfully entering faof documents; under p

ten in this form is a criminal offense (art. 251 of the Swiss Penal Code, forgeryf penal servitude of up to five years or a prison sentence).

Place and date

GE/~Dimitri000089

Case 2:11-cr-02385-JAT Document 180-9 Filed 02/05/13 Page 2 of 2