European Government Bonds

CLAIMANT IDENTIFICATION

The Claims Administrator will use this information to verify eligibility and for all communications relevant to this Claim Form. If this information changes, please notify the Claims Administrator in writing. If you are a trustee, executor, administrator, custodian, or other nominee and are completing and signing this Claim Form on behalf of the Claimant, you must attach documentation showing your authority to act on behalf of Claimant.

Section A – Claimant Information

Is the Beneficial Owner an Individual?

Is the Beneficial Owner an Entity?

Representative or Custodian Name (if different from Claimant[s] listed above):

Address 1: *

Address 2:

Country: *

City: *

State/Territory: *

Zip: *

Telephone Number (home or cell): *

Telephone Number (work):

Email Address (If you provide an email address, you authorize the Claims Administrator to use it in providing you with information relevant to this claim.):

Location(s) from which Claimant entered into European Government Bond transactions: *

For Brokers filing this Claim Form for its own account(s): Have you included European Government Bond transactions in which you acted as an agent?

Yes No

Section B – Authorized Representative Information

Name of the person you would like the Claims Administrator to contact regarding this Claim (if different from the Claimant name listed above):

Telephone Number (home or cell):

Telephone Number (work):

Address 1:

Address 2:

Country:

City:

State/Territory:

Zip:

Email Address (If you provide an email address, you authorize the Claims Administrator to use it in providing you with information relevant to this claim.):

* Denotes required field

SUMMARY PRICE TABLE OF EUROPEAN GOVERNMENT BOND TRANSACTIONS

Complete this if and only if you entered into European Government Bond transactions from January 1, 2005 through and including December 31, 2016. Do not include information regarding instruments other than European Government Bond transactions with a Defendant, Deutsche Bank, or Rabobank (or a direct or indirect parent, subsidiary, affiliate, or division of a Defendant, Deutsche Bank, or Rabobank or any of their alleged co-conspirators), and do not include European Government Bond transactions in which you acquired the bonds as an agent for another individual or entity.

TRANSACTIONS WITH DEFENDANTS

Date of Transaction: *

Transaction Type: *

Name of Counterparty: *

Notational Amount (Expressed in Euros): *

Maturity Date: *

Must click Add Transaction to save your information.

Date of Transaction

Transaction Type

Counterparty

Notational Amount

Maturity Date

Action

UPLOAD SUPPORTING DOCUMENTS

All supporting documentation for your positions and transactions should be uploaded to this page prior to moving on to the next step in your online claim submission.

Please use the browse option, by clicking on “Select Files” in the box below, to upload your supporting documentation being submitted to verify all of your positions and transactions.

Select files

Files To Be Uploaded	Size	Action

CLAIMANT’S CERTIFICATION & SIGNATURE

Certification

BY SIGNING AND SUBMITTING THIS CLAIM FORM, CLAIMANT OR CLAIMANT’S AUTHORIZED REPRESENTATIVE CERTIFIES ON CLAIMANT’S BEHALF AS FOLLOWS:

1. I (we) have read the Notice and Claim Form, including the descriptions of the Releases provided for in the Settlement Agreements;

2. I (we) am (are) a Settlement Class Member and am (are) not one of the individuals or entities excluded from the Settlement Class;

3. I (we) have not submitted a Request for Exclusion;

4. I (we) have made the transactions submitted with this Claim Form for myself (ourselves) and not as agents of another, and have not assigned my (our) Settled Claims to another;

5. I (we) hereby warrant and represent that I (we) have not assigned or transferred or purported to assign or transfer, voluntarily or involuntarily, any matter released pursuant to the release or any other part or portion thereof;

6. I (we) have not submitted any other claim in this Action covering the same transactions and know of no other person having done so on his/her/its/their behalf;

7. I (we) submit to the jurisdiction of the Court with respect to my (our) claim and for purposes of enforcing the Releases set forth in any Judgment(s) that may be entered in the Action;

8. I (we) agree to furnish such additional information with respect to this Claim Form as the Claims Administrator or the Court may require;

9. I (we) acknowledge that I (we) will be bound by and subject to the terms of the Judgments that will be entered in the Action if the Settlements are approved; and

10. I (we) understand that any trial by jury (to the extent any such right may exist) and any right of appeal or review of the Court’s determination with respect to my (our) Claim are waived.

Signature

Please Read The Release, Consent To Disclosure And Certification, And Sign Below.

I (we) acknowledge that, as of the Effective Date of the Settlements, pursuant to the terms set forth in the Settlement Agreements, and by operation of law and the Judgments, I (we) shall be deemed to release and forever discharge and shall be forever enjoined from prosecuting the Settled Claims against the Released Parties (as defined in the Settlement Agreements and/or Judgment(s)).

If signing as an Authorized Representative on behalf of an entity, I (we) certify that I (we) have legal rights and authorization from the entity to file this Proof of Claim form on the entity’s behalf.

UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE UNITED STATES OF AMERICA, I (WE) CERTIFY THAT ALL THE INFORMATION PROVIDED BY ME (US) ON THIS CLAIM FORM IS TRUE, CORRECT, AND COMPLETE AND THAT THE DATA SUBMITTED IN CONNECTION WITH THIS CLAIM FORM ARE TRUE AND CORRECT COPIES OF WHAT THEY PURPORT TO BE.

Signature of Claimant (if Beneficial Owner is an individual filing on his or her own behalf): *

Authorized Representative Completing Claim Form (if any):

Capacity of Authorized Representative (if other than an individual, [e.g., trustee, executor, administrator, custodian, or other nominee]):

REMINDER: YOUR CLAIM FORM AND REQUIRED DATA MUST BE SUBMITTED ONLINE BY 11:59 P.M. EASTERN TIME ON November 27, 2024, OR RECEIVED BY MAIL NO LATER THAN November 27, 2024.

* Denotes required field