Case File
efta-01291968DOJ Data Set 10OtherEFTA01291968
Date
Unknown
Source
DOJ Data Set 10
Reference
efta-01291968
Pages
5
Persons
0
Integrity
Extracted Text (OCR)
EFTA DisclosureText extracted via OCR from the original document. May contain errors from the scanning process.
WARNING: PRINTED VERSIONS OF THE BSA E-FILING FORMS ARE NOT FOR SUBMISSION
AND WILL NOT BE PROCESSED BY FINCEN.
Currency Transaction Report
OMB No. 1506-0064
Filing Name
152-5423
Version Number 1.1
9 Type of filing
Z Initial report
E Correctiamend prior report
K FinCEN directed Backfiling
Document Control Number / BSA Identifier I
Save
Validate
Print
Under penalties of perjury. I declare that I have examined this transmittal, including accompanying
documents, and to the best of my knowledge and belief it is correct and complete. In the case of documents
without recipients identifying numbers, I have complied with the requirements of the law in attempting to
secure such numbers from the receipts. I declare that this filing represents all Documents filed during this
reporting period except for those transactions reported on paper.
Sign with PIN
SDNY_GM_00049894
CONFIDENTIAL — PURSUANT TO FED. R.CON(F IDENTIAL
DB-SONY-0012718
EFTA_00 I 60502
EFTA01291968
WARNING: PRINTED VERSIONS OF THE BSA E-FILING FORMS ARE NOT FOR SUBMISSION
AND WILL NOT BE PROCESSED BY FINCEN.
Part I Person Involved in Transaction 1
of 2
00
'2
Person conducting
Flo Person conducting
a 11
- K
transaction on own behalf
b law transaction for another
3
O Multiple transactions
ri Person on whose behalf
b I—I transaction was conducted
d O
Courier Service (Private)
Check
K If entity
'4 Individual's last name
O Unknown
or entitys legal name
•5 First name
O Unknown
6 Middle name
Suffix
7 Gender
8 Alternate Name
9 Occupation or type of business
9a NAICS Code
'10 Address
O Unknown
'11 City
O Unknown
•12 State
O Unknown
'14 Country
O Unknown
•15 TIN
Indyke
Darren
LK.
Male
Attorney; owner of law lirm
2 Kean CT
Livingston
NJ
US
K Unknownil
18 Contact phone number
Unknowl.
•17 Date of birth
K
19 E-mail address
'20 Form of identification used to verify identity
'13 ZIP/Postal Code 0 Unknown
16 TIN type
Ext.
SSN4TIN
07039
Number
OUnknown
ig Drivers kcense/State ID O Passpon
O Alien Registration O Other
Country
US
21 Cash in amount for individual or entity listed in Item 4
Account number
Issuing State
NJ
22 Cash out amount for Individual or entity listed in Item 4
$
16.991
Account number [
0 0
•
Page 2 of 5
SDNY_GM_00049895
CONFIDENTIAL - PURSUANT TO FED. R.QPN(F
IDENTIAL
DB-SONY-0012719
EFTA_00 I 60503
EFTA01291969
WARNING: PRINTED VERSIONS OF THE BSA E-FILING FORMS ARE NOT FOR SUBMISSION
AND WILL NOT BE PROCESSED BY FINCEN.
Part I Person Involved in Transaction 2
of 2
00
Person conducting
Person conducting
'2
n
-
transaction on own behalf
b ri transaction for another
3
O
Multiple transactions
ro., Person on whose behalf
O
Courier Service (private)
c la d' transaction was conducted
Check
O If entity
'4 Individual's last name
O Unknown
or entity's legal name
'5 First name
O Unknown
6 Middle name
Suffix
7 Gender
8 Alternate Name
Epstein
Jeffrey
9 Occupation or type of business
9a NAICS Code
'10 Address
O Unknown
•11 City
O Unknown
•12 State
O Unknown
'14 Country
O Unknown
•15 TIN
0
Unknown
'17 Date of birth
0
Unknown
18 Contact phone number
19 E-mail address
President of SouthemElnanclal
6100 Red Hook Quarter, B3
St. Thomas
'13 ZIP/Postal
16 TIN type
Ext.
Code 0 Unknown
VI
loc.2
US
SSN4TIN
F
1112011963
'20 Form of identification used to verify identity
Number
OUnknown
IX Drivers license/State ID O Passport
O Mien Registration O Other
Country
US
21 Cash in amount for individual or entity listed in Item 4
Account number
Issuing State
VI
22 Cash out amount for IMNidlial or entity listed in Item 4
$
Account number
16.991
0
0
Page 3 of 5
SDNY_GM_00049896
CONFIDENTIAL - PURSUANT TO FED. R.QQN(F
IDENTIAL
DB-SONY-00 12720
EFTA_00 I 60504
EFTA01291970
WARNING: PRINTED VERSIONS OF THE BSA E-FILING FORMS ARE NOT FOR SUBMISSION
AND WILL NOT BE PROCESSED BY FINCEN.
Part II Amount and Type of Transaction(s). Check all boxes that apply.
'23 Date of transaction 12/19/2017
24
O Armored car (FI Contract)
0 ATM
0 Mail Deposit or Shipment
O Night Deposit
0 Aggregated transactions
'25 CASH IN: (in U.S. dollar equivalent)
a Deposit(s)
• Payrneal(s)
c Currency received for funds
transkri(s) out
d Purchase of negotiable instrument (s)
e Currency exchanges)
Currency to prepaid access
g Purchases of casinos Gilts, tokens
and other gaming instruments
h Currency wager(s) ncluding
ninny PleYs
I
Bills inserted inlo gang devices
• Other (specify):
$
.00
.00
.00
.00
00
.00
00
.00
.00
.00
Total Cash in
26 Foreign Cash in
28 Foreign Cash out
7,000
.00
'27 CASH OUT: (In U.S. dollar equivalent)
a Vathdrawal(s)
•
Advance(s) on credit (ncluding markers)
c Currency pad horn funds trans( (H(s) in
d Negotiable instrument(s) cashed
e Cunonry exchango(s)
f Currency horn prepaid access
a
h
Z Other (specify)
.00
.00
.00
7,500,00
9,491.00
.00
Redempien(s) ot casino chips. tokens.
TITO tickets end other earning instruments
Payments) on war(s) (Inducing race
and OTB or scats pool)
Travel and complimentary expenses and
took gaming Incentives
Payment for tournament. contest or other
promotions
Total Cash Out
Foreign Country
Foreign Country
00
.00
.00
BE
.00
.00
15,99100
O 0
O 0
Page 4 of 5
SDNY_GM_00049897
CONFIDENTIAL - PURSUANT TO FED. R.CON(F IDENTIAL
DB-SONY-0012721
EFTA_00 I 60505
EFTA01291971
WARNING: PRINTED VERSIONS OF THE BSA E-FILING FORMS ARE NOT FOR SUBMISSION
AND WILL NOT BE PROCESSED BY FINCEN.
Part III Financial Institution Where Transaction(s) Takes Place 1
of 1
0
0
17 Type of financial institution
Other (specify)
/9 Primary federal regulator
Depository institution
Federal Reserve Board (FRB)
38 If 37a - Casino/Card Club is checked, indicate type (chedc only one)
K State licensed casino
Tribal authorized casino
Card dub
'30 Legal name of financial institubon
31 Alternate name, e.g. trade name, DBA
12 EIN
*33 Address
'34 City
*35 State
K Other
IDeutsche Bank Trust Company Americas
346 Park Ave
New York
NY
'36 2IP Code
I10154
39 Financial institution ID type
ID number
'40 Contact ofhte
'41 Phone number
'42 Date Filed
DB PB AML
Ext.
(Dale filed wal be auto
-populated when la, form is signed.)
Page 5 of 5
SDNY_GM_00049898
CONFIDENTIAL - PURSUANT TO FED. R.CON(F
IDENTIAL
DB-SONY-0012722
EFTA_00I 60506
EFTA01291972
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