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efta-01345165DOJ Data Set 10Other

EFTA01345165

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DOJ Data Set 10
Reference
efta-01345165
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EFTA Disclosure
Text extracted via OCR from the original document. May contain errors from the scanning process.
legal Entity fdroittiber (Optional) II. Certification of beneficial owner(s) Persons opening an account on behalf of a legal entity must provide the following information: a. Name and Title of Natural Person Opening Account JEFFREY E. EPSTEIN, SOLE MEMBER b. Name of Legal Entity. Type of Legal Entity, and Address of Legal Entity for Which the Account is Being Opened: HYPERION AIR, LLC, A USVI LIMITED LIABILITY COMPANY 6100 RED HOOK QUARTER, B3 ST. THOMAS, USVI 00802 c. The following information for each individual, if any. who, directly or indirectly, through any contract, arrangement, understanding, relationship or otherwise. owns 25 percent or more of the equity interests of the legal entity listed above: ; Name Dote of Birth f JEFFREY E. EPSTEIN I Legal Aacress 6100 RED HOOK QUARTER, 63 ST. THOMAS. USVI 00802 For U.S. Pet tans*. For tlw-LJ.S. a.moons Soy of Seouillr (See 100trate 1 for aliN natives' Nunter to Satial Stayny Hume) L ---- I I i I I--..-- I ' For Nr.-U.S. Person& in edoilion to 3 Social Security Number er a Passport Number wan Country of issuance, an anon ieeniff calico cold quote. or number ono count.? of issuance of any othe, govetrinientitssorii continent evineockc nattionaCty or tesideme aria basting* photograph or sirnaz Safesuart sheltie to ormided. tit no individual meals this SiiniVari. piett,e write 'Not Appiicable.1 d. The following information for one individual with significant responsibility for managing the legal entity listed above, such as: • An executive officer or senior manager (e.g., Chief Executive Officer, Chief Financial Officer. Chief Operating Officer. Managing Member, General Partner, President, Vice President Treasurer); or • Any other individual who regularly performs similar functions. (If appropriate, an individual listed under section (e) above may also be listed in this section (d)). i Name I Oate of Binh I I legai Address I For U.S.Persons: For Nom-US. Proons: i Social Scantly Mae footivis I its iraetnativem i--- tAunber to Social Seaway Number) iI JEFFREY E. EPSTEIN I SEE 1 i ABOVE I i ....j !Fog Nort.u.s. Persons. in addition to a Social Slairity Number or a Passport Nirntswitti CountryOf ;Mance. an alien ktenolication c3r0 nunult. or ninth& 610 rowan; of issuance or any Mhot girv*rnirstrIt•istueo rtoctorkilt initially:Ina MrilCality Oi !talent.° one etfoing a plINZ0Tatti or Sellildr safesus iv sncuia ea OrGYWCO. natural person opening the account). hereby Certify to the best of complete and correct. Signature Ve 7/24/18 DEC susna4arc 0,4 Name (F44 Title: Dote: CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) roNFinFNTIAL DB-SDNY-0031350 SDNY GM_OO177534 EFTA01345165

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