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efta-01345167DOJ Data Set 10Other

EFTA01345167

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DOJ Data Set 10
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efta-01345167
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EFTA Disclosure
Text extracted via OCR from the original document. May contain errors from the scanning process.
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, PRESIDENT b. Name of Legal Entity. Type of Legal Entity, and Address of Legal Entity for Which the Account is Being Opened: JEEPERS, INC., A USVI CORPORATION 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: i Name Pate of Seth WO Address I For U.S. Persons: Social Security I Nombre For Non.US. Parsons: (See (Ootrrear 1 for olternat ... ro Sacral Security Number) JEFFREY E. EPSTEIN 16100 RED HOOK QUARTER, B3 I • St THOMAS, USVI 00802 • FIX Non-U.S Persons. in addition to a Sonar Security Number or a Passport Number wan Country of ;nuance. an alien identification card nurrc-ft, or nurntw arc coon:rye inuarce of tny other govecrintent-issued doximent evidencing rtatimality or resecence and l: oath a photooraph Or simaat saktaaro VlOokl prOireftd. (If no indricual moots triis definition. eteese ii.vrite Not Appliceen 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 (c) above may also be listed in this section (a)). Name Gate of Sinn I Legal Address n ABOVE JEFFREY E. EPSTEIN j SEE For U.S. Persona: For Non-US. Parsons: Social &murky/ (See footnote for oat:mauves I Number to Sens Sneer Number) • For Non-US. Pernms• in addition to a Social Security Number or a Panpvt Number WWI Country of Issuance. an am iventifreauco cord :Jumper. or number and country of Issuance of any other govarnncru4saurtd document evulanoMq nationality or resdence and bearing a utast:gr. uh ce rumger safeguard t'hou'c be provided. Legal En(ty Ithmtiber IC p:mne4 (name of natural person opening the account), hereby certify, to the best of ded above is complete and correct. 7124/18 Daze 51,044c Cpc Signature Vern Name (Print Title: Dote: r- CONFIDENTIAL - PURSUANT TO FED. R. GRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0031352 SDNY_GM_00177536 EFTA01345167

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