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efta-01345168DOJ Data Set 10Other

EFTA01345168

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DOJ Data Set 10
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efta-01345168
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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 AccounC 1JEFFREY 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: JEGE, 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 Date of 'sink I LegalAddress For U.S.' Parsons: Social Security Number For flon-U.S.nem.‘ns: (See footnote 1!cr aternatiyni to SoCthl Senrry Number) I JEFFREY E. EPSTEIN a 16100 RED HOOK QUARTER, B3 ST. THOMAS, USVI 00802 ' For kon.U.S. Poisons. In arrIcittiOn to a Social Security Number ore Possport Numb& min Country of issuance, an as WegitiliCition Card nut. Or nontOz: anti county iflOolsorA of any other covet rrient-lisued document itArtancing naftonallty or residence and nearing a Ohovniwn or Vorrilas fOferif art stloorn de provided. (If no exfividuat meets this deli:jean. Pleate mite "Not 40ohca.siel 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 (d)). Maine Date of Birth Legal Address JEFFREY E. EPSTEIN I SEE !ABOVE o For Non-US. Persons. In addition to a Sock Security Number ore PaSSOrfot Numoor with Country of 'nuance. en aim itientification Card numbly. or taunter ad Critelli'? Of issuance of any =et governm.ern-issued document evidencing nationality or resktence and bearing a pnotoqrapn or s;enga• aofecoard shine be wave:ed. For U.S. Persoim Soda! Seeunty Number For Non.U.S.PanOn.1: (See footnote 1 ke illternath•CS to Social Securi:y Moroi:seri J FREY E. EP EIN knowledge, that t e inf (name of natural person opening the account), here rtif d above is complete and correct Signature Ve 7/24118 Sig Date Legal Entity Identifier iDrxiolon t- Str itAte Owl Name (Print): Title: Date 17 CONFIDENTIAL - PURSUANT TO FED. R. GRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0031354 SDNY_GM_00177538 EFTA01345168

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