Case File
efta-01345170DOJ Data Set 10OtherEFTA01345170
Date
Unknown
Source
DOJ Data Set 10
Reference
efta-01345170
Pages
1
Persons
0
Integrity
Extracted Text (OCR)
Text extracted via OCR from the original document. May contain errors from the scanning process.
Legal Entity Identifier (Optician
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:
MORT, 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:
Name
Date of 8:t th
ilatuel Adage
For U.S. Parsons:
Social Security
Rumba,
For Non-U .S. Pocono.-
!
iSco footnote 1 for aitenstkesi
to Social Security Nurnoer)
JEFFREY E. EPSTEIN
! 6100 RED HOOK QUARTER, B3
ST. THOMAS, USVI 00802
I
I.
Far Non-U.S. Persons in acithtion too Social Security Number oe a Passport Number with Country of Inc nce, an alien identircodrin cow nines:, or numb*,
and count:y1)g issutoce of any other goveinment-istved document evideving notionally or residence ono tweedy o photograph or siniikr safes:tore shoina
be ocovided.
(If no in dividual:Deets this detnition. **rev:roe 'Not apOcable.")
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)).
i Nom
Date of aim
i Ley& Memos
For US Persons: I For Non-U.S. Penontt
Social SenuntY
I (Sea Iota note for one:native/
Mantic
I to Social SCtutity Number.).
ABOVE
•
1JEFFREY E EPSTEIN I SEE
, Poe Non.U.S. Parsons. ;n addition too Social Security Rundle, or a Passport Nominal stun Country of IStuAnce, on al:an itientificai ion card manor. CA nunibot
one country of issuance of any ether governmentossued document ovidenciitgn,nonalityxresidence Ana Ceti
DhOtailMDh Of Sitaaf Wrer.sdrti shoolt
DO PrOViCed.
(name of natural person opening the account), hereby cern
best of
providactabome is complete and correct.
Signature Veri
7/24/18
Date
stavidtAre
Name (Print)
Title
rt.!!..)
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
CONFIDENTIAL
DB-SDNY-0031356
SONY GM_00177540
I
EFTA01345170
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