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efta-01369139DOJ Data Set 10Other

EFTA01369139

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Unknown
Source
DOJ Data Set 10
Reference
efta-01369139
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1
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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, SOLE MEMBER b. Name of Legal Entity. Type of Legal Entity, and Address of Legal Entity for Which the Account is Being Opened: LSJE, 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 Cate of girth toga: Atldress For U.S. PCICAS: Social Security Nwnber Ere Non-U.S. Person:: (Soo footnote 1 for site, natives : to Soot Seofity Hunteaki JEFFREY E. EPSTEIN 1120153 6100 RED HOOK QUARTER, B3 ST. THOMAS, USVI 00802 For Nan•US. Persons, in acklition Ins Soda( Society Number or a Passport Numbed with Comity of issuance, an alien identification card member, or number end country of 'nuance of 8M/other government. issued document evidencing nationality or resicence and bearing a photograph or similm taltguani shoub be plc-video. (If no individual ateete tete Oorma.tri. OteaSe write 'Nat aPplitaigin 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 (Cl)). Name Cato of Binh j Legal Address 1 For US. Perrone: Social Secwity Number For Non-U.S. Persons: (See footnote?. for aiternatives$ to Social Stocky Numbed i JEFFREY E. EPSTEIN I SEE ABOVE ' for NomU.$. Persons, in addition too Social Security Number ore Passport Number with County of linaianCe, an alien 'codification card number. convector and country of issuance of any other government-issued document evidencing rmtionaCty or feSidefiee end beech:la ailcibeigraett a similar safeguard snoukf be provided. loyal Entity Identifier {Optionah of natural person opening the account), hereby certify, to the best of complete and correct. 7/24/18 Date CONFIDENTIAL - PURSUANT TO FED. R. GRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0061247 SDNY_GM_00207431 EFTA01369139

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