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efta-01369143DOJ Data Set 10Other

EFTA01369143

Date
Unknown
Source
DOJ Data Set 10
Reference
efta-01369143
Pages
1
Persons
0
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EFTA Disclosure
Text extracted via OCR from the original document. May contain errors from the scanning process.
Legal Entity Identdier Motional! II. Certification of beneficial owner(s) Persons opening an account on behalf of a legal entity must provide the following information: a. Name and Tine 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: J p6 r`LAN Co, LLC, A USVI LIMITED LJABIUTY COMPANY 100 RED HOOK QUARTER, B3 I 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: Nome I I— Date of Birth legal Address Far U.S Person' Soma' Secuilty Number For Non-U.$. Persons: (See footno te:curity for ofteinatives to Social Se Mantel I !JEFFREY E. EPSTEIN 1120153 8100 RED HOOK QUARTER, B3 St THOMAS, USVI 00802 I H I ' For Woo-US. Persona in adoltion to a Social Secunty NWAIW of a Passport titenoor with Country of Novara an ellen identification card number. tf, number and counuy of issuance of any other governmenvissued document otitis:fen nationality octetiKIONNI and bladog a la\atOgrePh a Wa'aricaole9LfOra should to provided. (lf no indivioual motes tnis definition. istease ite -Not AOPlicablen 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)), Nome I Date of Bath legatAtcaess For U.S. Persons: Social SeatrAY Number For Non4l S. PerfaiitS (See footnote I for altenethattS to Social Security Numb..) i JEFFREY E. EPSTEIN L___ SEE 'ABOVE ' For Non-US. Persona in adtEtIon to a Social Security Nwmber or a Passport Nighbar with Ccruntry of Issuance. an Oen identification card number. or nurater end country of issuance of any other government-issued document evidencing rationality or issiderre and blaring a photeemaa a siiiii‘v safeguard should be provided. ural person opening the account), hereby certify, to the best of °rotation e is complete and correct. 7124H8 Date CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0061251 SONY_GM 00207435 EFTA01369143

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