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efta-01370742DOJ Data Set 10Other

EFTA01370742

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Unknown
Source
DOJ Data Set 10
Reference
efta-01370742
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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, PRESIDENT b. Name of Legal Entity, Type of Legal Entity, and Address of Legal Entity for Which the Account is Being Opened: J. EPSTEIN VIRGIN ISLANDS FOUNDATION, INC., A 501(cX3) PRIVATE FOUNDATION/USVI CORPORATION 6100 RED HOOK QUARTER, 83 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 I Date al auto Legal Address 1 Fe, U.S. Parsons: I Social Seounq . Number he Ncrl.U.S. Persons: (See leo:natal for ttternaobeiI to SotialSetwity Nutter) I. NOT APPLICABLE ---- 4 I I 1 I NO:WAS.Personi. in addition CO a Social Scattily aturnbar or a Pitapat Plumper witn Country of issuin‘A en alien ieentificallen caw number. Or *WV& and country of nuance c1 any oilier gOvermrneng-imed documenteviCtkatv net:matey or sniOence and tearing a ahcceprapn eimilar safeguard ineob be provided. naindandual enacts this fttinnion. Please wale 'Not AoPlab4a.-) 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 atso be listed in this section (Cl)). Name Date of Sinn Lica:A Address Pot U.S. Persons: I Fo Non•U.S. Anent; Social geounty i (Sea femme a tar tarenartvasi Nurnaar ' to Satiaf StearitY Number) I JEFFREY E. EPSTEIN 11/20/53 6100 RED HOOK QUARTER, B3 ST. THOMAS, USVI 00802 • For Nen-V.S. Parsons, in addition to a Sobai SeCurity Mumbo: u, c Pasipon Mamba: %%id, Country of Issuance, on alien Idantificanon card wear. or *miter end (raillery al is of any otne: gavot mbent-iabed deburnent ovtogreing et:venality Of resident* and among a 011010QmOn or,ritar 511Ncara abOub be Dravided. FREY E. EP TEIN y knowledge, that tie info SI tesoi Entky identifier (Optional) me of natural person opening the acsount)• hereby certify. to the best of is complete and correct. 7124118 Date srpifruta4 Na rint):a Title: Deno: er CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0063751 SDNY_GM_00209935 EFTA01370742

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