Case File
efta-01370745DOJ Data Set 10OtherEFTA01370745
Date
Unknown
Source
DOJ Data Set 10
Reference
efta-01370745
Pages
1
Persons
0
Integrity
Extracted Text (OCR)
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:
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
i--
Date of Etkth
Legal Annan
For U.S. Persons:
Social Security
Number
For Non-U.S. Persons:
!
iSco footnote 1 for aiterastlasi
to Social Seamy Nurnoer)
I JEFFREY E. EPSTEIN
I
1/20/63
6100 RED HOOK QUARTER, B3
ST. THOMAS, USVI 00802
I
I
I
I
I
' Far Non-U.S. Persona in oath:ion too Social Security tiumbac a Passport Number with Country of Issu nct. anent, identirisettrin caw notes:, or numb*,
and county of issuance of any other govainment-istoniti document evidencing notionally or resicence anti thicento o photocaph or siniikr ssfesuere shoula
be ocoviOetl.
(If no individual meets this clef:ninon. *inst. write 'Not ao0catite.")
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
Dated aidn
JEFFREY E. EPSTEIN
SEE
Leytil Address
I ABOVE
For us Parsons: I For Non-U.S. Ocoonn
Social Security
(See foot note for anernativail
fatentic
I to Social Senixity Number;
Fc • Nuti.US. Persons. In sooit:on to a Social Security Water 04, e Passport Mantic into Country of Issuance, en atan identification card narrate. oi nuniiha
3,10 country of issuance of any other genunmontossued document evidencing nationality o residence ant":a:,r,^0a onotocaoh or sinner saferaierti shoo
orovioon.
fagot Entity Identifier (Optician
(name of natural person opening the account), hereby certi
hmst of
rovfdactabate is complete and correct.
Signature Veri
7/24/18
Crate
S trAttme-f
Warne (Pont):
Title
rosy._
•
CONFIDENTIAL - PURSUANT TO FED. R. GRIM. P. 6(e)
CONFIDENTIAL
DB-SDNY-0063756
SDNY_GM_00209940
EFTA01370745
Technical Artifacts (2)
View in Artifacts BrowserEmail addresses, URLs, phone numbers, and other technical indicators extracted from this document.
Domain
nuti.usSWIFT/BIC
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