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efta-01370748DOJ Data Set 10Other

EFTA01370748

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DOJ Data Set 10
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efta-01370748
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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, MANAGER b. Name of Legal Entity, Type of Legal Entity, and Address of Legal Entity for Which the Account is Being Opened: SOUTHERN FINANCIAL, LLC, A USVI LIMITED LABILITY COMPANY 8100 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: i Nam I Date &Birth LegarAtterese For U.S. Parson: For Plonet.).S. Pe-sons: socks Security Number (Sec footnotes toy alternatives to Social &storey Ntrr.boA JEFFREY E. EPSTEIN 1/20/53 8100 RED HOOK QUARTER, 83 St THOMAS, USVI 00802 7. For NormUS. Persons. in &coition too Social Security Number or a Nasport Number with Country of ISSUO5Ce an agen identiScotIon card number. or ilUrneer area courery of issuance of any Ced ler governintnt-issued document avelencing nationally cv residence ant: matins a photograph cr lehear safeguard sheula OS voyagers (If no incliktual mans this d4hiitiCet Oen: tvflIC 'Not Ap0liCabl47) 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, art individual listed under section (c) above may also be listed in this section (d)). Name f Leo Adorers I Date of Beth II JEFFREY E. EPSTEIN SEE ABOVE For US. Persona: Social Security Numb& kr Non-0 S. Armors: (Sea fool note I for *Narratives' to Social Security Number) For Non-tAS. Persons. in Wailtun to a Social Semeity Number or a Passport Ntemmer with Country of I siunrice. an alien Identificaton cans number, or !writhe and country of !stereo of any other govetrtment-issoed cowmen! eyloeiranci nationality or rcoicience and imatmg a photograph Or similar serogoord should be provided. me of natural person opening the account), hereby certify, to the best of ded above is complete and correct. 7124/18 Date ;(ertAw-e Cei Date Sr CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0063760 SDNY GM_00209944 EFTA01370748

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SWIFT/BICLABILITY
SWIFT/BICSOUTHERN

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