Case File
efta-01373045DOJ Data Set 10OtherEFTA01373045
Date
Unknown
Source
DOJ Data Set 10
Reference
efta-01373045
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, 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 Name
Date ot Birth
tenor Audrey;
For U.S. Parson:
For PlonAJ.S. Pt sons:
Sook2I SOCurkir
(Sec footnotes. toy allernyinec
Number
to Sow: Sectrey Nu'r.bor)
JEFFREY E. EPSTEIN
8100 RED HOOK QUARTER, 83
St THOMAS, USVI 00802
1
For Non•US. Persons. in &coition too Social Security Number or a Nsspott Number with Country of IssuanCe. an Open identiScotIon card number. Or iiurnnor
and courniyot inilonCe ut any Ced ler governintnt-issued document aVelencing nattenalty cv residence ann matins a puotogrape Cr Arniar sainuaro *haulm
OS wonders
(If no incliktual mutts this d4hiitiCet den: tvflIC 'Nat Applicabil.-)
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 Addrtyss
I Data of Bath
JEFFREY E. EPSTEIN
SEE
ABOVE
For US. Persona:
Social Security
Numb&
kr Non-0 S. Perform
(See foolnote I for ahanativesl
to Social Security Number,
For Non-tAS. Arsons. in Wailtan to a Social Semoity Number or a Passport Nienoor with Country Of Issuance. an alien Identificaton cans numbe,, or flambe
and country of !steam/ of any other govetrtment-issoed document
nationatity or residence and bearing a photograph Or simile: safeceord 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-0067036
SDNY_GM_00213220
EFTA01373045
Technical Artifacts (2)
View in Artifacts BrowserEmail addresses, URLs, phone numbers, and other technical indicators extracted from this document.
SWIFT/BIC
LABILITYSWIFT/BIC
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Medical Record/Clinical Encounter: DOJ-OGR-00026334
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1p
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