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efta-01375528DOJ Data Set 10Other

EFTA01375528

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Source
DOJ Data Set 10
Reference
efta-01375528
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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: ccLA fr,iN b. Name of Legal Entity, Type of Legal Entity, and Address of Legal Entity for Which the Account i Being Opened: Sothinenn 770,1,4 Cow-eat/14 , too et_ct bk-coVt>104,405 eaa SAT- • Tknetbso$ ..) 1/4,21 S\) k .8 0 c. The following information for each individual. if any, who, directly or indirectly, through any contract, arrangement. uncerstanding. relationship or otherwise, owns 25 percent or more of the equity interests of the legal entity fisted above: I e Owe of Beth I :egai:4:dsess Fm US. Parsons: Social Security Nome/ Far Non-J.S. Persons: l (Sao footnote I for alternatives to Saint Saosity Ntsvbet) . r e 1 evskt, • Ft to o I s3 G.,‘ co Rea tkact<e•-"{r-v/ 83 ,s4.-n,c.,...sJ , 1/41,1/4)l 0081)). I - 'Ear Non-U.S. Persons, in addition to a Social Security Number or a Passport Number with Country ot Issuance. an alien idmttilr.ation card nut. W number and Minty of iS0u4nCe 0f any othcr government-issued document evicencmg nationality cc residence ono bearing a DOotograpn or similar , safeguam stipule be orovietd. (if no individual meats this definition. plum* write "NOI. AO:Sir-OW.1 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 Name Elannew, °Moil:Soh I Legal Address SedilSocurdy (See foOtnOte I for akernativesl For U.S. .:twos: Fix NomU.S. Persons: Number to Social Security Number) I FOr Non-U.S. Parsons, In addition to a Social Security Number or a Passpoel Number •.v Country of Issuance. an alien idettif cation care number, or railellair and ceracry of issuance of any other governinant-issued document evidencing funintlali:yJe reicaulce and Ooring a photograph or simaar safeguard shoran be pf..1V1000 a V. X.14 (name of natural person opening the account), hereby certify, to the best of my knowledge, that the information provided above is complete and correct. Signature Legal Entity Identifier (Optional) nature V rif , W -. Name (Print): 47/b Kirin VP r.2018 Deutsche Sank AG. All rights reserved. WI4139666 026819.0SISIS e:511ILA ILI-e- eon4 nneci 9-77 ?fi -0 OM Corn-4A "Reso/vdion- CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0071033 SDNY_GM_00217217 EFTA01375528

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