Case File
efta-01379556DOJ Data Set 10OtherEFTA01379556
Date
Unknown
Source
DOJ Data Set 10
Reference
efta-01379556
Pages
1
Persons
0
Integrity
Extracted Text (OCR)
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Pre
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 It Natural Person Conning Attomatt:
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b. Name, or Legal EntitY. 'TVOn Cif Le.2ai Entfrr. anti Ad-drttss
Logal E.Mity to, Whitth the Account it? Being Opened:
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1,ne fo”owing information for ea0h individual if any. who. direeey or .i.direiCtly through arrf c.oritract. arrangement
urder5v.te•5.'O •,::it)t..;r, I lip or otherwise. owrot 25 percent or more of Ehe equity interests cti the legal entity 'kind ~lb:
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;Xwara fit ego OlOnlifi;Eicgrcsardrzwnba..n. gizimtAt anO COUrit, of Binumticf !arr yin« tiov~nen!-Ntind dwurnent evid!firdr"; ittuo.naht, of f•ELIOOPOIOnd Dialing 1 olfixogript;
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Of no rW4dual moet lo*Cr.. pkamniOp 'No! Appt:ultik!')
:1. The following Information for one Individual with significant responsibility for managing the legal entity tisted 31.1t,e,
i;tich 3B.
• An (.3xiiC,ItiV5 officer or serCor manager (e.g., Chief Exr-utive Offictn. Chia! Financial Officer. Chie€ Operating Officer,
Managing Memoir. Gener*! Partner, President Vita President, Treasurer): or
• An.i other individue, who regularly f).rforms Smilar tuneitx:e
al appropriate. an individual listed tender seettn (c) above may also be listed in this section cd».
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am endow, of baffle» nf any new ‘metnineni-hitpx1OOCUrnen, ludic:audit," f......facnence
ennienr.rar..)t bolds aaLlµ:kg ‘hoolif
Noridet.
.-----(nar a of neural person opening the account). hereby certify. to the best of
Knowted ovidett ObOVe Ltriplets and cfri^,,ct.
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4,‘ 20ai EiN:t;,,,,,..nse.A. AO. Ad si.?ht,t f61,4n.0(1. WAli 466'6 41D61Ø 0.41319
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
DB-SDNY-0077149
CONFIDENTIAL
SDNY_GM_00223333
EFTA01379556
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