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efta-01379562DOJ Data Set 10Other

EFTA01379562

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DOJ Data Set 10
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efta-01379562
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EFTA Disclosure
Text extracted via OCR from the original document. May contain errors from the scanning process.
IL Certification of beneficial owner(s) Persons opening an account on behalf of a legal entity must provide the followng information: a. Name and Title of Natural Peron Opening Account: Te.fg.,...r etj. for Wrdch Agy.,ount is 8t3a.2 or.,_tmed, AL, Coto° Iga 4 go oV.Qty eg s.k• j US° c. Tivt.rt foilowin4) ;El kin r1".0.;0ri IC.) each individual. if any, who, directie ot indirectly. t rough any contact, aortnoent t. understanding, toiattonshli) ot otherHttse owns 25 percent or more of the equity interests of the legal entity listed above; tuns? ..,:Q1AZ!ClietS ag,t + lc vs GA OO 4it a,c,se ås isk-11-4.sil.Sit OO U.51., gor :. For itor•US. 'e‘:A !Soo ioctioant I. ite olennthoo ':vinnat StiOta ' For !too. Pet1Orn. t'u iihooko )5;i:noott. ohooto) v.i))! Cc. ;Jr ct JMIC ketrnkiWe CM, Nallb" ionnotii eCtirlfy Ism/ante of arc) ).or gou•Inmenoitotion ik.oltoeri eFideiloin? inns:mow/a, nnol000ti•oo booing rdoxennipt ot Sdnilar oisfa-votr3 bagel LICAndiel al r!).ndmatol n•biln, got atlirlitt)n. 1:1•11:13Kera d. The following information for one indiViduat with significant rasponsibili for managing the legal entity listed above, such as: • An eve—tvtiye officer or senar manager (e.g., Cn;et Evectoitre Weer, Chief Financier. Officer. Chief Operating Officer. Managing Member. General Partnet. President, Vice Presicit . Treasurer): or ri Any other extividual who regularly pet-kepis smiler fun :tiara (If appropliate. an individual listed under section (c) above may also be listed in this section (d». : Nave thfsh.».‘ b.))* oi &In UF•pl \bo t g3 -4O—ce_ Fo) Pornno: g3t NOr • US. ,,eaLtst Z,Ond &Viz '.'aei0Otoo,it st4 3")Orookre..) `tonne.) SeUbtV `2Jenba, • r0: P^. tr,OF. sifea'iori tot, SOCMI St1/4:311V1/4 1~ rig d paas,„-mt) %robe wit?: Cociony moo , . mor "or:3),mi qntl noion't of hunoot of or:taint; ivrtionmooati,:rn Otou.inont omit:oak,' tst IFS<det*C".C411,, Jfing A PN"Mtilat.', nitiCSFi'd he otairit Lego; &tort iiicorityr (Opoonot) rat person opening the account). neteby ()Citify. )3 rile bast or e and correct. n201,3 Citie.olie Flunk AO. Ao eigi+t:• Pentet). W)A 1.91,P3Cre: )2‘3315.OStata CONFIDENTIAL - PURSUANT TO FED. R. GRIM. P. 6(e) DB-SDNY-0077155 SDNY_GM_00223339 CONFIDENTIAL EFTA01379562

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