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efta-01380833DOJ Data Set 10Other

EFTA01380833

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Unknown
Source
DOJ Data Set 10
Reference
efta-01380833
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1
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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, SOLE MEMBER b. Name of Legal Entity. Type of Legal Entity, and Address of Legal Entity for Which the Account is Being Opened: LSJE, LLC, A USVI LIMITED LIABILITY COMPANY 6100 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: Name Date of Thrth Lagat A.tldress For U.S. POsons: Ede. Non-U.S. Person:: Social Security (Soo footnote t for site, natives Nwnber to Soaith Sec only Plumbeel JEFFREY E. EPSTEIN 1120153 6100 RED HOOK QUARTER, B3 ST. THOMAS, USVI 00802 Fa; NarpU.S. Persons, in acklition Ms Seca! Satiety Number or a Passport Number-with Canntry of lssoence, an alien identification card minter, or number end country of isetance of any other government. issued document mildew:Mg nationality or resit; ence and binning a photograph or sirnaar safeguard shoub be provide°. (If no iatlividual nteet9 IMSOCEMitirt Olease write "NM Applicable: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)). Name Date of Binh j Legal Address ABOVE JEFFREY E. EPSTEIN SEE 1 For U.S. For Non-U.S. Persons: — 1 Social Savants (See footnote?. for akernarives$ Number to Social Smoky Member) I ' for Non-U.$. Persons, in addition too Soctal Security Number ore Passport Number oath County of Issuance.. an alien Modification card number. cementer and country of issuance of anyother government- esiad document evidencing roticausety or reSittetiee end beech:IS dhobagraMI or similar safeguard smolt be provided. Legal Entity Idenlifier {Optienat) 0 e of natural person opening the account), hereby certify, to the best of information ove is complete and correct. 7/24/18 Date CONFIDENTIAL - PURSUANT TO FED. R. GRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0079394 SDNY_GM_00225578 EFTA01380833

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