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efta-01380837DOJ Data Set 10Other

EFTA01380837

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DOJ Data Set 10
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efta-01380837
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EFTA Disclosure
Text extracted via OCR from the original document. May contain errors from the scanning process.
Legal Entity Identdier Motional! II. Certification of beneficial owner(s) Persons opening an account on behalf of a legal entity must provide the following information: a. Name and Tine 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: J p6 r`LAN 0, LLC, A USVI LIMITED LJABIUTY COMPANY 100 RED HOOK QUARTER, B3 I 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: Nome I Date of Birth I legal Address For U.S Person' Social Security Number For Non-U.S. Persons: (See footnote: for ofteinatives to Social Security Mantel I JEFFREY E. EPSTEIN 1120153 8100 RED HOOK QUARTER, B3 St THOMAS, USVI 00802 I H I ' For Non-US. Persona in addition to a Social Security NtaAIW of a Passport Memo( with Country of Novara an ellen identification card number. or number and county of issuance of any other govammormiseued document oriels:fen nationality Oe tatacIONNI and taadog a la\atMartieh a Wa'aricaole9LfOra should to provided. (If no indivioual matt tnis definition. Weave of itio 'Not ArMlicablen 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)), Nome I Dam of Bath legatAtcaess For U.S. Persons: Social SeatrAY Number For Non4l S. Pinions (See footnote I for laanethattS to Social Security Number) i JEFFREY E. EPSTEIN L___ SEE 'ABOVE ' For Non-US. Persona in addition to a Social Security Nwmber or a Passport Nismber with Cmuntry of Issuance. an Oen identification card nuffair. or marker and country of issuance of any other government-issued document evidencing rationality or oesidenoe and blaring a photeemaa a rims safeguard should be provided. ural person opening the account), hereby certify, to the best of °rotation e is complete and correct. 7124H8 Date CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0079398 SDNY_GM 00225582 EFTA01380837

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