Case File
efta-01381081DOJ Data Set 10OtherEFTA01381081
Date
Unknown
Source
DOJ Data Set 10
Reference
efta-01381081
Pages
1
Persons
0
Integrity
Extracted Text (OCR)
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. NRITIO end Tide of Natural Person Opening Account,
17c
Cebiret aig s•••••4 kt-t-,-Te-,SA-
—se..., ,r......... 3-01 wcalitv
Entity. Type of Lege! Entity, and Address of Legal EinV:y for Which the Account is Being Opened
•
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-
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)
h-.3 fc4hw;ng information for each inclivithial.
any, who, directly er indirectly, thtry.41h any oentract, rengernent:
relations?•:n v c•me•
Se. owns 25 Percenr O: . more of the equity interests of the legal entity listen above:
;:er VS :trots.
kat von. US. AUttie,•:
Sill`2-7:*`;
*3n ffrof rota 1 fvan (4P3 Titr.
n!locial Stant. !anneal)
3;4441 E•EPelYnh
Cato
S 3tra
too igah geuvawker, €3
-
US V( ootoa r.v.LI•••et• fPo.S.Crev+
•N :i.:,.••;) a at!EXT11. .13:301 et: ,O ttr 4
Irarl,..!
f ,tfr Lnnt!!raffon raid rumbe-_1:r 11.þritt end cunt,of fs.uoince oiarzytflheccovArfunOnf- fLmged dOtainnf't evene'Lltii
nta.sfince end Winn 4 1,110:09f.nik. Of
to:nkl
be
Of ro .rarmelLni meets Um; acfiretion. Ovate resin ' Hot Aoolitliole.1
d. The following information for uneindividuai with significant responsibility for managing rho iegai entity listed abave
such as:
• An executive officer or senior manager (e.g., Chief Execufive Officer. Chief Financial Officer, Chief Operatin Oniter.
Managing Member. General Partner, President, Vice President, Treasurer); or
• Any other individual who regularly mforms Shliffaf functions.
(If appropdata, an individual listed under section (c) above may also be listed in this ieetInn
Horn.
fAiesot. Da wc4-• uleo.o ;".• :
xtfrion end “"2,' • r•. Oda Y gert.rozvt!,,It,ni C5N.uwtre rie).Snj ratiNwt eir te.Leiteltt tiro
•
-
p
,occ.
Oaf it of Son is # Arfort.slf rot ll.s.f!nars.
&tn.!! iscurk, umber
For Non.t!..S Pown
&if !'xonn.
to
.e.•M•ete
(na my •ulowiedge, tnartho nation pro‘tieed above b'ff'..braf!!
'
in; Endo :dengrito (OPtIonai of natural person opening the account) hereby certify, to the best of
complete and correct.
()201E ow:rev Hank 46.. AI nonn
1,..411898(fe 02$819.C61319
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
DB-SDNY-0079828
CONFIDENTIAL
SDNY_GM_00226012
EFTA01381081
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