Case File
efta-01381126DOJ Data Set 10OtherEFTA01381126
Date
Unknown
Source
DOJ Data Set 10
Reference
efta-01381126
Pages
1
Persons
0
Integrity
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U. Certification of beneficial owner(s)
Persons opening an account on behalf of a legal entity must provide the following information:
a. Navne and Title IF Natural Person Conning Pe:onurit:
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b. Name, ot Legal Entity. 'Typn Cif Le.2ai (flit. ane.? AC-dmes ol*Lege! Entity to, kkit..•;Cli the Account iS Being Opened:
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fo”owino information for each indiwiva1 if arw. who. direeey or Mdirectly. through am( c.oritmet. arrangement,
lip or otherwise. owns 25percent or more of the equity interests& Me legal entity Mixed above:
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:1. The following Information for one Individual with significant responsibilhy for managing the legal entity listed 31.11.%fe,
ate_'! 3B.
• An ii)niitffifVf5 officer or serCor iranaeer (e.g., Chief E,cecutive
Chiet Financial Officer. Chief Operating, Officer.
Managing M9Illb-ail Genen* Partner, Presidens, Vice President, Treasurer): or
• Arc other ;ndividua who ree,blarly performesfra ar (iicetexit
(II appropriate. an individual listed tender secttn (*above may also be listed in this section (d».
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.._knar d of natural person opening the account). hereby certify. to the best of
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CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
DB-SDNY-0079895
CONFIDENTIAL
SDNY_GM_00226079
EFTA01381126
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