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efta-01381126DOJ Data Set 10Other

EFTA01381126

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DOJ Data Set 10
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efta-01381126
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EFTA Disclosure
Text extracted via OCR from the original document. May contain errors from the scanning process.
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: .3—e-Wqrc•-f fs‘ År•et," i Pere b. Name, ot Legal Entity. 'Typn Cif Le.2ai (flit. ane.? AC-dmes ol*Lege! Entity to, kkit..•;Cli the Account iS Being Opened: TE G E- , c.. ‘be (a (ot 00 Q. kAticAh a-tv-, 83 S4-• ‘ -"Lest.ta.0 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: r +to p;:,! ,e;:: rAtt”iw ....1L•Vil it' Seemib 'Ante') 6lt:(0 eat k4...4ZO..)".+er, 93 6-‘zlick,1/4 tised C3 s3/4-. s ) °cut OOloa. is•90 —4*- 311-eSr- i=f7 tcricim. rnis -thzin in.1 St•iciti "funibef .•tuffibevniitil COnnti V Of ;tiara MItsCSI IOMIXFX-1;iCM inwnba. IMMtAt MIOCOUIII, of iesucibiief mrf :sin« vion~nani-ifAtind dnrument evinfincinii; nimionahVy Of MOLIOOPOIOOd olfmogript; of ninitar 'AfInfratil nifnintf (If no a'W4dial mi/St I Illt CMIHMKIX. etan pirVP Apptialtiki") :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». f.f.tcni! : ti<i ffacrin:vf 1err.14 !>oØ FM! LE S. ;MX50".. RO USO RN xt--4: iiirrarnn t:iaetx!rro;elianhmrnn.mf %nintpit iv SfrJ.liStvenntv ~if )1-.J1`,1J-t?. RXIOXIA. 'SIX9Of NOOMM ~fey:Jin, rain iv-mint...a riiirntiff am country of &unmet nf any oeini atniznnineni-filivii<lchicurnein n.inennini nanmulY.r vr vviaii(ne 'Ind !Xining finny:n.3(.54. nfnniir tfitivinfrif vhifolif p-in•enkt. .._knar d of natural person opening the account). hereby certify. to the best of Knot: ed ovided NlY`,Ve. is Ltriplete and ctrl %; Untal ,Snaty tuentfriw ioccone t ft 20ai nsi Ael. s intjr.,nf. 'M114666 td&is eft I31.9 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0079895 CONFIDENTIAL SDNY_GM_00226079 EFTA01381126

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