Case File
efta-01381131DOJ Data Set 10OtherEFTA01381131
Date
Unknown
Source
DOJ Data Set 10
Reference
efta-01381131
Pages
1
Persons
0
Integrity
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H. Certification of beneficial owner(s)
Persons opening an account on behalf of a legal entity must provide the folbeing information:
a. Name and Tide of Waite a! Pe! son
• •
Zele•Pr-../
h. Name c.f legà Entity. Type ell Leoal E. •
•
Add! ets
Lega: Em;ty freWhe.h the Account is Seine Openect:
fete-,
SzzÂle- Uit.e‘e•-•L -eV
(i
Ca-r
-e-1
c. The folkmeMe, infernation for each indk:idual, if any, wtKi. directly
indirefffly, thro:)h env coninc!;. arranajernern.
understanding, relationship or otherwise, owns 25 percent or more of the equity interests of the legal entity listed above:
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t,
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S - t ..11.
LEV(
alai>
'Of
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amrone
eleoideSteu...zo
i.Seo focoteee I
oireynoci.
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!
Sock, Seoutilt 71Jinter:
.
g0c e‘ct.C...S t.e1cret. uodete toe "<tocOei Sete it", ora.ro.Uo
s 7eIrtelf Citt•nclee with C;oor
Gg 4;,Jame.an aihr:43emezince. nied ',urge!, C.; *erg»;
enuoire seis:Jamb of amf oche goeecone.r.Istuto dotwooto eyo-O,nowoo name:eye cw caltienob and beam ig a ea.:opeh .31 tInoilor :salm/4M diottiln
lto picee-td.
td oindre000t rtlte
anise: an. >tee. ver!to "Mot tentoc.»ti.")
d. The following information for one individual with significant responsibility for managing the legal entity listed above,
SVC% as:
• An executive officer or sergor !nonage: (e.g.. Chief Exc-aitive Officer. Chief Financioi Officer. Chief Operating Ofrefer.
Managing Member, General Panne:. President. Vice President. Treasurer); or
• Any ether ?nt.i ividu& who reoutany performs sk*ar *function.
(if appropriate, an individual listed under section (ra above may also be listed in this seotion (d)).
.Xectt ci bird:
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eor V S. ikirtoott:
&o:al Zoco.e;ty
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,.an fen-sent i« ittetret‘i.r.
re 5'v/14er:wit, ',mote;
;or
Permrc itoorkirtion too Sr-"-:! stKowiietioriber rw t ›assfeet it-weber v:eittiasery of trminnw. ;et, e 2r
zyd ramose,
'WO COVntri Crf icicclancc. e
Cent i)C•rernilet,e.iii acci
tc.ieect.:eg need:eke or foredo/let oro bt•tolnu a otootoleson M Meer Jilin.* d ',hook)
be otopo.oj.
toe f.noto Morten« i000Oran
(name ct natural person opening the account), hereby certify. b we hest of
v;_
bmpiete and twee.
k
Cas
tt
2;128 site,inciie Son'
mane metro wmtee666 (eel) oust»
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
DB-SDNY-0079900
CONFIDENTIAL
SDNY GM_00226084
EFTA01381131
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