Case File
efta-01381917DOJ Data Set 10OtherEFTA01381917
Date
Unknown
Source
DOJ Data Set 10
Reference
efta-01381917
Pages
1
Persons
0
Integrity
Extracted Text (OCR)
Text extracted via OCR from the original document. May contain errors from the scanning process.
Pre
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 It Natural Person Conn no Pe:onurit:
‘ A-
-t
e
b. Nome ot Legal EntitY. 1.,ifi n Cif Le.2ai Entfrn ancl AC-dross ol* Loge! Entity to, vdt..•;Cli the Account iS Being Opened:
TE G E- , c..
‘be. I 0,..›are_
(ot OO Q. kAticA.c.
a-tv-i 93 t tØaL foeow;no information for ea0h indiinduak. if arw. who. direeey or Mdirectly. through arrk c.oritraet arrangement
urdemioi.• 5. -c •,::it)t..;r, I lip or otherwise. owns 25percent or more of the equity interests& die legal entity gem( hbovb:
5:fins swit
For ecnoui:
soce;Setioc,
: €.$4.? k.^.1L,(46 fitMf2tti
..,rnet io Social Secnont I:ulnInn
C>lt:(O ea& k4...105)..).trier, 93
6-‘zlick,1/4 tiso1C3 s3/4-ritt,1/2, 5 )1/4.xut oc>toa.
kn' tensent r110-"then 1n.1 StnCIt.I I4itte/IIZy "Iunitin C. PI I;JOepOit .•tee'nbertitil CrWIltil'r of inklara
tSCO lOODOWEICF. nod foonfic. ar OziOttOr af4 COUllt, of Bosom:fief mrf whir Quw~nen!-KtInd dnrunwnt evinnfinenr; nnuonaky or f•ELIOMXMOOd DOIIIIIIflo.pflxogopt;
VAXXI: meminenl Want/ inn ,:eåetret
(II no ~dual meet Illit LYIItItCn, perane nrrQn 'NG! Anpnalbe!')
:1. The following Information for one Individual with significant responsibility for managing the legal entity listed 31.11.%fe,
ate_'! ae.
• An r)nliCIItieW officer or serCor franaeer (e.g., Chief Exroutive OffiIXII. Chief Financial Officer. Chief Operating, Officer.
Managing M9Illb-ar, Genen Partner, President, Vice President, Treasurer): or
• Arc other ;ndividua who regularly bait:ohmBlitslav funetexie
(II appropriate. an individual listed tender secttn (*above may also be tisted in this section 0».
r.l.tne?
:
er3h:h eri ,nacric-es
1err.14
!>oØ re's* LE S. ;11nence.
IinnUSe
Are' rSuiå4:;u!7:
enenrnegn
;Ave.-Anne.
%tige«
IQ Sncill Stecunle ',1urnten, g;),' rtr.s‘n
?I‘oi‘O; :X O
NOISIXE *chi:centre of '31,OXO4, 'Xi SONO kX.0~.O.E' rwo foriiina numb,*
arvr COLIOtre of inseinnee et any new ‘,burtninenr•I'morrlOOCIXOC/X nelnennini neonnslitti er .enirlonne /Ind OfOring a onoi.of.ron of omits
if-io,odiin
.-----(nar a of natural person opening the account). hereby certify. to the best of
Knot:led ovided ni%tVe. Ltriplete and cfri^a..:t.
loaoi ff nob toonfierieioncine t ft
4,‘ 20ai
Rini AO. Ad s f61,4n,o(f. WM1 466'6 fr1efs if erii31.9
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
DB-SDNY-0081125
CONFIDENTIAL
SDNY_GM_00227309
EFTA01381917
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