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efta-01388728DOJ Data Set 10Other

EFTA01388728

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Unknown
Source
DOJ Data Set 10
Reference
efta-01388728
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1
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EFTA Disclosure
Text extracted via OCR from the original document. May contain errors from the scanning process.
Leo Entky idenaiier (Optional) II. Certification of beneficial owner(s) Persons opening an account on behalf of a legal entity must provide the following information: a. Name and Title of Natural Person Opening Account: JEFFREY E. EPSTEIN, PRESIDENT b. Name of Legal Entity. Type of Legal Entity, and Address of Legal Entity for Which the Account is Being Opened: J. EPSTEIN VIRGIN ISLANDS FOUNDATION, INC., A 501(6X3) PRIVATE FOUNDATIONIUSVI CORPORATION 6100 RED HOOK QUARTER, B3 St THOMAS, USVI 00802 c. The following information for each individual, if any, who, directly or indirectly, through any contract arrangement. understanding. relationship or otherwise. owns 25 percent or more of the equity interests of the legal entity listed above: Name NOT APPLICABLE I Date of Sidi" Legal Address 1 Fo' U.S. PICSOIS: Social Security Number Fit NcrpU.S.Persans (See lootnote t to' alternatives! to Sotia!Seorizy Niger:Carl 1 NoMIS. Persona. In addition to a SeedSorority Numbor or a Pasapoit Plumper witn Country of issuaniA on alien iaeoPftallon tato number. Cr *WV& and country of issuance of onY dinar gOvernioloo:453444 doeuntent evickekPev neEtnabty or lasktence and tearing a ahocapr pn oak/nerd shoub be provided. (11 IX) inekiChlall meets this Odinnion. pease write 'Not AoPhoebt•-) 0. The following information for one individual with significant responsibility for managing the legal entity listed above. such as: • An executive officer or senior manager (e.g.. Chief Executive Officer, Chief Financial Officer, Chief Operating Officer. Managing Member, General Partner. President. Vice President Treasurer): or • Any other individual who regularly performs similar functions. (If appropriate, an individual listed under section (c) above may also be listed in this section (a. I NMI* . Date of afro Loco Address ! I For U.S. Perin Soda( Sappily Norntter 1 - 16100 RED HOOK QUARTER, 83 JEFFREY E. EPSTEIN 11/20/53 4 I ST. THOMAS, USVI 00802 P=. For Nott-U S. Fano= (See footnote! for allUnarivosi to Seta Securitv NU:Ube* • For Non-V.S. Persona in addition to a Socui Security Nunn*: tri a Passport Number with County of Issuance. en alien identilication card wear, or ramiber one county of is of anyeine: gam ntnera-istvad aoarnent otnatrting nittiOnsfity Of mikterat anti IkMetng a onotovaon or 3,014Y saff‘ogurc shout be DMA:Wet a of natural person opening the account)• hereby certify, to the best of is complete and correct. Signatur 7/24/18 4 srplitc. 044 Na Title: Dole: CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0092450 SDNY GM_0023134334 EFTA01388728

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Phone3134334
SWIFT/BICCORPORATION

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