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efta-01388730DOJ Data Set 10Other

EFTA01388730

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DOJ Data Set 10
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efta-01388730
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EFTA Disclosure
Text extracted via OCR from the original document. May contain errors from the scanning process.
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, SOLE MEMBER b. Name of Legal Entity, Type of Legal Entity, and Address of Legal Entity for which the Account is Being Opened: LSJE, LLC, A USVI LIMITED LIABILITY COMPANY 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 Dote of Binh Legal Address rot US. Persons: Social Security Number For Nomi).S: Prams: I (See footnote I for alternatives to Social Setwey atkenbei) JEFFREY E. EPSTEIN 1120/63 6100 RED HOOK QUARTER, B3 ST. THOMAS, USVI 00802 09044-3348 -- r For Non-U.S. Person& in adohion to a Social Security aimbo: or a Pampa Nude°, With Counlry ['lasso not: on ellen identircorion card numbs:. or molar and comity of issuance of any olive government-issoW WO-event e-:ittenzingi natiractafity Or Tesidenet and tearing a pholograort or similar safeguoto shoutc: 0 orovreieu. Of no individuat meets this defection, please:vita Wet Atpticah:O.1 d. 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. Of appropriate. en individual listed under section (c) above may also be listed in this section (d)). i Nam* !JEFFREY E. EPSTEIN I SEE Date of Beth Legal Address t For U.S. Persons: For Nan-u.s. Pcsons Sotial Security Met footnote I for atleditIWS Nurnoet 10 Satiol Security Number) ABOVE 11 For Non.U.S. Person& in addition to a Social Security Number or a Passport Number with Country of Issuance, on oriels identlficat iOn cord numbr. a number Sid COUIWY iSSUtrott of any other government-Sewed document ear.onemil natiotality as residence am hearing a oho:3gram or sinutte sok-pare should ho provided. m REY E. E TEIN knowledge, that t information Sign Lego: Entity Identifier (OPtketel) ne of natural person opening the account), hereby ce to the best of pve Is complete and correct. 7/24118 Da:C. Srpriv re Signature Name Tale: Mee: 77 14. C IT CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0092454 SDNY_GM_00238638 EFTA01388730

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