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efta-01388732DOJ Data Set 10Other

EFTA01388732

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DOJ Data Set 10
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efta-01388732
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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, MANAGER b. Name of Legal Entity, Type of Legal Entity, and Address of Legal Entity for Which the Account is Being Opened: SOUTHERN FINANCIAL, LLC, A USVI LIMITED LABILITY COMPANY 8100 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: i Nome I Date o! Belli Legal Attdrese I For U.S. Parson: For Plon.U.S.Pnons: 1 Soc Nuiol lbetScourity (Sec footnotes. toe alternatives to Soria: Seco* Number) JEFFREY E. EPSTEIN 1/20153 8100 RED HOOK QUARTER, 83 St THOMAS, USVI 00802 For NoriaUS. Portions. in &coition too Social Security Number or a Nevelt Number with Country of Is$0105Ce. an Oren identification card number. Of twrnifer area boweryof issuance of any Ced ler governtotnt-issued document ev'elcnoing nationally o. residence ono matins a oftatogrape Cr *Nat sainuarc *haulm OS oroviclers (If no inclik'h;almitelj this O4htlitiCa Olen: write 'Not APPliCithin 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. (if appropriate, art individual listed under section (c) above may also be listed in this section (d)). Name f Leo Addrttss I Data of Bath JEFFREY E. EPSTEIN SEE ABOVE For US. Pesono: Social Security Numb& kir Non-0 S. Armour (See foolnote I for ahanativcil to Social Security Number) 1 For Non-U.S. Persor4 in admit ion to a Social Sembity Number or o Passport thentiet with Country of issuance. an alien Identification cans number. or !loathe end countryof issuarxe of any other govetrtment-issoed document tide-wino nationeety or rcoicience end camp a ouotcgrach or similar surecakuo snood be pro.mted. me of natural person opening the account), hereby certify, to the best of ded above is complete and correct. 7124/18 Date ;(ertAw-e Cei Date Sr CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0092459 SDNY GM_00238643 EFTA01388732

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SWIFT/BICLABILITY
SWIFT/BICSOUTHERN

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