Case File
efta-01583343DOJ Data Set 10OtherEFTA01583343
Date
Unknown
Source
DOJ Data Set 10
Reference
efta-01583343
Pages
1
Persons
0
Integrity
Extracted Text (OCR)
Text extracted via OCR from the original document. May contain errors from the scanning process.
Apr•M-2013 (1,9:06 AM JPhiergan Chase 307•Ci34-4580
Special Consideration Form
r)
T.
It]
P Morgan
Instructions:
For Consumer and Business Card, fax C0Mpeted tort and apollcation to 1414404744108i
For ConsumeoBusiness Cards for al Ladn Arnerktan Chests, promo c- -rail the competed form and
applicabon le rfsbtution list: 'SrAscial SW/Zeta NY'
Section 1: Line of Business: (select one)
J.P. Morgan Private Bank
C JP. Morgan Private Wealth Management
Q Chase Private Client
J.P. Morgan Securities
C J.P. Morgan Law Erm Program
Section 2: Type of Inquiry (Oleos me from oast section below)
A) 0 Domestic
0 triternstional
8) ['Consume,
C) CI New Application
Fl Business
Reconsideration
0 Credit Limit Increase (Account * 4116315 7060810" mitt)
Credit fiat Requested:
4140.000
Section 3: Banked' information: {con:Oita all fields}
Today's Date: 028/2013
Requester Janet F Yourg
E-Ma I Address ph-sentx13 8
Phone Number.
Standarc II)
Section 4: Applicant Information: (canplese ell reteart (its)
ECI-
CAS ID:
Nan* of App icart
Authoriang Cificer Jeffrey Epstein
Business Mayne: I-SJ. LLC
Social Scanty Number or MN:
Tax idoritifcaticm Number mar
USA Patriot Mt (USAP) I' no Social Sosurtty Numbs, or Inn, Chars* Can ScrvInti IS **ins -O to cosecs the rollatsing
man's:
Identification Type r:s.
Idenliltatim Cart or abbea apperaped Gyonnyerd Itx,ed Prot.; Or
• IdeMfficetIon Number:
' Country Issued By:
Issued Dale:
Expiration Date:
ApplicantsiComporyi physical address (it ciffiesnt or ins appleatcd);
Present Empbyer.
Occupation I Pusilion:
Tyne wit Present Employer:
yrs.
mantis
'Gross Annual Income: $
Business Income' S
stallecry.
supnan. Gs separate meintenaeop ner4 ncA be irnaidea It yru abed
with 19 cagy on b. Cron ittetali Won is 'WWI. ltd you an able it usaa wt
rePtYrr9
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..fl. natal Sioaairbes, Sods Seca/ berets sea ntremert ocaeLnas
Net Worth (cisuelre Pernora Reladence; S
Investable Assets 3
Section 6: Depository/Investment Relationship Information: emits u matt Math rce as wank
waxen Wan r needed)
Account Number
Type
Balance
Open Date
• Indicates Raw&
Confidential Treatment Requested by JPMorgan Chase
JPM-SDNY-00062992
EFTA01583343
Technical Artifacts (2)
View in Artifacts BrowserEmail addresses, URLs, phone numbers, and other technical indicators extracted from this document.
Phone
4116315Phone
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