EFTA01583493

Form ol Asset Ownership Coroccabon Data cd In:crawsdm. )4itZ230T SID . Organization Code. 33242 Account Officer Code: 033 Employee Accourt Marton Segment Coda OM: 99 FX SAC Coda 9999 %barn NINI4en %SW Pang...id Market Segment Cods Tow 38 Tax ID: 32-0201294 Appian1 *ppkat 2 Applicant 3 Applicant 4 Doss CU ID End? Yes CAS tO a 0220534454 Applicant Ian: Pan 0. Inc Tat &SU: 324201234 II Clint Ceetliadt Yes Cartrricadwe COS: l Olen& cn F re Cnruhcation Oa: 04/2C470C 7 Type Or Ceelikatiort: W.9 it %II StalO type II Vs' a NRAft TOO Ctuenshiplauntry US Lrisial Domicile UNITED STATES Sate of Legal Risschince. Inotcpcation Truitt Mimed') WITTED STATES Citrary of location to Treaty Bent C rnolelarl No A( rano We iraormairwiCommemt Stale Detre re tats a Dacationary Account? No Legal Seas . Choose Address.. ' 209 Chancre Sent ri rinfrOn Coseny el New Castle 19.80t Ocean Telephone Numbot(s): Aid Modify Delete 'elephon• Nurneedld " No Tett:none Nvnbers Spec:See Relationship Team Liam inform allon Region Irw VOA Bards Privy C CaseiflaiASE Chet Sawn Team: Reel P Malty Carol R Senoll CU Ann Code: Confidential Treatment Requested by JPMorgan Chase JPM•SDNY•00063172 EFTA01583493