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efta-01594873DOJ Data Set 10Other

EFTA01594873

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DOJ Data Set 10
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efta-01594873
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EFTA Disclosure
Text extracted via OCR from the original document. May contain errors from the scanning process.
Non -Special Entity Attestation Form J.P.Morgan This Certification Regarding Special Entity Status (this "Certification") is required to be made by clients entering into a derivatives relationship with J.P. Morgan. In order to engage in a derivatives relationship with J.P. Morgan, the Client must certify to J.P. Morgan that it is not considered a Special Entity for purposes of the Dodd -Frank Wall Street Reform and Consumer Protection Act (the "Dodd -Frank Act"). Prior to making this Certification, the Client should perform appropriate due diligence and, if necessary, consult with legal counsel, in regards to this Certification. This Certification should be read with the Derivative and FX/Commodity Transactions Regulated by the Dodd -Frank Act and the Bilateral Dodd -Frank Agreement, as amended, supplemented or replaced from time to time to reflect changes in applicable law, regulation and industry standards (the "Agreements"), both of which are incorporated by reference. The client acknowledges and agrees that (i) the information set forth in this Certification is true and accurate as of the date of the making of this Certification; (ii) in the event of any material change to the information set forth in this Certification, the Client will contact J.P. Morgan and update the Certification in a timely manner; (iii) the information set forth in this Certification is, and shall be considered in all respects, Relevant Information pursuant to the Agreements; and (iv) J.P. Morgan will rely on the information set forth in this Certification in evaluating whether to enter into a swaps relationship with the Client. Notwithstanding any provision set forth in the Agreements, any disclosure given hereunder which is incorrect or misleading in any material respect or which is rendered incorrect or misleading by the failure of the Client to update this Certification on a timely basis may be considered an event of default of the Agreements by the Client and may give rise to termination and/or reversal by the Bank of any Swap made in reliance of this Certification. (a) The client is the following entity type (check one): n A Special Entity', as defined below. El A tax-exempt organization filing under Internal Revenue Code Section 501(c)(3), which is not an endowment. IR Neither a Special Entity nor a tax-exempt organization filing under Internal Revenue Code Section 501(c)(3). (b) Was the client created (check one): IT By a public official, entity, or authority through an action pursuant to such person's official capacity or directly or indirectly through authority or direction of law (e.g. through legislation, regulation, court order, or other similar authority)? F. By private individuals or entities, unrelated to a public official, entity, or authority? (c) Is any person responsible for or otherwise holding direct or indirect influence regarding the client's selection of J.P. Morgan to act as a Derivatives counterparty and/or to provide a Derivatives Account (including, but not limited to, the client's directors, management, investment managers, or other authorized persons or employees holding such iespunsibflity or influence): EFTA01594873 17 A public official or public employee acting in his or her official capacity or directly or indirectly selected or appointed by one or more public officials in their official capacity or by individuals directly or indirectly selected or appointed by one or more public officials in their official capacity? Frj None of the client's employees or management or any other person holding direct or indirect influence over the client's selection of J.P. Morgan in regards to any Derivatives services or accounts are subject to public integrity rules/codes of ethics or reporting requirements or selected or appointed by others subject to such rules. 'A Special Entity is any of the following: A Federal agency; A State, State agency, city, county, municipality, other p0/ft/cal subdivision of a state, or any instrumentality, department, or a corporation of or established by a state or political subdivision of a state; An employee benefit plan subject to Title I of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1002); An endowment, including an endowment that is an organization described in Section 501(c)(3) of the Internal Revenue Code of .1986 (26 U.S.C. 501(c)(3)); or An employee benefit plan defined In Section 3 of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1002), not otherwise defined as a Special Entity, that elects to be a Special Entity by notifying a swap dealer or major swap participant of its election prior to entering into a swap with the particular swap dealer or major swap participant. The undersigned,' on behalfNc_the Clierjr.,--h) certifies that s/he has reviewed the information set forth above and that such information is/true and correct stiate of execution of this Certification; and (ii) agrees to the provisions set forth above in regard to . tnis ceruncanon. c*, r*, c=> Signature -(Accountholder) —10'-'13 Date Jeffrey E. Epstein Print Name Signature (Accountholder) Date Print Name Signature (Accountholder) Date Print Name Signature (Accountholder) Date Print Name J.P. Morgan Use Only 1 of 1 SOUTFIERN TRUST COMPANY, INC Title SPN CAS Banker/Investor 6/13 1663 EFTA01594874

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