Case File
efta-efta00601794DOJ Data Set 9OtherENDORSEMENT
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DOJ Data Set 9
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efta-efta00601794
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ENDORSEMENT
Date: May 1, 2012
Endorsement: Effective as of Anniversary Date: May 8.2012
Attached to and Forming Part of Policy No: UMOO
S26
Issued by: Xt. Specialty Insurance Comoanv
For the Account of:
Leon Black and Debra Black, etal
It Is understood and agreed that the NAMED INSUREDS are hereby amended to read as follows:
Leon Black and Debra Black and/or Pent Holdings, Inc. and/or Narrows Holdings, LLC and/or
Black Family 1997 Trust (Debra Black, John Hannan, Anthony Ressler, Barry Cohen, Trustees)
and/or Leon D. Black Investment Trust A (Leon Black and John Hannan, Trustees)
and/or Benjamin Eli Black Trust, Joshua Max Black Trust, Alexander Samuel Black Trust
and Victoria Rachel Black Trust between U/AID November 30, 1992 between
Leon Black, as senior and Debra Black, Barry Cohen and John Hannan, as trustees
and/or Benjamin EN Black Trust, Joshua Max Black Trust, Alexander Samuel Black Trust
and Victoria Rachel Black Trust between U/A/D August 1, 1988 between Leon Black, as settlor
and Barry Cohen, as trustees, ALMA
All other terms and conditions remain unchanged.
In Witness Whereof, the Company has caused this endorsement to be signed by a duly authorized
representative of the Company.
WELLS
FARGO
Wells Fargo Insurance Services USA, Inc.
epresentatIve
7
EFTA00601794
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