DS9 Document EFTA01193775

S H R SECKENDORF /LAWN & REDLY, CPA'S 1.1.0 Plow: rat June 26, 2014 JEFFREY EPSTEIN 6100 RED HOOK QUARTER B3 ST THOMAS, VI 00802 VIRGIN ISLANDS Dear Jeffrey. Enclosed for your review: Form 114 Report of Foreign Bank & Financial Accounts Each tax return or form listed above should be filed in accordance with the enclosed filing instructions. Please be sure to call if you have any questions. Sincere)z i DAV . HASSON, CPA EFTA01193775 2013 FEDERAL FILING INSTRUCTIONS JEFFREY EPSTEIN FORM TO FILE: FORM 114 - REPORT OF FOREIGN BANK AND FINANCIAL ACCOUNTS THE ABOVE TAX RETURN WILL BE ELECTRONICALLY FILED WITH FINCEN, DEPARTMENT OF THE TREASURY FINANCIAL CRIMES ENFORCEMENT NETWORK, UPON RECEIPT OF A SIGNED FORM 114A. PAYMENT: NO PAYMENT IS REQUIRED. TIMELY FILING: A FOREIGN BANK REPORTING FORM 114 MUST BE 'ACCEPTED' OR 'ACCEPTED WITH ERRORS' BY JUNE 30, 2014 FOR THE FINANCIAL CRIMES ENFORCEMENT NETWORK (FINCEN) TO CONSIDER IT TIMELY FILED. IF AN ORIGINAL FORM 114 IS E-FILED AFTER THE JUNE 30, 2014 DEADLINE, THE LATE FILING EXPLANATION PORTION OF THE FORM 114 MUST BE COMPLETED. FINCEN CAN LEVY PENALTIES WHEN THE ORIGINAL FOREIGN BANK REPORTING FORM 114 IS E-FILED AFTER THE DEADLINE. IF THE FOREIGN BANK REPORTING FORM 114 IS REJECTED IT MUST BE RESUBMITTED AND ACCEPTED BY THE FINANCIAL CRIMES ENFORCEMENT NETWORK (FINCEN) BY JUNE 30, 2014. THE FINANCIAL CRIMES ENFORCEMENT NETWORK (FINCEN) DOES NOT ALLOW A PERFECTION PERIOD FOR CORRECTING REJECTED SUBMISSIONS. IF THE ORIGINAL FOREIGN BANK REPORTING FORM 114 E-FILING IS 'REJECTED' BY FINCEN AND THE SUBSEQUENT E-FILING OF THE ORIGINAL FORM 114 TAKES PLACE AFTER THE FILING DEADLINE, THE LATE FILING EXPLANATION PORTION OF THE FORM 114 MUST BE COMPLETED. IF THE FOREIGN BANK REPORTING FORM 114 IS 'ACCEPTED WITH ERRORS' BY JUNE 30, 2014 DEADLINE, FINCEN WOULD LIKE TO SEE AN AMENDED FORM 114 E-FILED WITHIN 30 DAYS EFTA01193776 Form 1 1zia Department of the Treasury Financial Crimes Enforcement Network (FinCEN) October 2013 Record of Authorization to Electronically File FBARs (See instructions below for completion) Do not send to FMCEN. Retain this form for your records. IALN .1 l se \ vac 0 43 Pert I I Persons who have an obligation to file a Report of Foreign Bank and Financial Account(s) 1. Owner last name or entity's legal name EPSTEIN 2. Owner first name JEFFREY 3. Owner PA I. 4. Spouse last name (if Jointly filing FEAR - see instructions below) 5. Spouse first name 6. Spouse M. I. Uwe declare that 'Ave have provided information concerning 2 (enter number of accounts) foreign bank and financial account(s) for the filing year ending December 31, 2 013 to the preparer listed in Part II that this information is to the best of my/our knowledge true, correct. and complete; that Uwe authorize the preparer listed In Part II to complete and submit to the Financial Crimes Enforcement Network (FInCEN) a Report of Foreign Bank and Financial Accounts (FBAR) based on the information that 1/we have provided; and that Uwe authorize the preparer listed in Part II to receive information from FInCEN. answer inquiries and resolve issues relating to this submission. lAve acknowledge that, notwithstanding this declaration, it is my/our legal responsibi ity. not that of the preparer listed in Part II, to timely file an FBAR if required by law to do so. 7 et signature (Authorized representatNe if entity) NA t BDate 9 Owner or entity TIN 10 TIN a typo b C U EIN 0 SSNIITIN Foreign mar DD I Wye 11. Spouse signature 12 Date 13 Spouse 11N 14 ym a type b c EIN r SSWITIN Foreign swop i YYrir Pait.01 . . . Individual or Entity Authorized to File FBAR on behalf of Persons who have an obligation to file. 15. Preparer last name CPA 16. Preparer first name DAVID 17. Preparer . 18. Preparer PTIN 19 Address 20 City 21 State 22 ZIP/postal code 23 Country code 24 Preparers (item 15) employer's (Entity) name STIR, CPA' S LLC 25. Employer EIN 26. Preparers signature Instructions for completing the FBAR Signature Authorization Record This record may be completed by the individual or entity granting such authorization (Part I) OR the individual/entity authorized to perform such services. The completed record must be signed by the Individual(s)/entity granting the authorization (Part I) and the individual/entity that will file the FBAR. The Preparer/filing entity must be registered with FinCEN BSA E-File system. (See httpabsaefilingfincen trees gmernain.htne for registration). Read and complete the account owner statement in Part I. To authorize a third party to file the Foreign Bank and Financial Accounts Report (FBAR), the account owner should complete Part I. items 1 through 3 (as required), sign and date the document in Part I, Items 7/8 and complete Items 9 and 10. Accounts Jointly Owned by Spouses (see exceptions in the FBAR instructions) If the account owner Is filing an FEAR jointly with his/her spouse, the spouse must also complete Part I. items 4 through 6. The spouse must also sign and date the report in items 11/12, and complete items 13 and 14. A third party preparer may be one of the spouses of the jointly owned foreign account. In this case, both spouses must complete Part I of form 114a in its entirety. The third party preparer (spouse) that will file the FBAR on behalf of both spouses will complete Pan II in its entirety (do not use such terms as see above, or same as Aem number x ). Complete Part tl, items 15 through 18 with the preparer's Information. The address, items 19 through 23, is that of the preparer or the preparers employer If the preparer is an employee. Record the employer's information (if any) in items 24 and 25. tf the emperor does not have a PTIN, leave item 18 blank. The third party preparer must sign in item 26 of Part II indicating that the FBAR will be filed as directed by the authorizing authonty. The person(s) listed In Part I. and the person listed in Part 11 as authorized to file on behalf of the person(s) listed in Part I. should retain copies of this record of authorization and the filing itself, both for a period of 5 years. See 31 CFR 1010.430(d). DO NOT SEND THIS RECORD TO FinCEN UNLESS REQUESTED TO DO SO. BAA PDMb3OIL *mans Rev. 10.4 July 11, 2013 EFTA01193777 DO NOT MAIL FinCEN Form 114 Department of be Treaty 06B no. 1506.0009 (Rev September 2013) Filer information 2 boo or now &Drabber b LI Partnership c K Corporalbn d III Consoldated • 11 Flabby a Other — Enter type --- MUST BE ELECTRONICALLY FILED REPORT OF FOREIGN BANK AND FINANCIAL ACCOUNTS Do NOT tile with your Federal Tax Return Do no1 use previous editions of this form ********** 1 Ths report as tor calendar year faded 12/31 2013 Amended n 3 U.S. Tarawa identirmatico Number it Net Are no U.S. Menbllubort Martha =pick awn I 3a lb type ourWINN DEIN 4 Fors* ideracabon (Comp4te • Timm 9Pa:sport heron:oar only Waste 3 a nal appkabte) Li Foreign TN 111 CP-or 5 Intlittettco te rty 4 dale *to 1/20/1953 e County of Issue 6 Last Name or Orgernatmo Name EPSTEIN 7 First Name JEFFREY If Middle Initial Pa Sulfa 9 Meat address guar& steel, and apartment or suite number) 6100 RED HOOK QUARTER B3 10 City 11 Sate 2APossel Code ST THOMAS 00802 It Cony VI 142 Does Me tiler have a enamel Interest at 25 a more 4nalfdal accounts? El be Enter total number of accounts Do not complete Pad ■ a Part Ill, but mantel,. words of he annollon. tio 140 Does the tiler have samba eutfority ow bre no finendal inbred In 25 or more financial accost? Ye, Enter total rumba of accounts Complete Pon N. items 34 fr00/7 43 for oath corset on bob beholf trio fib has sanative autainty. it rata:4 Information on financial accounts) owned se rately 16 Maximum Lebo of account &tog calendar see 166 Ano int 16 type wow* • plank (See instructions inlet Monetary amobs, step 2) L a K b I 1 Sat C jails — &Sr bye Lab 17 Pbrra of Finatcial Institution In which account a mu PART II INFORMATION WILL PRINT ON PAGE 2 18 Account nubs( a ober desIgnetion It /tido; address (number, beet. or suite numbed rd loancial Instabon a ankh bomb b nab m City 21 Sato. of knob 22 Fargo postal coded: lumen n Country $IgflatUnti1;: ..., 41a Check hen x il Ws report s completed by a bra part' preparer and canceele be third fairly oreperer sector.. 44 Filer Signalise tae resod will be eimitronroelly ;caned when fled 45 Filer Tile, if not reporting a personal account 46 Date (laVDCMYY) 1lb date ell auto-al bin the /BAR a electronently signed Third Party Pr(parer Use Only 47 Prep/rah last nave CPA 418 Fist robe DAVID K 611 MI SO Check. seibemplcbd if 51 TN 514 Tile type SWUM E3 Fort I Resign $2 Corsa Ftion na 52•Ed 53 tem% nun 54 Form's TN 54a TIN bib x po . ' SHR, CPAS LLC Fawn ta Man address (number. sheet apartment or sub raters 5$ Cfty 57 SOW SO ZIP/Postal Code 51) Country Us This sho..d be used to report a Marcia/ barest n, signature aulhriy. Or of outlay over bowmen, financal boast in beryl babies, as required by It Depanant or the Treasury Regulation 31 CFR 1010.350. No report is require:1ft* aggregate value ol elm accounts did not exceed 610.030. Sea intirsetions la definitions. PRIVACY ACT AND PAPERWORK REP chat ACT NOCCE Pursuers to to reptinalogie el Public Law 93-579 (Privacy Ad of 1974), notice is hereby green that the baba& to cab information tin FtrCei Form 114 m ecoordenos with 5 USC 562a (5) is Public Law 91.916; 31 USC 5314: 5 USC 301; 31 CFR 1010350. The principal purpose for conecbra et Obviation is to assure botbance of reports varse sum reports or records awe a MO decree of babas in criminal, la ce regulars inviatIcabors or peoreedwgis The Irsormaton coaled may be prefab to Vase aria AM employees of any at ignitors rant or the Department d tie Treasury who obtained for the wont in be performance of fhb dubes. Tte records may be teemed to any other department or agery of rte Untied Slates upon the raters of be head of such depaftnent or wan for use in a crtracal . tie. a nigulakey investfoston a proceeding. The informabb retorted may also to provided to arstopria stale, local, and foreign low onloromett and regulars)! personnel In the pelican/at ol they nniuel dubs. Orman at Nor lagiviblion is mardAlay. Chit end cumin.* umbras. includam in rotten cranstances a fete of not nate tan 3500,000 and inprlsonmers of rot more ban be yaws. ate presided for failure to Plainest:rt. for late et sup* inkemalion. and tae ang a false or karsioient resort. Disclosing of be Social Seaway media is mandatory. The attrxily to soled a 31 CFR 1010.360. The Social Scanty numb( will be used ass means to idareify the otivitsai who furs ere report. Tie mangled .reface bunion assonatec with Ors col bake ci mkernalltm is 60 Wrenn per respondent a record keeper, depending on insivuow cituralbinCeS. Garments regarding the accuracy of Ns bubo ntirnat. and subbsbons to reducing tie grab should be mods to to Finarcial Crimes Enforcement Network...Box 39. Vienna, VA 22183. Alb Office of Regiblory Poky. BAA FEAA13201L CigeC6/14 Rev 5.7 - 6/3F2013 EFTA01193778 ********** DO NOT MAIL --- MUST BE ELECTRONICALLY FILED ********** 'Part II l Information on financial account(s) owned separately Complete a separate block for each account owned separately Add an additional Pad II page as many times as necessary in order to provide information on all acoaunts FinCEN Form 1M Page Number 2 of 2 1 Fling ha carobs/ year 2013 3-4 Cheat appInglak identicaten number g Ts 1448« MantillostIon Number D Farer iderstificabon numben Enter dentication numb« hens: 6 Last name or °manta/Ion mires EPSTEIN Maximum value el account donne csaardar yew (Ste imataltaa radar Member annarts, alert 2) 111,425. 15a Arent streerme 16 Twee/faeces« a .118ank b I ISecvties H Othat — Ester type below 17 Name or Finale/al ~tubas in Kids scooted le hold BNP PARIBAS 18 Accmax number a aherdssenaban 20 Cm, PARIS 19 Maitine address (olaotrer, steel or suite number) of Snarerål ir ben ii /Much accoatl n held 16 BOULEVARD DES ITALIANS 21 Stale, e snow I n %mien Postal code. d Iowan 75009 Country FR 15 markarn »la el køull Owing osteroer yew (See instruckes under netary amounts. ske 2) 76,651. 17 Name of Financial Irstituton in Stich account k hob BNP PARIBAS li Acoourd minter or ether datemelke 19 Moline addicss ( muter, *eel asete number) d Inancel Instartke in rates aeon, Is held 16 BOULEVARD QgS ITALIANS 15• Amount tremown is Type of •croutl • pieank h Li Sticurilles c Udeet — tit bye ado.. 20 CØ PARIS 15 Madman value of account Main; calerdet year (See Insbuctrons urder Moneenly enema, ;to 2) 21 State. I looYpi 122 Fore* poste/ cab, A know/ 123 Country 17 Name of Financial lostilubm in Wfith beacon/11s held 15e Amount uskronn 75009 FR 16 Type of account a Oar* b I I Saturn« c UOlhor — Enter lyre back. 18 Account number or otter oesionaPon 19 Mailing address (number, street, or sukle number) of financial India/lice in which acosunt Is heed 20 cay al Mato, r known n ncoalan postal code, it known 23 Ciaanry 15 Maiman !rake d account during calembr year (See instructions later Monplary amants, map 2) 15a Amcunl 9 unknywn 16 Type at accord a U Bank tattooer/1es c U Other — Enter two below 17 Name of Finweial kartilutice Such attain is held 18 Accouet Maher a enerer ~Oman IS Maine adckess (number, street a sulle ['UMW) ol Mantel ~MAIO» NI oftlCh account 6 held Cay 21 Stele. knOsAn 15 Kelm" yam ot account dorg cabmen year (See enstructoris urder Monetary amcvnts. stets 2) 17 Name of Financial Instil/den in *ids account is held IS. Amount ~mite 22 Faelon postal øde. a MOH. 123 Country 16 Typo of accent • &ink U Securities c UOther Ereu bee bedew 15 Amount number or odor deslanaticn 19 Will% Salim (rusbor, Wool. or suite number) of Financial insblution M wild. enteam is held 20 City 21 Stale, e know• 22 f ~ban ensue code, it imam 23 Ø1y 15 Maximan vac of aropuM duke calendar year (Soo imIlUctOriS unbar Monolory enmana, asp 7) 15a, Annuli "T 16 Type of account a )Bank b U Secattles c U°Itier — Enter lyre bobo 17 Name ot Financial Institution In which warn is held 18 Accost number or other assignation 19 Mailine address (number. steet. a suite nuns() or enancial ins/Arbon In wtw i account b held 20 City 21 Sn. a knows 22 Foreign Nab code. if kroen 23 COUrgry 1B.M02(CL 02128/14 EFTA01193779