EFTA Document EFTA01298072

II. Certification of beneficial owner(s) Persons opening an account on behalf of a legal entity must provide the following information: a. Name and Title of Natural Person Opening Account ;JEFFREY E. EPSTEIN, MANAGER b. Name of Legal Entity. Type of Legal Entity, and Address of Legal Entity for Which the Account is Being Opened: !SOUTHERN FINANCIAL, LLC, A USVI LIMITED LIABILITY COMPANY 18100 RED HOOK QUARTER, 63 ST. THOMAS, USVI 00802 c. The following information for each individual, if any, who, directly or indirectly, through any contract, arrangement. understanding, relationship or otherwise, owns 25 percent or more of the equity interests of the legal entity listed above: I Name Date of Birth legal Address I Foe US. Newry& SooialSOFterlf Number For Non-U.S.Fyitons: . Wee fOtmtite I for alternatives to Social Security Millbrae, JEFFREY E. EPSTEIN 1120153 6100 RED HOOK QUARTER, B3 ST. THOMAS, USVI 00802 For Non-US. Martens in addition toe Social Security Nun:Otr or a kvitspor t Number velth Conroy of issvarce, an akm identircetion card nertuvr. or number ciao cots-myof issuance of any other government-issued document evidencing nationality ow resioener ono orceelc a ohologreon or similar selewaro should 00 Dttlneta. Of no mdiveaset meats this definition please vane Not ApOlicable.1 d. The following information for one individual with significant responsibility for managing the legal entity listed above, such as: • An executive officer or senior manager (e.g., Chief Executive Officer, Chief Financial Officer, Chief Operating Officer, Managing Member, General Partner, President. Vice President Treasurer): or • Any other individual who regularly performs similar functions. (If appropriate, an individual listed under section (c) above may also be listed In this section (d)). Name Date of Beth LegatAaderss I For DS dorsi:etc kw Non-U.S. downs-. SotaiSctulLy 1 uumbef Mee facnoze 1 k: atterriedvcs to Social Security Woman) ABOVE JEFFREY E. EPSTEIN SEE • I For Non-U.S. Ati044. in °dation to a Social Security Humpy es a Paswoet Niontier yisth Country at Issuance, an Or kiontifiestion card number. or number and country of 4suadde of any other government-issued document evidencing nationality or rcsicknora and bearing a photograph or simile: sefognard should bit moulded. TEN Sir alum Legal Entity Identifier (Optclad CONFIDENTIAL — PURSUANT TO FED e of natural person opening the account), hereby certify, to the best of ded above is complete and correct. Sign- • ;KS ii:44^/z ad Date R caNt IDENfiIAL • SDNY_GM_00082014 DB-SDNY-0024839 EFTA_00172524 EFTA01298072