EFTA Document EFTA01370955

II. Certification of beneficial owner(s) Persons opening en account on behalf of a legal entity must provide the following information: Na: a. to! d 7::!q C. ria:urn! ri(or OF-scin.7! Acz..."17 Te r-4-c-t 61:-Si"jr e" n ) CY\ °L'Act"-- Luc, t_.) Qk tc&b.t.hi cscapc,ny 1 c> ea ckcloi< CaJcwr6t %el ,13 3 a k • \Law-if:Ls) LiSQ 0 0 %Cla !,:f '73 P'.•:, ,::,U•1'. • <he. 4;re-Ztly fl inu,m1h r <;1!,ew.,..vi oval,: 25 v.4..er.,ent mOre cif tb:, %am, 0:44.93,4th -"cruet& €.04,' 6100 ea ticotastrivi n uz\lt oce:a. %RH.= mier ^.I1Cat 'r.% exlc•Paryi .):1 I:1'11,1;r ,C•' P. • tliiPt • a p ri.: 6e I:.S:rC01 d 1.17e EPOILOppirtg :NUJ; ftbiLVI1 for ..vw :nrSvi,Suall...jUis;gri;fivant 1/2 sufmtiabi ay for martanlinc :he it ux, Oritt 1:Sted •:001 • An esocur.r.47: or Serjor illaneger Clbel ()Oil OPqt•icl"fj Memb,v. parmec. urusiient. Vice or • Ary oti'ku irrivival why rOgULuiy pe:r )rn0 1,Cli pl iunCrO:Iti. if Z.0})/fIcLii ,1C3P.•:4.:01 (C) abnyo ma", qki -, be lir.,zeu n ;h* ;e:;:,y: &At) '4 1 6- Ce4 4 4% liklb0•4 31C:':: Stv1:•,.. to,p 4/ igno I- ..•pr P•a Ag m atn u; CZtar loporfatewp•At.p•P 9, NpPalivase.lepsperl.r .vona:, faao t e rke, i ,time 0i (mints flt,IfSi.ri C1)...1.1414 1.1•0114CCAii, t), MI My talk TO "ebes:..0 cornWete art, Coere.: Signature v Name Titalern S4 6 `i CA-AY - V./ye CONFIDENTIAL - PURSUANT TO FED. R. GRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0064059 PROT1 10243 PROT0