EFTA Document EFTA01379158

II. Certification of beneficial owner(s) Persons opening an account on behalf of a legal entity must provide the following information: ch Name and Tide of Natural Person Opening Account Te k e‘," k fix •Which the Account is Being Opened. t-t-C_JJ (:-‘, (.4.1 CA.t70 V4watLebocA-tri 63 S+ ) 1/4.11 0 Q C let c. The following information for each individual, if env, vtho, dlrf..Ctly or indirectiy. through any tentract, arrangement understanding, fi.ilatiOnShIp or otherwise, twins 25 percent or more of the equity interests of he tega) entity listed ab- ve: e!•:iete ..:.syr 0 . ,:rt:.U.S.P•"itt: ;r:irt ft;otrei, Werigivr$ ti/Satfil Etcorf:ytio.11t»l: 6 t on ea Pocillau.,Lers 1' ‘" • 'U-tent.as usv tØØ.. 7 ----Frwty€-.4ic-iww I 0 ) t ib: nns•'.3Æ. rtrtanaiit•MC;00,03, 70 SO:104 SeCOntr Nuiltif (4 r. Stk2pC09 thim etafty nl itzgzoorr Rion antific,)tion cznIl rturnby'.:, nantee led alone): 0i:sit:hew esi my ot>er,:mentnitne,:irnarl ibetnitet tetresnelrg rtPtidi:nCe fine Wilting J P(P »XIMIUtth or ~lb* 14f4;Jrzi tn•:;;Ile "JJ r•no*didi.sin,~ th4" , tinat9n. go rse trip ;1ezt awAie.rc4o.1 it The following intormdtion inc one individual with significant responsibility for n waging the keel entity listed aboee. Such as: • An e../e-sutive ofiKtei or manager (ea., Cjijoi Exoeurive Officer. Chief Financial Officer, f lo{ Operating Officer. Managing Member, General Partner, President, Vice President, Treasurer); or • An'? OthW" rnd;Vir.hi/fl tv ho regularly performs similar tundons. tlf appropriate. an individual listed under section ici above may also be listed in this section O)), i..fry‘VA(gkRis TeM-Prai (fs-4",, ti>01C3 See 444124:"j&- ' r: år r•år..!). S Je4lons. Scc ><+a , 0:0`Zei tir .,31'¥10€!' ~X4 *IN. t..0;i0t.) of r(sifirct fin situ: ctigific)tIne tfin7 taainbm rra• am; •,:0;00-, 01 .3 in rom.0 of 01W 'Or/ 01:Zunl",t 0..r.forc.0.g 91.0",t, Miry t`• (09:1004...! /WO betiloR J 10hOtOgir.110, *SI& tJfeWarJ S0C4110 b0r-.1.00.1*0 F,x Strian $10,...10kfc 'ZVI!~ Å fin•Aratr;fi4 Itfinber tr•Scoul Sx:n ;1011b0t) , nowledge i tasint 'tennSer tOottnisi (name of natural person opening the account). hereby certify. to the best of frits4led-otrais co toles rind correct 2111.3 .:!etitsd* ear). Ail. AE reaentu. 026219.051J:16 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0076473 CONFIDENTIAL SDNY_GM_00222657 EFTA01379158