EFTA Document EFTA01379553

II. Certification of beneficial owner(s) Persons opening an account on behalf of a legai entity must provide the following information: a. Name and Titie of Nature) Parson Opening Account; 7c '""`"" Cr icetn jal".rs tbae--i t 4ArC s`°-4 3 -01 t4,04:1/4). ;:11%31 Entity. Type of Legal Entity, and Address of Legal Entity fer Which the Account is Being Opened. • (..LC_ a Usu, t L.4 (c 0-th (, 4,/ Cava lb° -L..te OLx‘vireirt 63 - VtAtbov...a tJSJi O Ca-- ) c Tee fcenviing information for each individnai. any, who; directiy or indirectly, thtry..41h any contract, airangement; relaticnr;f1 C.V• c!n •:rice. owns 25 oercenr 0:. mons of the equity interests of the legal entity listed above: ”1. Tarsi 6:6,pcfetri Spica Ct>too igah geuvawker, OS 1a7 ItA 3 nu ao Vc tvg Coic,m r- k Lo CL" -as OSVt OOtoa Coa /s—oez, La..er Ptta t. er ;Neon" : Far von.U.S.rturfom: 74)(1.E reinrem. 'Iry int:447hr. toSocial Sant: ranilbiti) 7,>E S, ”onc.ollei .3a.,$ 347;a.4 k`gitt..4 ttr 4 P.M.I.S..0e! 'Aanbe cith Co: r.trr Is:pions :to titir ca:rafration nine rumba_ or il.=egrir Mid WW1?, Cd ant *the, citICOIMOI, O•ahltddOtaltOtOt eVietV.Itg og few/axe end ceniiiig 4 chatagtigfr. 01 Jima', ustep.,..vu twa t, el ro ireividea meets INC. tlerifition Mean reite • Hot Aeakeoni d. The following information for uneindividuai with significant reaponsibility for managing me iegal entity fined above. stet: as: • An executive officer or senior manager (e.g., Chief Execufiva Officer. Chief Financial Officer, Operatirg Ofliter. Managing Member. General Partner, President, Vice President, Treasurer); or • Any other individual who regularly mforms ShriiLli• functions. (If appropriate, an individual listed under section (c) above [nay also he listed in this ieorinn ttie 11 8, (OO anse-v.4.-01....4-4.-s,c 00 a era-is Pras., flae.o s ad'idion a • aM ..1., •A• • of Imo. On' c& •• •• • • Alec. ek&e-1 fna my ::Sedge, vlat the pro‘tieed above ate,b10.gr!' TIMIN':denVrrito tnetioma U.S. Fr:el'es. Saul c_an Lehi t.ulher Oar heo.U.S !amen c.r.ier. i fr: bit Of.`4,0•,,• to Sc.o.e Po.ccier.."4" or (lacteal person opening the account) hereby certify. to the best of complete and correct Cr 201E Ornenea Hank AC: Al ryes taste.ti, 1,9•1189806 02$819.Co91319 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0077145 CONFIDENTIAL SDNY_GM_00223329 EFTA01379553