EFTA Document EFTA01379579

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, SOLE MEMBER b Name of Legal Entity, Type of Legal Entity, and Address of Legal Entity for which the Account is Being Opened: PLAN CI, LLC, A USVI LIMITED UABIUTY COMPANY 6100 RED HOOK QUARTER, B3 ST. THOMAS, USVI 00802 c. The following information for each individual, if any, who, directiy 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: Name JEFFREY E. EPSTEIN Date of Seth Legal Address 1120(53 6100 RED HOOK QUARTER, 63 ST. THOMAS, USVI 00802 I cor U.S. Parsons: I For Non-U.S.Passont SocialSedurAY (See footnote 1 ler Clikr 'LIMPS N'JMtiti • to Social Sacday Ntenber) For Pion-US. Persons. in acioinon to a SOCiaiSeCtrity Number or a Pasrpon Number with Country of issmoote. an ellen ktentircation card nor*cs, or numnar and county of issuance is: any other geyonimant -issued ticianerri evidenci^.9 noticnahty or residence and Warkng a Pi otonrada or SkriLlt sateguart should be provided. of no melhOdual meets this deli:Ikon. please write "Not Apolicet:e.1 d. The following information for one individual with significant responsibility for managing the iegal 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 Oats of 8nh I Loath:Jewess Far Persons: Social Security Number For Non-U S. Pgrsont (See footnote for aitenuelvasi j to SQC:111 Security Number) i JEFFREY E. EPSTEIN SEE I ABOVE For Non•US. Persons in addition toe Social Security Number or a Pain= NOTbra ?AO Country 0! ISSuallCe, an ebb) itilAtilitOl.arl CWC Mutt.; or cumber and country of Issuance Many otnor s.c.veingttertI4SSOC4 CCCunlent eviditnying nationality c, residence anti bearing ai Or Sinutvlilt7hIrci Should bc Provided. Legal entity !Snuffer (00tional) rat person opening the account), hereby certify, to the best of aye is complete and correct. 7124118 Dalt Sp/juke eid CONFIDENTIAL - PURSUANT TO FED. R. GRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0077186 SDNY GM_00223370 EFTA01379579