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efta-efta01384799DOJ Data Set 10CorrespondenceEFTA Document EFTA01384799
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DOJ Data Set 10
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EFTA DisclosureText extracted via OCR from the original document. May contain errors from the scanning process.
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 LABILITY COMPANY
8100 RED HOOK QUARTER, B3
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 Bird,
LecialAttdrass
I For U.S. Parsons:
j Zover.rft : feCurifY
For Plone!.).S.Pesons:
tir seotrat .euf..,tor
y Nolte:be:ma ems
----
JEFFREY E. EPSTEIN
7. For NomUS. Persons. in addition too Social Security Number or a Nastiest Number with Country of ISSUO5Ce an aden identircoton card number. or ilUrneer
area courery of issuance of any Od ler governtotnt•issued document arab:lying nationally cv residence ann rmarins a phateorapn cr Smear safeguard shook.
OS °forlorn
(If no incliktual coatis this d4hiitiCet Oen: tvflIC 'Not APPliCithl47)
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, art individual listed under section (c) above may also be listed in this section (d)).
Name
f Leo Addams
I Date of Beth
JEFFREY E. EPSTEIN
SEE
ABOVE
For US. Persona:
Social Security
Numb&
kin
s. Perform:
(Sea foolnew I for *Nana:ins'
to Social Security Number)
For Non-PAS. Persons. in Wail tan to a Social Semeity Number or a Passport Niermer with Country of Issuance. an alien Identificaton cars number, or bombe
end country of !store/ of any other govetrtment-issoed crocument 'tribe-win naciebarity or 'abidancean° imaging a photograph Or simile: sefecrkutf should
be provided.
me of natural person opening the account), hereby certify, to the best of
ded above is complete and correct.
7/24/18
Date
;(ertAw-e Cei Date
Sr
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
CONFIDENTIAL
DB-SDNY-OO85323
SONY GM_OO2315O7
EFTA01384799
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