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efta-efta01386247DOJ Data Set 10Correspondence

EFTA Document EFTA01386247

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DOJ Data Set 10
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efta-efta01386247
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EFTA Disclosure
Text extracted via OCR from the original document. May contain errors from the scanning process.
AGP LP 519 Alpha Group Capital Paul Barrett APPENDIX G AML Requirements You (the "The New Limited Partner") must complete this supplement (the "Anti-Money Laundering Supplement") in order to become a New Limited Partner of the Partnership. Your subscription agreement will not be deemed complete, and you will not be deemed a New Limited Partner of the Partnership, regardless of whether you have already wired funds, until all of the required documentation listed below is received by the Administrator. I. PAYMENT INFORMATION (a) Name of New Limited Partner (no initials): Address, including Apartment Number (no PO Boxes): Telephone Number: Occupation of Individual New Limited Partner or Description of Business of Entity New Limited Partner: Nationality / Country of Organization of New Limited Partner: Taxpayer Identification Number (Employer Identification Number for U.S. entity; Social Security Number for U.S. individual; or non-U.S. equivalent and country of issuance): (b) Name of the bank from which your payment to the Partnership is being wired (the 'Wring Bank"): Bank Account Number: ABA/Fed Routing No. or Swift Address: Bank Address: Bank Phone Number: Name of Account: You must wire the payment from an account in your name. You must provide a letter of reference from the Wiring Bank or a bank or broker-dealer located in a FATF-member country. (A sample letter of reference is attached hereto as Annex F.) (c) Were the funds for this investment generated by your occupation or the business of the entity investing in the Partnership? Please provide a statement explaining the source of the funds being invested on Annex A below. (d) Is the Wiring Bank located in a FATF Country? (e) Are you a customer of the Wiring Bank? YES NO K K K K K K Appendix G-1 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0087858 CONFIDENTIAL SDNY_GM_00234042 EFTA01386247

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SWIFT/BICINFORMATION
Wire Refreference

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