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efta-efta01386249DOJ Data Set 10CorrespondenceEFTA Document EFTA01386249
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DOJ Data Set 10
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efta-efta01386249
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AGP LP 519 Alpha Group Capital Paul Barrett
(c) For Trusts
K
An incumbency certificate attesting to the title of the individual executing the Anti-Money
Laundering Supplement on behalf of the prospective New Limited Partner (a sample Incumbency
Certificate is attached hereto as Annex B).
K
A copy of the trust or evidence of its formation.
K
A completed copy of Annex E.
K
Source of Funds (please complete Annex A).
K
A bank reference letter from the Wring Bank or a bank or broker-dealer located in a FATF-
member country (A sample letter of reference is attached hereto as Annex F).
K
United States IRS VV8NV9 form (as applicable).
Please refer to the official IRS website,
www.irs.qov, for the appropriate form.
(d) For Privately Held Entities (other than a Fund of Funds, Entity that Invests on Behalf of Third
Parties, or Trust)
K
A copy of the entity's organization or charter documents filed with the jurisdiction of organization.
K
An incumbency certificate attesting to the title of the individual executing the Anti-Money
Laundering Supplement on behalf of the prospective New Limited Partner (a sample Incumbency
Certificate is attached hereto as Annex B).
K
A completed copy of Annex D listing the name of each person who directly, or indirectly through
intermediaries, is the beneficial owner of 10% or more of any voting or non-voting class of equity
interests of the prospective New Limited Partner, and the names of the entity's directors, general
partners, or members, as applicable. (You must complete Annex D regardless of whether there
are any 10% beneficial owners.)
K
Source of Funds (please complete Annex A).
K
A bank reference letter from the Wring Bank or a bank or broker-dealer located in a FATF-
member country (A sample letter of reference is attached hereto as Annex F).
K
United States IRS WPM form (as applicable).
Please refer to the official IRS website,
www.irs.qov, for the appropriate form.
(e) For Publicly Held Companies
K
A copy of the entity's organization or charter documents filed with the jurisdiction of organization
or the most recent annual report.
K
An incumbency certificate attesting to the title of the individual executing the Anti-Money
Laundering Supplement on behalf of the prospective New Limited Partner (a sample Incumbency
Certificate is attached hereto as Annex B).
K
The name of the exchange on which the entity's shares are listed and the ticker symbol.
K
United States IRS W8/V19 form (as applicable).
Please refer to the official IRS website,
www.irssiov, for the appropriate form.
Appendix G-3
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
DB-SDNY-0087860
CONFIDENTIAL
SDNY_GM_00234044
EFTA01386249
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