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sd-10-EFTA01298375Dept. of JusticeOtherEFTA Document EFTA01298375
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Dept. of Justice
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sd-10-EFTA01298375
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Summary
IL 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, PRESIDENT b. Name of Legal Entity. Type of Legal Entity. and Address of Legal Entity for which the Account is Being Opened: J. EPSTEIN VIRGIN ISLANDS FOUNDATION, INC., A 501(cX3) PRIVATE FOUNDATION/USVI CORPORATION 6100 RED HOOK QUARTER, 83 St THOMAS, USVI 00802 C. The following info
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IL 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, PRESIDENT
b. Name of Legal Entity. Type of Legal Entity. and Address of Legal Entity for which the Account is Being Opened:
J. EPSTEIN VIRGIN ISLANDS FOUNDATION, INC., A 501(cX3) PRIVATE FOUNDATION/USVI CORPORATION
6100 RED HOOK QUARTER, 83
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:
None
I Data of Seth
Legal Address
rFor !LS. Persons:
, Social Secutity
I Number
Fe Mon.U.S. Persona:
(See loot0ft i tor alternati.
to Soda! Satiny Number)
i NOT APPLICABLE
I
I
I
I
I
I
i
i
I
' For Non-US. Persons. In ode Wact to a Social Security Nutmeat ore Pateprxt Iltatiftr wrtn Country of Issuance. et alier. t000rilleation we narrow. Di owned/
ono country Di ;nuance of any eine government-10mM document evidencing nationality or residence and bearing a olvtograpn a simile safeguard stral
be provided.
(Ii no kb:lin:kat meets this dot inition. ukase write "Not AnoticablOn
cl. 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, an individual listed under section (c) above may also be listed in this section (d)).
Nam*
JEFFREY E. EPSTEIN !
Fa Non-US, Parsorc, in addition to a Social Scatrey Numuc: to a Passport Number t0l. Country of issuance. an Aticti Wt.:nits:anon card number- or number
ann country o1 itrurnyto of any otne: gore nment-issued document eviciencIns nationakynr resrctmee and bearing a c?rotogrann at sinter Seenuard rokluit
be provided.
Date of Sire,
1/20/53
Legal Az.o. toss
6100 RED HOOK QUARTER, 83
ST. THOMAS, USVI 00802
Foi U.S. Pylons: I For Non.U.S. Persons:
Social Set.utity
I (See foomoza for altenarivar
Number
! to Social seamy Nuarder)
EFFREY E. EP
EIN
knowledge, that t le info
Legal Entity Idenolnir (00001)
gn
Date
me of natural person opening the account). hereby certify, to the best 01
is complete and correct.
Signalur
7/24/18
SrplfAtt 04-(
Na
nnl):a
Dale:
SDNY_GM_00062720
CONFIDENTIAL - PURSUANT TO FED. R.QPN(F
1DENT1AL
DB-SDNY-0025545
EFTA_00 173228
EFTA01298375
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