EFTA Document EFTA01362341

'apt Entky identifier (Optional) 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, 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(4X3) PRIVATE FOUNDATIONIUSVI CORPORATION 6100 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: Name NOT APPLICABLE I Date of Binh Legal Actress 1 Fe' U.S. POCSOIS: SOCial Security ---f Number Fit NcrpU.S.Persans (See I cootnate 110f alternatives! to Socia!Seority Niger:be') 1 • NoMIS. Persona, in addition to a Seed Security ['Jumbo( or a Neap°, f Plumper witn Country of ;sewn,* an alien ioef f Mention caw number. Or earnest and country of inuance eSonY ofilOf gave:enrol DM -feefed docunfent evident:fey n4E:maw or latiOence and tearing a ahocoar on or telt/nerd eheob be provided. (ft na inthvidUal meets tni$datinalon. please write 'Not AoPhoobfe." 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, an individual listed under section (c) above may also be listed in this section Name Date of NW, I Leaol Ad 'rose i (See footnote a for allunartasi Pot U.S. Fanatn: I Fot Non-U.S. Amos: Social Sorority 1 Momper I foSocialSetcrity NUMMI* I I --r --- I 6100 RED HOOK QUARTER, 83 l JEFFREY E. EPSTEIN i 1/20/53 i _ I ST. THOMAS, USVI 00802 1 ; i • • For Nan-tl.S. Persona in addition to a Soc.a Security Nemec oi a Pncport Number with Cocoon). of Issuance, en alien Idantificanan card wear, or ramiber end muntry of 4.41.011Ce of any atm: gavot nment-faueif document twining nationality or mildews and beefing a Oh010VaDn or ' ,mar s lie aurd shout be Dravidsni. IN a of natural person opening the account)• hereby certify, to the best of is complete and correct. Signatur 7/24/18 4 srplitc. 044 Na Tale: Dote: e CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0051719 SDNY_GM_00197903 EFTA01362341