Text 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, SOLE MEMBER
b. Name of Legal Entity, Type of Legal Entity, and Address of Legal Entity for which the Account is Being Opened:
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
Dote of Binh
Lepel Address
rot US. Penont:
Social Security
Number
Fcr Non-11.S Pe arts
I (See footnote I for alternatives
to Social Setwey fakenbei)
1/20/63
6100 RED HOOK QUARTER, B3
ST. THOMAS, USVI 00802
1 For Non-U.S. Person; in acketinn to a Social Security hieniee: or a Pas0Cet NufTeer With C0WIlly at Issu nce. en arse, identircerinn card nuneaor. or nuttier
and county? of issuance of any other vorarnment-issoto document C.:Wen:Mg natiractafity Or T eSiCienee anC nearing 0 p0Werann O sinfiter soteguero
O effninea.
no ineivickne mews this dalwwtgn, please wit° "tact Atpticah:e.1
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.
Of appropriate. en individual listed under section (c) above may also be listed in this section (d)).
i Nam*
!JEFFREY E. EPSTEIN I SEE
Mateo( Beth
i Legal Address
t For U.S. Penons: I For Nan-u.s.Pcsons
Sotial Security
Mee footnote I for agenneliva
lewnoei
10 $0601 &Wanly :lumber)
ABOVE
11
F0r lean.U.S. Person& in addition to a Social Security Number or a Passport Number with Countryof Issuance, on alien identlficat KAI cord numbe. of number
Sf•4 COteerY d inSutnet Of any other govenvnent-issued documenr eetoeffeeffi netinneley ore residence am hearing a oho:3gram or sinew eakpare should
bo provided,
m
REY E. E
TEIN
knowledge, that t
information
Sire
Legal Entity Identifier tOPtfamet)
ne of natural person opening the account), hereby ce
to the best of
pve Is complete and correct.
7/24118
Da:C.
Srpriv re
Signature
Name
Rae:
7 714
—.C
T
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
CONFIDENTIAL
DB-SDNY-0051723
SDNY_GM_00197907
EFTA01362343