EFTA Document EFTA01362467

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(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: Name I Date el Binh Legal Address 1 Fe, U.S. Persons: I Social Security . Number he Ncm.U.S. Persons: (See lac:natal for etternaobeil to Soda! Security Number) i NOT APPLICABLE ---- 4 I I 1 I • NO:1•LIS.Personi. In addition tea Social Sorority Numb."( or a Pasture t Plumper witn Country of issuin.* en alien identification caw number. Of earner and country of inuance c1 any oilier gOvemment-icited document eviClek:iev nationabty or lesittence and tearing a anctoprapn salegimit eboub be provided. (ft nor iock.ndual enacts trionatiatuon. ukase mite 'Not AoPhoaUe•-) 0. 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 (Cl)). Name Date of Ben Legit Address Fat U.S. Perin I Fe: Non.u.s. ;boom Social Seaurity i (See footnote a tar altrunarivasi NthltOte ' to SatiatStailitY Numbs* I JEFFREY E. EPSTEIN 11/20153 6100 RED HOOK QUARTER, B3 ST. THOMAS, USVI 00802 • For Non-V.S. Patient, in addition to a Sotoi SeCurity Mumbo: u, c Pflipzrt Nemec: rat Country of Issuance. on alien Identification card number. or *miter inn country of itituance of any °vie.' gavot nment-istved document evut.roing nationality Of residence aid manna a OhOldVaan 3,014r 511Ncara ShOut be Dravided. FREY E. EP TEIN y knowledge, that tie info SI Legit Entky Identifier (Optional) me of natural person opening the account). hereby certify. to the best of is complete and correct. Signatur srpifruta4 Title: Dale: t CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0051885 SDNY_GM_00198069 EFTA01362467