EFTA Document EFTA01362468

tent Enift Idmtifier tOpixins.). 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: JEEPERS, INC., A USVI 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: i Name Date of Birth Lugar Address I For U.S. Persons: Social SrsctrMy I Nombre For Non.US. Pomona: (See (Ootrrenr 1 for olternat ... ro Sacral Security Number) JEFFREY E. EPSTEIN 1/20153 I 6100 RED HOOK QUARTER, 63 • ST. THOMAS, USVI 00802 I IMI , • FIX Non-U.$. Persons. in aoCiUon to a Soma( Security Number or a Passport Number wan Country of issuance. an alien identification card nurrc-ft, or nurntw arc Countryof issuance of tny other govecrintent-issued doximent evidencing rtatimality or resecence and t: oath a photooraph Or simaat saktaaro VlOokl prOireftd. (If no indrinual moots tbis definition. please mite -Not AppliceMen 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 (a)). Name Gate of Sinn I Legal Address n ABOVE JEFFREY E. EPSTEIN j SEE For U.S. Persona: For Non-US. Parsons: Social Seamy/ (See footnote I for altornaimes I Number to Seel( Stony Number) • For Non-US. Peraons• in addition to a Social Society Number or a Panpvt Number WWI Country of Issuance. an arei iventifreauco cord :Jumper. or number and country of Issuance of any other govarnrmni4Multd document evulanoMq nationality or resdence and bearing a utromer, uh ce ,inns' safeguard thou' be provided. (name of natural person opening the account), hereby certify to the best of ded above is complete and correct. 51,044c Cpc Signature Verffic r Name (Print oN. Title: CONFIDENTIAL - PURSUANT TO FED. R. GRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0051886 SDNY_GM_00198070 EFTA01362468