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II. Certification of beneficial owner(s)
Persona opening an account on behalf of a legal entity must provide the following information:
a. Name and Title of Natural Person Opening Account:
b. Name of Legal Entity. Type of Legal Entity, and Address of Legal Entity for Which the Account is Being Opened:
OM DO RED HOOK QUARTER, B.3
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
Date of Sinn
Lead Meilen
I For U.S. Avsons: I For Icon-US. parsons
! &tate Security
(See footnote I or °Remo:Nest
' 'cumber
; i Social Ser.4y Number)
6100 RED HOOK QUARTER, 83
MOMS
ST. THOMAS, USVI 00802
fat Non-LIS Persons. in addition too Social Security :lumbar or a Passport Numuor vatn Country of issuance. en arren identification card nomeit, or nun del
et tawdry el fact:once ot any tither guyetnivent-issued document evidencing nafienaltyce residence aro beddry a pbotownoti o urnilas adequate addukt
be provided.
(If no individual :netts din eefinitiOn. darewrite 'Not Applicabla.")
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 (d)).
Pen
I
Date of Elan
I
SEE
Legal Address
ABOVE
I For US. Persons: j For Non-U.S. Parsons:
Soclai Security
1 15cC footnote i y Nak
timb
ei;finted
ro
For NomUS. Persons. in *edifier, to 8 Social Security Number cr a Passport Numb*, %yen Count!), of Issuance en aeon IdendriCatntin Card number. nr remibe
and country of issuance of any other qovernmentnnued document evieencing nationality ce resktente and boding a photograon or lenity adequate shout
be nrovicee.
kfriErFiltri
PsTEIN
(name of natural person opening the account), hereby certify, to the best of
/my knowledge, tat the information prowl
bewe;seamplete and correct.
Signetu
7/24/18
Date
Less] £ntty IdmitifieriOptional).
stow, (1
Name(
Tie.
Data:
fre
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
CONFIDENTIAL
DB-SDNY-0051895
SDNY_GM 00198079
EFTA01362474