EFTA Document EFTA01369135

II. Certification of beneficial owner(s) Persons opening art account on behalf of a legal entity must provide the following information: a. Name and Title of Natural Person Opening Axount: ,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: 1-.). EPSTEIN VIRGIN ISLANDS FOUNDATION, INC., A 601(c)(3) PRIVATE FOUNDATION/USA 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: Narna Bate of Birth Lagai Address For US. ANSCIftt Social SeculitY Number Fdr firion-U.S.Nrsont —1 (See footnote t for alternatives to Social Seheity Number) NOT APPLICABLE For Non-US. Persons. inaddition to a Social Smithy Number or a Passport Number with Co:mtry of issuance. an gen identincation card floater. or numnor and country of issuance of anyether government-issued document evioencing nationality or residence and bearing 0 photograph or seni-Sti ureguatc shook% be provided. (lino individual meats this definition, pease write 'Not Auelicabiel a. 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)). I Nan. Nan ,e s : Detect Both 4 I Legal Address ' I For US. Peroons: Cot Natl.:1S. Persona: I Soca, Security (See footnote l tor altmlativos 1 Number i to Scare: Searcy Numbed 1 li !JEFFREY E. EPSTEIN 1/20/53 16100 RED HOOK QUARTER, 93 I St THOMAS, USVI 00802 i i ____i ' For Nen-U.S. Persons. in addition to a Social Security Number or a Passport Number with Country of Issuance. en alien idardilicatton ears norm% or number and country of issuance et any Mho voi•OlterOfit-iSSOeti Magma tvidencing not or reiCeRC:1 and Dearing a ',holograph or %Molar safeguard %build be brovided. FREY E. E TEIN y knowledge, that t e infp Legal Entity Identifier (Opuonag tame of natural person opening the account), hereby certify, to the best of is complete and correct. 7/24118 Date CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0061243 SDNY_GM_00207427 EFTA01369135