EFTA Document EFTA01370944

II. Certification of beneficial owner(s) Persons opening an account on behalf of a legal entity must provide the following information: «vay G Crbk-gri, ) evn Oci t'4).•••:T1,...61.•• 5-0A uonal ser. of !,.o. Efr;tv. TyveC't leVT art, Eitf;;. 'cum 't7e 4:;e0;:m Op,net: VavIc e Est Usk) t 1 °Stn. G. 4,-T yak:04)47 t teel @45012 QQ.s.vc-t)ei ga S"1/4 • rcinaznAxat Ogg?( The fo:ol-v.;:tf4 "oform000n for .ne;" rttifoch:e!, r47:1.:liiiit ft" . ,:heierrep oing wept: Mho elservo5e. ern's :5 !Yr`rCsInr mOut &the Aquity ir:erosN tg:!gy:t! an!z? re-Msel 6Fl ock.i Colool-ei) ReciZao-Aw; n Co s.° L O z t r 1•::.•14 •• ". '17 •i! `kr /1 :41..J Z.1".'- ••11. flfOrn18:10n Vr:11-1priliZAV:n53.001'4:1"rEity r.0; filar:mg:1V ' 4.p !: 1%. I.StIfi such es; • Ar 4zormtiveofrecer or Senior titantiga, Ch;er E.temo;ve Office!. Chief r;r411C111: Ofi;;:•tr. CKla 0'1%3016P:3 ktirult31;-:.; 7'1/3:)!LI.C. Genera! Rif::!*: Presiin Vv;, • An• other +rdpicclua who re.?u!er 1. performs sintrar func:Ssts. 3PPrufw Mch,.-idua; Cetee, unrilr sevior.(:`i ah:r.. 1.6s -".ret r.-.n•. 41•111"•••••:7.1:11•11. ea4,T. 11. et":11` nc,e):.• 404 :! • 0.; (nan • :I natodl he n,on oimn;t44 the 'oereby :o • re oust Vl in" rivw, o.,for;ete orr3 zofrom. ore 15 US" Signa!ur er Name-Print): Date: - 47Ute•-: VP 9-(m 14- Sv.),,d0.1.1Art- 631r-e( CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0064048 CONFIDENTIAL PROT1 10232 PROT0