EFTA Document EFTA01370954

II. Certification of beneficial owner(s) Persons opening an account on behalf of a legal entity must provide the following information: J !' .1 Nr• • 1").fl •rar arr4" IN; TeQ--el £ C.Rsi-etv, I S.k. -Q \o D r Lc- c_. , v lt 01), -kr Cot..0-ptA (clop y la Si 4,IDn4 CJoa.4~PROT2 83 SA • 71-Nib-Lb-Qs j U.Ski t cc) S'orl_ ir,41€ ts (oleo el 41.4i 34:11,1.3 osh co (11... .2 r4., at'''. :4:.4:rr- g•J.! . *-,•4 r:r .4!" rrArr A •J!' ."• : 14 The. to!..v6m; ;flfarrnati-a for one 'ncla.;Mi4p signilichm iesporstr,,ty to:* manang the iajaian.:..v :;5:00 '.G,e. such es- • M. awcucive olfcer er lemor manager (a.g., Chef Fir4lVtiA• 0ttnel. CM-at Octera:;rg i)th: et it ielagMg Gertlefil: Paltrflf. Prit tr, '140. pre.tr4r,.r4. Twin:;rpir; Or • Any mh,r innlvklua: 1/4"41.1 regular iv peri:tims iumnuni.. ai: I;szeduruel abi!ve w :icriej 4! t4fs sce..7ion art 0as Filra 4:41a.jO 1-4 4_44,t, \bots3 U S. ai:t1.•:•t- ""lr:..:sr,• . ',4 ot• :!f 4a -ft'fl att".:`""'''•" . many) pr natural person ookning the 3ccaumi cc' riy. "i) rre •-rr'artrk're 0.n.S e:Hre.,tr. Ae..; All • pro ,CWItti Signature v Name "t): Title: Date: Vi CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0064058 PROT1 PROT0