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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:
b. Name of Legal Entity, Type of Legal Entity, and Address of Legal Entity for which the Account is Being Opened:
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:
Name
Gate at Birth
Legal Address
For US. Penont:
Social Security
Number
For Non-11.S Petems:
I (See footnote I for alternatives
to Social Stowe). fatenbei)
6100 RED HOOK QUARTER, B3
ST. THOMAS, USVI 00802
1 For Non-US Persons, in aatation to a Social Security Number or a Paoport Nude°, With COuntly of lase not. on arse, ieentircorioe taro numbs:. or author
wt countyy of issuance of any other vavarnment-issoto Oct:wren, et:Wending natiractafity oe Tesidenet anc aaaringa phelograan of sirtoler sateguero shoatc:
0 oroVeieu.
no indlekluat meets this deified* pleat:emit° "Not Atpticab:e.1
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.
Of appropriate. en individual listed under section (c) above may also be listed in this section (d)).
i Nam*
!JEFFREY E. EPSTEIN I SEE
Mateo( Beth
Legal Address
t For U.S. Penons: I For Nan-u.s.Pczecnr.
Satial Security
Mdt footnote l for aftemadva
lettendef
10 SXMISecurtly Number)
ABOVE
11
re, thon.U.S. Person& in addition to a Social Security Number or a Passport Number with Country of Issuance, on alien identlficat ien card numbe. of number
Sf•4 chtentrY Of inutnet of any other government-Sewed dacurrenr &adobe/Ail r•atichaley as residence am hearing a oho:3gram or lemur eakparo should
ho oroviaed,
m
REY E. E
TEIN
knowledge, that t
information
Stela
Lego: Entity Identifier tOPticael)
ne of natural person opening the account), hereby ce
to the best of
eve Is complete and correct.
7/24/18
Da :C.
Srprivre
Signature
Name
Tale:
Date:
77 14. C
IT
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
CONFIDENTIAL
DB-SDNY-0067031
SDNY_GM_00213215
EFTA01373041