EFTA Document EFTA01375824

Certification of beneficial owner(s) Persons opening an account on behalf of a legal entity must provide the following information: a. Plana and Title cf Natural Ptaw.n Octimino Account t13.91111:10f Legal tnritv. Fipe of Legal Entity, and Address of Legal Entity inr 1-0:•:.ount iS Being Openeyd use l ( " a t 4-4,41 4>tiap GOA el ildirectly. through any conbwa airangement 'He it, tarests of the legal ender listed above: . . _ ce, U9. nereAn For non.t, S. Pawns Smis SThrAirri fiXerete Number to Sm. '441 St; i)(1:0144:»Diirl TSP.+ *6,, I (),(s-3 Lk OO te..4-4,0v abiAel (33 S$• c )Lsit Cx3Exa i•Os MAA-;33, CAiAA SA:Wit ..A1A7t. V 4 on s,>;)0, t ;estate wen COW,ITY (If 10004" 40 gee eteetecee4., to le mete: ryjet.,tt and • ).:4) n rr. af issuer. 41.11At Atha gOVVIAITIOnt.otirsed Per :rode:tine nation:WA leteiente end be owe a plc.:Awe!) eremite tail:wee s holed VATAt*:: I no At .thlAi mean the aefineker Mese mite tact Apreittibte."1 n. The following information for one individual with significant responsibility far mene9 inQ tha legal entity listed above. Rrn es: • An executive officer or serthr managerteg , Chief ftitive Officer Chief Financial Officer. Chief Operating Oftkar, Managing Member. General Partner, President. Vice President, Treasurer): or • Any other in:114SW -dm regularly ixdotras &miler functions. (if appropriate. an individual listed under section (c) above may also tya listed in this section (di). Nit Al earn Aar:sett. S-c.ge_ 44)0 F-':A k'nfen °ore it+en.1,1' fACIAi (ate Weser, I !A: ~nai ves PAM*/ A> Scsnol Secutity Nentei1 Fof 1e".e.;11.r. Pertene. A SA- --)!Sweate tiAle•eirce• a Pktew..e! Riertnewgr t1:42ner at 4C-iiala an gen ....A.net...r.atee. 4:AS nAentw. rtAdtbk: and C.(1.2rt:, r: *the: Lieneennertesa ,ea new:vent renrenting onnAneintar nneterni•Ard be 10114 A nbetweaph or *Air salt:T.41e inceet ere!. la 5A7:11, (Cptiar )4/ of natural parson opening the accounti, hereby ceitifv, to the bast of ,ompleie and correct. e; 201e nir ester: (leer res, AO nohe. tre,e6. rthltoe;64 sno mostas CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0071447 CONFIDENTIAL SDNY_GM_00217631 EFTA01375824