EFTA Document EFTA01375827

IL Certification of beneficial owner(s) Persons opening an account on beha€f of a legal entity must provide the following information: :I. Maine and Into of Naturei Plt(SOC, Opening Atmoont: TeORNeil ‘ csAletia) Soka b. Nana of Legal Entity. Type of :ega€ Ennty, and Address or Legs: Entity iPiNch the Account is Being Opened: c. The following inforMatiOn for BachWiltiehat if any. who. direct., or indireCtly through ery contract. arrangement, understanding, relationship or otherwise, owns 25 percent of mole of the agility interers of tha legal entity listedabove. pi-t• LbwlAdesr•Os Wean clativa For Pawn: number sof (.90+ tootmlit 7 It, to Scelal Secorn Number) ' - AO( ai assign it, 3 Sc•Sol Se.viity Norther 0 n :c•ttr,acqt Komtav •actlitAJoIre Of .,Iaarr..4 rao Ws, Cent „alion zon.i milOIXt or .-krotitt Ore A•UoTIti issalOrm. 111N% jirceoloori;.in•Fact deCtotent thirle,*(34•D Ammon:Ilk? or if 7tOrFACa l'azoing a pno!ograpti pc sanOot 3a/ectiatif St oak' t's ce•widrrd. (If no ittrthq•ii.2 This d:Hisiltxxi. *one tsrhe "%to:AO:table el. The following information for one individual with significant responsibility for managing the lege! entity listed above, such aa: • An WoiCUtivt- officer or senior manacer (e.g. Chief Executive Officer. Chief Financial Oftker. Chief Operating Officer, Managing Member Ganef& Partner, President Vice President. Treasurer): or • Any other iheinfidual who re4Adatly perf,xin sim;tar auntie's. (If appropriate, an individual listed uncle! section (c) above may also be listed in this section (cf)). T.Stat t NV? tt!' Matta', ‘1)rep t ra See- 4=40,4 U.S S1?3t Seer: car :4:in.it:S. (See OlOO TI, 1 ON n to SocLO St ::tfiqv r.tyn Fm "koa.u.11. tze,:xet. hAplAft to :tier-04y )1.-ants., ai ONAlligr. 3oeitto".oith COLA-Ort ,ft - of", nen r4r- o-br itant•*: Ma COMO? Oe WoJOIV* of airy out, (owf n men 1-131•••0 doeumers esioormrg mitonalits of :tater 4:4 ant: ON,' too Ott)tOlr-ral 0, -INNS inflOos:$1-K- 014 ne (name of natural person opening tha account), hereby csitify. the hest of widge Opt the Ent envie:4 end °went. %rgai ktnntithrr ((5), tong) 2 20 t8 1)4u:::etie 94is‘k AO.Alid9on tesernm. 'NMI:n.466 0:Nalthiti au le CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0071450 CONFIDENTIAL SDNY_GM_00217634 EFTA01375827