EFTA Document EFTA01379155

II. Certification of beneficial owner(s) Persons opening an account on behalf of a legal entity must provide the following information: J. Name and Title Neo.iral Person f7.9aning Account: 7:••-4 *a C. --I,/ b. Nemecf fro 7 - 4.....C)&42%;:r...-it • I r3/439%) Cancnic•i-(td 1/4-Nc.4:44 Caogss-61 (CR tar. osvt CoVti Tne Vicwirg infOinlazion for each irdiVidU9 v.; • I mcw,,urifling. relationship or otherwise, °Wile: 2 Oew Nee. ,..egelAckeee, ES14'g 01r., throLigh any ccntraer. arrangement. I. 'a rad the equity interests of the legal entity tested above: TiWai C. Cicliv s 3 .AN= ipt oo (-ea \-44:tote-taw:srEr St. )C, °I To,e0r-o'ItS neresw. Fe! Svsw.s: fletitl Sector; ; ?Sat feenele3 fe • WA-3 taii i ti WS Settle,' !Nunn?, tIon.LIS rgtreart flit:RICI` :08 :3COM Srcovity 'aktint.o• av NI:M:4n roam tax toi:11 Country of ill turmv..kr yg:m jeztfilkatjmn d tq ra nbcr jhut.MIOJJ.10 4%1M:frt. M Sc;; other 9itorattitoor • oflutd oszween evadtoca* ginionaiorr rettationoe avid beating ti ;threat:vac& Or *tellilr tene?wed be we...iced. Enna elcia.lusi teens thiteei.lt.:', C. wati! Ot .4N6:,}blen d. The following information for one individual with s;gnitcant responsibiliti for managing the legal entity listed above. such as: • An executive officer or ::•eic>or 'nonage! (e.g.. Ch,et Exec.,..give Officer, Chief Financial ott-cor. cwet 0paratiny otevar. Managing Member Genet al Penner, Preefdent, Vice Pre,ildent, Treasurer): or • Any octet ;neiwkinal who E egulariy sirnher functions. (If appropriate. en ;Itthvidual listed untied' sacnurt (6 above may geso be listed in this section rd)) Te4r41 6. (-141,,,01 Oats rr r• Leyee Ad.Pets Sc a 14ACa0 ;et: VS. neeeN't SE:r.Ftr: t.ilfriber FW FIC,11:).S. POMO): ftP)Z1)(M,P i't. SmajSIC113$7y 'tar •tarrU.S. gettoor• it oath tvOn AJ So..-4 Snooty PMF.21 HVEMIM r: Oar;Sti 4Viadtra Avg :tient!! dor.or cod voord.ov. grater aid rotting of (smance of Per artier 00a:foie OM*. (M u moil I in 0.'10110 1:1I;On4if I ' ,MCIOnt-Al d tWa a rhartpgrorin N t•^ nitre-ea nx4e be perdr...., itneledgerlat the Igo Legal Ng? loinaior plipttreol; nail% , (hided above is co. 1 - atural cersen opening the account), hereby certify, to the best of :clefc and co rect. (Oki Er Cso.vtachr Sena otit. AN WM10.CM..1 025gliAS1814 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0076470 CONFIDENTIAL PROT1 PROT0