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U. Certification of beneficial owner(s)
Persons opening an account on behalf of a legal entity must provide the following information:
a. Name and Title or Natural Person Conning Account;
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b. Name ot Legal EntitY. 1.ekn Cif Lapel Enntr. ane? AC-dtcsa ol* Legal 5.ntity sG. vdt..•iell the Aotount it? Being Opened:
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C. T. fo»wing information for each indiint uak. if any. wh0. direeey a, li
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tbrough am( c.critroct arrangement understanding, relationship or otherwise. owns 25 percent or more of the equity interests al Me lagis entity Iiistee above:
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'iiaistsinie, €.$4.? k....~4 I Irt"f fitMc2thti . Noe is Social Se:alie ,:umbei
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MItsCSI owl ;apnea. el' reenter and COUIII, of Bastian:* cf mrf :sin« tauekneneneatoad dnrument evelnneepe Neuman:yet MOILIOOPOIOOd DiMMIQ,I.plyntogript; or MIMS& 'Aligratil WatiltS
(If net ~deaf meet
CMIHMKIO. panne MOP ~ask?
a. Tire following Information for one Individual with significant responsibility tot managing the legal entity liSted 31.11.%fe,
altich 3$
• An exisentka officer or senor inanaper (e.g.. Chief Ever-Wive Offil:ee!. Chief Financial Oftkei:
Chief Operating (fiffg:ei:
Managing Merilkall Generki Partner, President, Vice President, Treasurer): or
• Arc other indivichte, who regularly perform; ',0i17; twvzii(x1a.
(II appropriate. an individual listed tender aecttn (*above may also be listed in this section (d».
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(St ensernke 1 ia neerr.nnees atentanc .Setke Secunte lurnbee.
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IMOMIlliky ..MOOM:0 noel OfffillIg I %Mk...army:4.
senenr aafeμ'nd ahnele eekeekt.
-----(trar a of natural person opening the account). hereby certify. to the best of
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Untal ansty oiinsein (ieneraii t ft
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CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
DB-SDNY-0076471
CONFIDENTIAL
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