EFTA Document EFTA01379157

li. Certification of beneficial owner(s) Persons opening an account on behalf of a legal entity must provide the following information: e. Name and Title of Natural Poison Opaning Account' Pr-frei ‘.. C-firi-eo"1 (tk.‘_,...46 -4 V b Nara of t. cog t nOty. Type 7 E lot A.:COI:lilt is Being Opne. Ts. oskj 4-4 t; at, 1, 4..r (.04.0.ecuAr-t or to 0 k.kock Oucork•etr g 3 Visa 4 a.s, L.1SQ ta5i. c. The fog owing inforMatiOn for each indlIrtioa1/4 f eiTy. WhO, rilrecdr or indirectly, through eny contact, rangement otwfltystdrto ot en:65e. (),,,n5 25 oei,:ent 'y more of the equity interest of the legal entity listed above: co, t.I.S.Permes kit tion.0 S Petwets SocIS -9Thlrir'21 clIes lacerotel lc/ SMAA Sh-OtICOVV»rolti I () 0(s-3 Lao 1241-kirbeiL Cl.).44e) S$. TGa3 S &ft C.x.)80 Os MO:•-;33, ViOt: %IA SbAsiit(..4:111t. V 40 1.1.2>P0it kiewwwitn COW,ITY (If ;40004, at. y4r4i- 'yew:L=4..44cm ryjet.,•1 and -).:Dntrr. of issri4nr;# 41Vrt ,the gOVVAII1Wit.otiseel trizionirtat rrirdenting nationallw or rewierreetird be oteg a plcrtotazah et smitu tafewall thorird sl no Atksual meats chit oefineitr, ma Se Mite '140t, APO:13NC, o The following information for one individual with significant responsibility for marleginQ the legal ernity listed above. SUCK 8s: • An executive officer or serther nranagerfeg , Chief Ftteee Off c Offer Chief Financial Officer. Chief Operating Officer, Managing Member. General Pdrtne.I, President. Vice President, Treasurari: or • Any Citttqf 'rho regularly rxrfotras &miler functions. of appropriate. an individual listed under motion (c) above may also b listed in this section (d1). 1)Ni, It earn 14-4s)0, ..sz Fn!U.. k'nfeln rtor ticort.t.S. itrirattt fACIAi f3fel 4iVer•tves PAIRIbe >rozsciol Sterility N,serttit Fof ft.yrscrai. t *r... rrorr re 4 $a:-. --or Switate kiirr?Ar r: Pitsyrw..n RiertneWgr. etilft1 Of '4C-ithrza an xeierriitrotitir.b1h-e:4.7St.dnbze. rtiRitbit:' and ;rout., n..”inze c.! zaw *thin Licniennert.isose:, dew/vent evidencing ontinmliwnr mfatittroe.ted be 10114 a illretycirapir or Jager salcgi.ercl Omni° Protij LOOM 5n7:n, (Cptinr )4/ of natural person opening the eccounti, hereby cooly, to the bast of ‘cmplere and tweet. ti; 201S Mr:tic:NJ Oft.* ers, AC NM*. ituler•tti. WhIgoe;64 enstkostass CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0076472 CONFIDENTIAL SDNY_GM_00222656 EFTA01379157