EFTA Document EFTA01379160

II. Certification of beneficial owner(s) Persons opening an account on beha€f of a legal entity must provide the following information: :I. Name and Trite of Nature %SOP Opening Account: TecR...1 L. (,,,,,4,t" ) Soka vvtawl-ev-- u. NBnte of Legal Entity. Type of Legal Entity. and Address of Legai Entity Which the Account is beint; Opened: t.../e..? A-NAne J L-L C.- ) )be_kc.i.oce. eel co...Ilk 6 14 It a CZ (. Cot t70 iaa 4.00Loo.vrbec e3 Sflinsat.uc. ) L75vt Oc,1a 0 - 1 it 7 kcic,!;!:Thg ;ni,);tnatir, Or .?3Ch 4t0. CrreCttii Cs indirectly. through contrTct arrangemet tinflerStOz !ging, felationskp or otherwiSS, owns 25 nerceir ni mole of the lenity Interem of the legal drib(, listed above: ;:,,,t" of eti- tt. :LEIt'C dt-c.t.; 4,64"," woo ea k4ciov usv( p;;I. LI a Ptit0fRa: .:F1C1E11.3171::eiltle umber Fat meii.4,tS. rxtpar.r: tootmlo I !V' 3S3welsitital to Social Sewn!, s ...ttober) Non•U:S.!%raont. T sott--ticto 3, ) Stettd Scrwrity Norther ou n 'times *.trots .6'44County, of .Thiatr..4 Ri.cOtiew. Cent raittflo r4td mwobo. IStstliat Nod AN.OtTly of iosustecti et my, otter otrcoronorc.issooddectotoot levirleitcug ',atonality or /f7tODOtte)anntwoing a prtowtoraoti ix 0Mo/3403914M st nalti t'a ccovidod. (it no meth This d:HislIttiti.pfreco !mg, e "%to:AO:table') ci. The following information for one individual with significant responsibility for managing the lege! antity listed above, such as: • An executive officer or senior manacer (e.g,. Chief Executive Officer. Chief Financial Off-zer. Chief Operating Officer, Managing Member, Genteel Partner, President Vice President. Treasurer): or • Any ocher ihejiwoual who re4Adatly perfwIn3 sim;tar itinctians, (If appropriate, an irucividual listed under section (c) above may Ws° be listed in this section (d)). DOTS tt!':'.31E".t- t. i:3-4 Matta', s o_ Alec, °.rlt5 Ptitottc: .etac.at ZSOC.WI: Oi in "ttg to PO: hlOn•il.S. 0,!:g.ott t:St3OlOtt or lO CrOttot n SOOLO St rut titcr.tti FOI titoo.U.S. tzevoont.htotkit v:3 Eit."-otki Ststvrity nottib.../ ot Ot:tatmor. ,forttbet .t>ithroottefti instuora, to, tit i•wtOf-cta. !t.tct cam noTobr. or oats*: Ma COMO? OteltIvOittg of wy otltw govstnment-immodocurnets evioecrirg nmonalits InefOrc; ant: ntoroto a OttItt>3r3PO m -OrMIS-InfttO3O31-kt.13 CrW "O ?el t rp t fnam(d of natural person opening tta account), hereby usitify. to tie, best of cadge, ttpt the Ent omplete. and °went. ktontitior t(tsc tong) 20 tn Ocuzetie %Pk AO. Ali (19otatesernm. seiM1£9666 le IS CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0076475 CONFIDENTIAL PROT1 PROT0