EFTA Document EFTA01379557

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' TCPAG1 ‘..Qs{-eOA 1 Sa t (tk.‘_,...46 -4 V b r.,,sru a of t. cog nOty. Type 7 E lot A.:COI:lilt is Behlg Opne. (.04.0.ecuAl 610 O k.kock Oucork•er g 3 Visa .-c..s L.1SQ ta$d1 c. The fog owing inforMatiOn for each lc:dbl.:Ina,. if eiTy. WhO, rilrecdr or indirectly, through eny contact, rangement otwfltystdrto ot en:65e. (),,,n5 25 oei,:ent 'y more of the equity interest of the legal entity listed above: co, t.I.S.Permes kit tion.0 S Petwets SocIS -9Thlrir'21 `kAlibet U SMAA Sh-OtICOVV»Pdfl I i) 0(s-3 6100leaMicbeg t44rf63 S$. c )Lfsit WSW- ;:o: Mon-;33, ViOn %/It ..•iirSti:uflit:•+.1:Dtre' V 40 1.1.2>P0it kiewe?..t.itn COW,ITY (If I 40004, an y4r4i- izLefoggIn4ncicid ...nte: a ryjet.,tt and -).:Dntrr. of issri4nr;# 41Vrt Othri gOVVAII1Wit.otiseel nil mat rrirdenting nationallw,wrewierreetird be oteg a plcrtotazah et smitu tafewall sl no iltbual meats chit oefineitr, ma se Mite '140t, At013bie., o The following information for one individual with significant responsibility for marleginQ the legal ernity listed above. Rrn es: • An executive officer or serther nranagerfeg , Chief Ftteee Off c Offer Chief Financial Officer. Chief Operating Officer, Managing Member. General Pdrtflal, President. Vice President, Treasurari: or • Any Citttqf 'rho regularly rxrfotras &miler functions. Cif appropriate. an individual listed under motion (c) above may also b listed in this section (d1). Diflt I/1 earn 14-4s)0, ..sz Fn!U.. k'nfen rtor ticort.t.S. itrirattt 54X1Ai f3fel 4iVer•tves PAInlbe Scsnol Sterility N,serttit Fof ft.yrscrai. t *r... rrorr re 4 $a:-. --or Switate kiirr?Ar ea a Pere w.., r.yar.eWgr. C:42:1710f '4C-ii.bna an xeierriitrotitir.b1h-e:4.7/t.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 Sens ers, AC NM*. ittier4tti. WhIgoe;64 enstkostass CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0077150 CONFIDENTIAL SDNY_GM_00223334 EFTA01379557