EFTA Document EFTA01379575

II. Certification of beneficial owner(s) Persons opening an account on behalf of a legal entity must provide the following information: a. Name and Title of Natural Person Opening Account: IJEFFREY E. EPSTEIN, PRESIDENT b. Name of Legal Entity, Type of Legal Entity, and Address of Legal Entity for Which the Account is Being Opened: JEGE, INC., A DELAWARE CORPORATION 6100 RED HOOK QUARTER, B3 St THOMAS, USVI 00802 c. The following information for each individual, if any, who, directly or indirectly, through any contract. arrangement understanding, relationship or otherwise, owns 25 percent or more of the equity interests of the legal entity listed above: Mae JEFFREY E. EPSTEIN Date of Beth Leal Addams 6100 RED HOOK QUARTER, 83 ST. THOMAS, USVI 00802 For US.Pirsons: IF Fe Nve•UPJ.Pag sons: SoveI Srztlivi (Soo footnote 3. lot alternatives! Number n to Social Setway Number) Fat Non-U.S. Persons. m addition to a Socol Semany thenber or. Passport Number with Country of Issuance. en alien ceonneatiOn we bombe,. 0, number, ant Couture 0' ilnane•of any other goveurneni-issued doti.onemevitArneingnahoneew or esidenot and Waring a ohotnara pa or simkar tasked should be provided. (If no incividual meets this definition. 01.13$0 veito "Not Appoco*10.1 d. The following information for one individual with significant responsibility for managing the legal entity listed above, such as; • An executive officer or senior manager (e.g.. Chief Executive Officer, Chief Financial Officer. Chief Operating Officer. Managing Member. General Partner, President, Vice President, Treasurer); or • Any other individual who regularly performs similar functions. (If appropriate, an individual listed under section (c) above may also be listed in this section (d)). Name 041e of Birth I Legal Address I For U.S. Persons: For teon.U.S. Persons: Social Securely Number I (See fdo:ootc for alternatives! i _toScciat Security Number) JEFFREY E. EPSTEIN SEE I ABOVE Re Non-U.S. Persons, in addition too Social Security Novae: or a Passport Number with Country of Issuance. en aben iOtrUification Caro Nancy. or nuerbe sue country of UptuanCe 01 any other ocvueirrent-issued document eadencl a nanoeli!vot res;stoce ant beacino a ahotorir aph or seei,or Ogegua•O Monks bo provided. I JEFF my k N SiUn3t re Date (name of natural person opening the emorovidecfeb0ve • complete and correct. Sig Legal Entity Identifier (Optional) 7124118 craw Cad Date: CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-OO7718O SDNY GM_OO223364 EFTA01379575