EFTA Document EFTA01379576

II. Certification of beneficial Ownef(S) Persons opening an account on behalf of a legal entity must provide the following information: a. Name and Title of Natural Person Opening AccounC 1JEFFREY E. EPSTEIN, SOLE MEMBER b. Name of Legal Entity, Type of Legal Entity, and Address of Legal Entity for Which the Account is Being Opened: JEGE, LLC, A USVI LIMITED LIABILITY COMPANY • 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: Name Date of Binh I Legalaldose For U.S. Parsons: Social Security NUMbe For lion-U.SP*MooS: (See footnote 1!or oternativell to SOCiIII Senrry Number) I JEFFREY E. EPSTEIN • ' For Non.U.S. Petsorc In arrIcitOOn Ku a Social Security Horner ore Possport Numb& min Country of /Swum an alien WegilIliCition Card nut. Or nontOro enet county Wiest:Once of any other covet rrient-Issued document itArtencing nakinallty or residence and scaring a Ohornown or Vorrilas Oferpart snotrrn 00 provided. (If no inOividua? 'nen this delinitaxi. Pleate write "Not Aopficaotel d. The following information for one individual with significant responsibility for managing the legal entity listed above, such as: 16100 RED HOOK QUARTER, B3 I ST. THOMAS, USVI 00802 • 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 Date of Birth i ! Legal address For U.S. Persoor For Non.U.S.PanOn.1: 1 Saab! Seennty Number (See footttoto tier nIternathys to Social Secuagy Nurnberi JEFFREY E. EPSTEIN I SEE iABOVE i For Non-US. Persons. In addition to a Sock Security Number rre PaSSOCrt Number with Country of 'nuance. en al k% kientification cob norribtr. or WOW: aid Critelli' Of issuance of any =et governr.ent-issued document mice:ming nationality ce residence ono bearing a pnottaqraph or sieriab oofeguaret shone be aeoveled. EIN (name of natural person opening the account), hereby certify he est of d above is complete and correct r 1/4 Signature Verifica 7124118 •/A Legal Entity Identifier (Optional) sir jhAte Name (Print): Title: Dote* 4-1Thec VP 11-17/ CONFIDENTIAL - PURSUANT TO FED. R. GRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0077181 SDNY_GM_00223365 EFTA01379576