EFTA Document EFTA01380174

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 It Natural Person Conning Account: .3-e-Wqrc•-f fs‘ År.e,t," i Pere b. Name or Legal EntitY 'Tiffin Cif ts2& E ntrrr. ancl AC-dmss Lcgal Entity toi Whitt! the Account iS Being Opened: TE G E- , c.. ‘be (a (ot Or-) lamb kAticAh .4-t sr, 83 ,..1S+Jt tØai "fte fo”owing information for ea0h individual if any. who. direeey or through am( c:oritret.t. arrangement, urder3e"4, 5. •,::it)t..;r, I lip or otherwise. owrot 25percent or more of the equity interests e7,1 the legal entity 'kind abo,iet r p;:,! ,e;:: rAtt”iw • ....1L•Vil it• Smeenn 6lt:(0 eat k4...4ZO..)".+er, 93 6-‘zlick,1/4 tised C3 s3/4-. s) °cut OOloa. ci90 —4*— _311-rSr- "F0t eMette.S.ttratim. tacktzin n Sttti :441M/I.EZy CI o I'MOVII0it .'fumbef tither/L/0/1'r of ;Para owe Nenbo.fr M4COUlltijoi minumti of mrf :sin« tattninentiflteed demument meineennent; eltuveahty a MIELkIel/OIM,IIMIMIIIQ,I.pnmgript; or MIMS& s)Mrpitil eentilef eft iif no rW4dualftli/St I Illt c#nae MOP 'Net Appteufbef The following Information for one Individual with significant responsibilhy for managing the legal entity liSted 31.1t,e, ilttoh 3e,. • An executive officer or ser: or manager (e.g., Chief Executive Offictn. Chief Financial Officer. Chief Operating Officer, Managing M9IIIDOC Generns Partner, President, Vita President, Trassorer): or • An= other individue, who regularly f).rforms Smilar tuneitn (II appropriate. an individual listed tender sectX:in (c}above may also be listed in this section cd». : Lfj AGMS, 1err.14 esa- FM! Li S. R$1 U-S. RN AL-4: %me: r 1 IV $4c.is Seeuntk l• unBtef: )1-.Arri..AtA RNIMPA. h MMI:{iMI 5•II-VM`f nth ese `]Stem-,t, tIliffitM arcr CMIIIIre of ieseeenee nf any oetti emtenment•leteten eincurnew t.beenesni ntoonslitt et eteineennt end ['teeing • efnentertoeh seereler nitepelni ehoolif en: ptettlekt. d of natural person opening the account). hereby certify. to the best of knowledg ovided L.-triplets end cfri^,,ct. Untal ,Snaty tclentfLrt irjpncin+H t ft 20ai nse A. AO. Ad s intp•Auf. '4,AlagArsiti e2681 131.9 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0078392 CONFIDENTIAL SDNY_GM_00224576 EFTA01380174