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H. Certification of beneficial owner(s)
Persons opening an account on behalf of a legal entity must provide the folbeing information:
a. Name and Tide of Waite a! Pe! son
• •
Zele•Pr-../
h. Name c.f legà Entity. Type ell Leoal E. •
•
Add! ets
Lega: Em;ty freWhe.h the Account is Seine Openect:
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SzzÂle- Uit.e‘e•-•L -eV
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c. The folkmeMe, infernation for each indk:idual, if any, wtKi. directly
indirefffly, thro:)h env coninc!;. arranajernern.
understanding, relationship or otherwise, owns 25 percent or more of the equity interests of the legal entity listed above:
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s 7eIrtelf Citt•nclee with C;oor
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enuoire seis:Jamb of amf oche goeecone.r.Istuto dotwooto eyo-O,nowoo name:eye cw caltienob and beam ig a ea.:opeh .31 tInoilor :salm/4M diottiln
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d. The following information for one individual with significant responsibility for managing the legal entity listed above,
SVC% as:
• An executive officer or sergor !nonage: (e.g.. Chief Exc-aitive Officer. Chief Financioi Officer. Chief Operating Ofrefer.
Managing Member, General Panne:. President. Vice President. Treasurer); or
• Any ether ?nt.i ividu& who reoutany performs sk*ar *function.
(if appropriate, an individual listed under section (ra above may also be listed in this seotion (d)).
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Permrc itoorkirtion too Sr-"-:! stKowiietioriber rw t ›assfeet it-weber v:eittiasery of trminnw. ;et, e 2r
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'WO COVntri Crf icicclancc. e
Cent i)C•rernilet,e.iii acci
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be otopo.oj.
toe f.noto Morten« i000Oran
(name ct natural person opening the account), hereby certify. b we hest of
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CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
DB-SDNY-0079900
CONFIDENTIAL
SDNY GM_00226084
EFTA01381131