EFTA01362343.pdf

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: JEFFREY 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: LSJE, 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 Dote of Binh Lepel Address rot US. Penont: Fcr Non-11.S Pe arts Social Security I (See footnote I for alternatives Number to Social Setwey fakenbei) 6100 RED HOOK QUARTER, B3 JEFFREY E. EPSTEIN 1/20/63 ST. THOMAS, USVI 00802 1 For Non-U.S. Person; in acketinn to a Social Security hieniee: or a Pas0Cet NufTeer With C0WIlly at Issu nce. en arse, identircerinn card nuneaor. or nuttier and county? of issuance of any other vorarnment-issoto document C.:Wen:Mg natiractafity Or T eSiCienee anC nearing 0 p0Werann O sinfiter soteguero O effninea. no ineivickne mews this dalwwtgn, please wit° "tact Atpticah:e.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. Of appropriate. en individual listed under section (c) above may also be listed in this section (d)). i Nam* Mateo( Beth i Legal Address t For U.S. Penons: I For Nan-u.s.Pcsons Sotial Security Mee footnote I for agenneliva lewnoei 10 $0601&Wanly :lumber) ABOVE 1 !JEFFREY E. EPSTEIN I SEE F0r lean.U.S. Person& in addition to a Social Security Number or a Passport Number with Countryof Issuance, on alien identlficat KAI cord numbe. of number Sf•4 COteerY d inSutnet Of any other govenvnent-issued documenr eetoeffeeffi netinneley ore residence am hearing a oho:3gram or sinew eakpare should bo provided, REY E. E TEIN ne of natural person opening the account), hereby ce to the best of m knowledge, that t information pve Is complete and correct. Signature 7/24118 Sire Da:C. 7 714 T—.C Name Legal Entity Identifier tOPtfamet) Rae: Srprivre CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0051723 CONFIDENTIAL SDNY_GM_00197907 EFTA01362343