EFTA01369135.pdf

II. Certification of beneficial owner(s) Persons opening art account on behalf of a legal entity must provide the following information: a. Name and Title of Natural Person Opening Axount: ,JEFFREY E. EPSTEIN, PRESIDENT b, Name of Legal Entity, Type of Legal Entity, and Address of Legal Entity for Which the Account is Being Opened: 1-.6100 ).EPSTEIN VIRGIN ISLANDS FOUNDATION, INC., A 601(c)(3) PRIVATE FOUNDATION/USA CORPORATION 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: Narna Bate of Birth Lagai Address For US. ANSCIftt Fdr firion-U.S.Nrsont —1 Social SeculitY (See footnote t for alternatives Number to Social Seheity Number) NOT APPLICABLE For Non-US. Persons. inaddition to a Social Smithy Number or a Passport Number with Co:mtry of issuance. an gen identincation card floater. or numnor and country of issuance of anyether government-issued document evioencing nationality or residence and bearing 0 be provided. photograph or seni-Sti ureguatc shook% (lino individual meats this definition, pease write 'Not Auelicabiel a. 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)). I Nan. Nan,e : Detect Both I Legal Address I For US. Peroons: Cot Natl.:1S. Persona: s I Soca, Security (See footnote l tor altmlativos ' 1 Number i to Scare: Searcy Numbed 1 4 16100 RED HOOK QUARTER, 93 !JEFFREY li E. EPSTEIN 1/20/53 I St THOMAS, USVI 00802 i i ' For Nen-U.S. Persons. in addition to a Social Security Number or a Passport Number with Country of Issuance. alien idardilicatton en ears norm% or number ____i and country of issuance et any Mho voi•OlterOfit-iSSOeti Magma tvidencing not or reiCeRC:1and Dearing a ',holograph or %Molar safeguard %build be brovided. FREY E. E TEIN tame of natural person opening the account), hereby certify, to the best of y knowledge, that t e infp is complete and correct. 7/24118 Date Legal Entity Identifier (Opuonag CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0061243 CONFIDENTIAL SDNY_GM_00207427 EFTA01369135