EFTA01379580.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, MANAGER b. Name of Legal Entity, Type of Legal Entity, and Address of Legal Entity for Which the Account is Being Opened: SOUTHERN FINANCIAL, LLC, A USVI LIMITED LABILITY COMPANY 8100 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: i Name Date of Birth legal Address I For U.S. Persona: For Plon.U.S. Peron: Soak2I Satiric? I Set Coccootel toy alternatives Number to SOS: Securay Numbed 6100 RED HOOK QUARTER, 83 JEFFREY E. EPSTEIN St THOMAS, USVI 00802 1 For NomUS. Persons. in &coition too Social Security Number or a Naspod Number with Country of IssuanCe. an Open identirrcellon card Welber. Or ',floater and courciy of issuance of any Ced ter governintnt-issued document evelencing nettecially cv resicence ann matins a oftatoorapn or *Nat safeguard doculo OS amid= (If no incliktual mans this d4hiitiCet dense tvflIC -Not Applicable) 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. (if appropriate, art individual listed under section (c) above may also be listed in this section (d)). Name I Date of Bath f Legal Addarn For US. Persona: kr Non-0 S. Perfordr Social Security (Sea foolnote I for *Nana:ins' Numb& to Social Security Number) ABOVE JEFFREY E. EPSTEIN SEE For Non-tAS. Persona, in addition to a Social &wordy Number or o Passport Niermer with Country of stuance. an alien Identificaton cam number, or mailbag end countryof issuaree of any other govetrtment-issoed document oviterwinc natiOnaaty or reticence and beating a taborcgrabb Or simile: surer old should be provided. me of natural person opening the account), hereby certify, to the best of tied above is complete and correct. 7124/18 Date 47//(4 ;(ert Sr AIN Cei Date CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0077187 CONFIDENTIAL SDNY GM_00223371 EFTA01379580