EFTA01379579.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: PLAN CI, LLC, A USVI LIMITED UABIUTY COMPANY 6100 RED HOOK QUARTER, B3 ST. THOMAS, USVI 00802 c. The following information for each individual, if any, who, directiy 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 I Date of Seth Legal Address cor U.S. Parsons: I For Non-U.S.Passont SocialSedurAY 1 (See footnote ler Clikr 'LIMPS N'JMtiti • to Social Sacday Ntenber) 6100 RED HOOK QUARTER, 63 JEFFREY E. EPSTEIN 1120(53 ST. THOMAS, USVI 00802 For Pion-US. Persons. in acioinon to a SOCiaiSeCtrity Number or a Pasrpon Number with Country of issmoote. an ellen ktentircation card nor*cs, or numnar and county of issuance is: any other geyonimant -issued ticianerri evidenci^.9 noticnahty or residence and Warkng a Pi otonrada or SkriLlt be provided. sateguart should of no melhOdual meets this deli:Ikon. please write "Not Apolicet:e.1 d. The following information for one individual with significant responsibility for managing the iegal 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)). Name Oats of 8nh I Loath:Jewess Far Persons: For Non-U S. Pgrsont Social Security (See footnote for aitenuelvasi Number j to SQC:111 Security Number) i I ABOVE JEFFREY E. EPSTEIN SEE For Non•US. Persons in addition toe Social Security Number or a Pain= NOTbra ?AO Country and country of Issuance Many otnor s.c.veingttertI4SSOC4 CCCunlent eviditnying 0!ISSuallCe, an ebb) itilAtilitOl.arl CWC Mutt.; or cumber nationality c, residence anti bearing ai Or Sinutvlilt7hIrci Should bc Provided. rat person opening the account), hereby certify, to the best of aye is complete and correct. 7124118 Dalt Legal entity !Snuffer (00tional) Sp/juke eid CONFIDENTIAL - PURSUANT TO FED. R. GRIM. P. 6(e) DB-SDNY-0077186 CONFIDENTIAL SDNY GM_00223370 EFTA01379579