EFTA01370743.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, PRESIDENT b. Name of Legal Entity. Type of Legal Entity, and Address of Legal Entity for Which the Account is Being Opened: JEEPERS, INC., A USVI CORPORATION 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, understanding, relationship or otherwise, owns 25 percent or more of the equity Interests of the legalarrangement, entity listed above: i Name (Meet Birth Legal Address I For U.S. Persons: For Non.US. Pomona: Social Socurity (See fOotrION 1ior alto:nal ... I I Nombre to Sacral Security Number) 16100 RED HOOK QUARTER, B3 JEFFREY E. EPSTEIN ST. THOMAS, USVI 00802 I= , • FIX Non-U.S. Persons. in aoCiUon to a Social Security Number or a Passport Number wan Country of :ssuance. an alien identification card nurrc-ft, or nurntme one count/ye asuante of tny other goecrintent-issued doximent evidencing rtatimality or resecence and baathv a Photograph or rnrtar salepard VlOold prOlteed. (If no indrinual moots diis definition. please k.wite 'Nat aeolicae.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. (If appropriate, an individual listed under section (c) above may also be listed in this section (a)). Name Cate of Sinn I Legal Address Ii For U.S. Persony: For Non-US. Parsons: Social Security (See footnote f for alternatives Number to SeeeeSsarrny Mantel) n ABOVE JEFFREY E. EPSTEIN j SEE • For Non-US. Peraons• in addition to a Social Security Number or a Panp,xt Number WWI Country of Issuance. and country of Issuance of any other goyarnrmnt-isfrurtd document evrelanoMq normality et resdence an arca IrentiSeinion cord :Jumper. or number and bearing a utast:eh uh ce rumger safeguard thou' be provided. (name of natural person opening the account), hereby certify to the best of ded above is complete and correct. Signature Verific r Name (Print tent Enift Identifier tOpMina4 Title: oN. 51,044c Cpc CONFIDENTIAL - PURSUANT TO FED. R. GRIM. P. 6(e) DB-SDNY-0063752 CONFIDENTIAL SDNY_GM_00209936 EFTA01370743