EFTA01291973.pdf

WARNING: PRINTED VERSIONS OF THE BSA E-FILING FORMS ARE NOT FOR SUBMISSION AND WILL NOT BE PROCESSED BY FINCEN. Currency Transaction Report Version Number 1.1 OMB No. 1506-0064 Filing Name 152-6426 9 Type of filing Minitel report ❑ Correct ia mend prior report ❑ FinCEN directed Backfiling Document Control Number / BSA Identifier L Save Validate Print Under penalties of perjury. I declare that I have examined this transmittal, including accompanying documents, and to the best of my knowledge and belief it is correct and complete. In the case of documents without recipients identifying numbers, I have complied with the requirements of the law in attempting to secure such numbers from the receipts. I declare that this filing represents all Documents filed during this reporting period except for those transactions reported on paper. Sign with PIN SDNY_GM_00049899 CONFIDENTIAL — PURSUANT TO FED. R.QQN(F IDENTIAL DB-SONY-0012723 EFTA_OOI 60507 EFTA01291973  WARNING: PRINTED VERSIONS OF THE BSA E-FILING FORMS ARE NOT FOR SUBMISSION AND WILL NOT BE PROCESSED BY FINCEN. Part I Person Involved in Transaction 1 of 2 00 ri Person conducting Person conducting Person on whose behalf b Courier Service .2 a " transaction on own behalf transaction for another c I—I transaction was conducted d O (Private) 3 O Multiple transactions Check O If entity '4 Individual's last name O Unknown Indyke or entity's legal name '5 First name O Unknown Darren 6 Middle name K. Suffix 7 Gender Male 8 Alternate Name 9 Occupation or type of business Attorney; owner of law arm 9a NAICS Code '10 Address O Unknown '11 City O Unknown •12 State ❑ Unknown [ O Unknown '13 ZIP/Postal Code 0 Unknown • '14 Country US '15 TIN 0 Unknown 16 TIN type SSN4TIN '17 Date of birth ❑ Unknown 18 Contact phone number Ext. 19 E-mail address '20 Form of identification used to verify identity OUnknown IX Drivers kcense/State ID O Passport O Alien Registration O Other Number Country US Issuing State • 21 Cash in amount for individual or entity listed in Item 4 Account number 00 22 Cash out amount for irxlmdual or entity listed in Item 4 $ 108.778 Account number) 10 • Page 2 of 5 SDNY_GM_00049900 CONFIDENTIAL - PURSUANT TO FED. R.QQN(F IDENTIAL DB-SONY-0012724 EFTA_00 I 60508 EFTA01291974  WARNING: PRINTED VERSIONS OF THE BSA E-FILING FORMS ARE NOT FOR SUBMISSION AND WILL NOT BE PROCESSED BY FINCEN. Part 1 Person Involved in Transaction 2 of 2 00 '2 a rn Person conducting O Person conducting — Person on whose behalf ❑ b Service I—I transaction behalf own on transa ction for another c El transaction was conducted d C°tirier (dr".) 3 O Multiple transactions Check O If entity '4 Individuars last name O Unknown Epstein or entitys legal name '5 First name O Unknown Jeffrey 6 Middle name Suffix 7 Gender 8 Alternate Name 9 Occupation or type of business 1President of SouthemFInancial 9a NAICS Code '10 Address O Unknown 6100 Red Hook Quarter, B3 —It City O Unknown [ St. Thomas ----------- '12 State O Unknown VI '13 ZIP/Postal Code O Unknown [00802 '14 Count!), O Unknown US '15 TIN ❑ Unknown 18 TIN type SSN4TIN '17 Date of birth ❑ Unknown 0112011963 18 Contact phone number Ext. 19 E-mail address '20 Form of identification used to verify identity OUnknown ig Drivers kcense/State II) O Passport O Alien Registration O Other Number C000000029913 Country US Issuing State VI 21 Cash in amount for individual or entity listed in Item 4 Account number 0 0 22 Cash out amount for Individual or entity listed in Item 4 108.778 Account number [ 10 0 Page 3 of 5 SDNY_GM_00049901 CONFIDENTIAL - PURSUANT TO FED. R.QQN(F IDENTIAL DB-SONY-0012725 EFTA_00I60509 EFTA01291975  WARNING: PRINTED VERSIONS OF THE BSA E-FILING FORMS ARE NOT FOR SUBMISSION AND WILL NOT BE PROCESSED BY FINCEN. Part II Amount and Type of Transaction(s). Check all boxes that apply. '23 Date of transaction 01117/201S 24 O Aimored car (FI Contract) O ATM ❑ Mail Deposit or Shipment O Night Deposit O Aggregated transactions 15 CASH IN: (in U.S. dollar equivalent) '27 CASH OUT: PO U.S. dollar ItquNalent) a Deposit(s) .00 a Ildthdrawal(s) .00 b Payment(s) .00 b Advance(s) on credit (Including markers) .00 c Currency received for funds translor(s) out .00 C Cestency pail from funds transfot(s) n .00 d Purchase of negotiable instrument (s) .00 d Negotiable instrument(s) cashed 100.000,00 e Currency orchange(s) 00 e Currency exchange(%) 8,778.00 f Currency to prepaid access .00 I Currency from prepaid access .00 g Purchases of casinos chile, tokens Redemploo(s) or casino chips. tokens, and other gaming instruments 00 TITO tickets and other gaming instruments 00 h Currency vrage(s) including h Payments) on race(s) roductem moo money plays .00 and OTB or sports goon .00 Travel and complimentary expenses and I Bills inserted into gaming devices .00 took gaming Incentives .00 Payment ler tournament. contest or other z Other (speedy): promotions .00 .00 z Other (specify) .00 Total Cash in .00 Total Cash out 108,77100 26 Foreign Cash in Foreign Country 0 0 28 Foreign Cash out 7,000 Foreign Country BE 0 0 Page 4 of 5 SDNY_GM_00049902 CONFIDENTIAL - PURSUANT TO FED. R.QPN(E IDENTIAL DB-SONY-0012726 EFTA_00 I 605 I 0 EFTA01291976  WARNING: PRINTED VERSIONS OF THE BSA E-FILING FORMS ARE NOT FOR SUBMISSION AND WILL NOT BE PROCESSED BY FINCEN. Part III Financial Institution Where Transaction(s) Takes Place 1 of 1 0 0 '37 Type of financial institution I Depository institution Other (specify) '29 Primary federal regulator I Federal Reserve Board (FRB) 38 If 37a - Casino/Card Club is checked, indicate type (chedc only one) ❑ State licensed casino ❑ Tribal authorized casino El Card club ❑ Other '30 Legal name of financial institubon I Deutsche Bank Trust Company Americas 31 Alternate name, e.g. trade name, DBA '32 EIN '33 Address 346 Park Ave '34 City New York '35 State NY '36 ZIP Code 110154 39 Financial institution ID type ID number '40 Contact office DB PB AML '41 Phone number '42 Date Filed (Dale filed will be auto -populated when Ihe form is signed.) Page 5 of 5 SDNY_GM_00049903 CONFIDENTIAL - PURSUANT TO FED. R.CON(F IDENTIAL DB-SONY-0012727 EFTA_00I605 I I EFTA01291977