EFTA00619503.pdf

TAX RETURN FILING INSTRUCTIONS REPORT OF FOREIGN BANK AND FINANCIAL ACCOUNTS Prepared for PLB, LLC C/O ELYSIUM MANAGEMENT LLC Prepared by RAICH ENDE MALTER & Form must be filed on JUNE 30,2015 or before Special FORM 114 HAS BEEN PREPARED FOR ELECTRONIC FILING. PLEASE Instructions SIGN, DATE, AND RETURN FORM 114A TO OUR OFFICE. WE WILL THEN TRANSMIT YOUR REPORT TO THE FINCEN. 400097 07.31.14 EFTA00619503  Form 114a Record of Authorization to Department of the Treasury Financial Crimes Enforcement Electronically File FBARs Network (FinCEN) (See instructions below for completion) October 2013 Do not send to FinCEN. Retain this form for your records. PLBLLC20140001 Part I Persons who have an obligation to file a Report of Foreign Bank and Financial Account(s) I. Owner last name or entity s legal name 2. Owner first name 3. Owner M.I. PLB, LLC C/O ELYSIUM MANAGEMENT LLC 4. Spouse last name (if jointly filing FBAR • see instructions below) 5. Spouse first name 6. Spouse M.I. Vwe declare that Vwe have provided information concerning 17 (enter number of accounts) foreign bank and financial account(s) for the filing year ending December 31. 2014 to the preparer listed in Part II: that this information is to the best of my/our knowledge true. correct. and complete: that Vwe authorize the preparer listed in Part II to complete and submit to the Financial Crimes Enforcement Network (FinCEN) a Report of Foreign Bank and Financial Accounts (FBAR) based on the information that Vwe have provided: and that Vwe authorize the preparer listed in Part II to receive information from FinCEN. answer inquiries and resolve issues relating to this submission. Vwe acknowledge that. notwithstanding this declaration, it is my/our legal responsibility, not that of the preparer listed in Part II, to timely file an FBAR if required by law to do so. 7. Owner signature (Authorized representative if entity) 8. Date 9. Owner or entity TIN 10. TIN a LxJ BN type b 0 SSN/ITIN MM DD nye 300751322 c 0 Foreign 11. Spouse signature 12. Date 13. Spouse TIN 14. TIN a U EIN type b 0 SSN/ITIN MM OD wry c 0 Foreign Part II Individual or Entity Authorized to File FBAR on behalf of Persons who have an obligation to file. 15. Preparer last name 16. Preparer first name 17. Preparer M.I. 18. Preparer PTIN TURRIN HOMAS P00850244 19. Address 20. City 21. State 22. ZIP/postal code 23. Country 24. Preparers (item 15) employer's (En ity) name 25. Employer EIN 26. Preparer's ignature code US RAICH ENDE MALTER & CO., LLP 11-2336434 Instructions for completing the FBAR S gnature Authorization Record This record may be completed by the individual or entity granting such authorization (Part I) OR the individuaVentity authorized to perform such services. The completed record must be signed by the individual(syentity grant ng the authorization (Part I) and the individuaVentity that will file the FBAR. The Preparer/filing entity must be registered with FinCEN BSA EFile system. (See http://bsaefiling.fincen.treas.gov/main.html for registration). Read and complete the account owner statement in Part I. To authorize a third party to file the Foreign Bank and Financial Accounts Report (FEAR), the account owner should complete Part I. items 1 through 3 (as required), sign and date the document in Part I. items 7/8 and complete items 9 and 10. Accounts Jointly Owned by Spouses (see exceptions in the FBAR instructions) If the account owner is filing an FBAR jointly with his/her spouse. the spouse must also complete Part I. items 4 through 6. The spouse must also sign and date the report in items 11/12. and complete items 13 and 14. A third party preparer may be one of the spouses of the jointly owned foreign account. In this case. both spouses must complete Part I of form 114a in its entirety. The third party preparer (spouse) that will file the FBAR on behalf of both silences will complete Part II in its entirety (do not use such terms as see above. or same as item number )0. Complete Part II. items 15 through 18 with the preparer's information. The address. items 19 through 23, is that of the preparer or the preparer's employer if the preparer is an employee. Record the employer's information (if any) in items 24 and 25. If the preparer does not have a PTIN. leave item 18 blank. The third party preparer must sign in item 26 of Part II indicating that the FEAR will be filed as directed by the authorizing authority. The person(s) listed in Part I. and the person listed in Part II as authorized to file on behalf of the person(s) listed in Part I. should retain copies of this record of authorization and the filing itself, both for a period of 5 years. See 31 CFR 1010.430(d). DO NOT SEND THIS RECORD TO FinCEN UNLESS REQUESTED TO DO SO. 05.01.14 Rev. 10.4 July 11.2013 EFTA00619504  FINANCIAL CRIMES ENFORCEMENT NETWORK BSA E-Filing - Report of Version Number 1.1 Foreign Bank and Financial FinCEN Form 114 Accounts (FBAR) OMB Control Number: 1506-0009 PLBLLC20140001 Effective January 1, 2014 FiMg Name PLB, LLC Submission Type NEW PIN NOT REQUIRED Check here al if this report is submitted by an authorized third party, and complete the 3rd party preparer section on page one of the report. The E-file system will auto complete item 46. NOTE: The FBAR must be received by the Department of the Treasury on or before June 30th of the year immediately following the calendar year being reported. The June 30th filing date may not be extended. This report filed late for the following reason (Check only one): a P Forgot to file b O Did not know that I had to file c O Thought account balance was below reporting threshold 0 Did not know that my account qualified as foreign e 0 Account statement not received in time 0 Account statement lost (Replacement requested) g O Late receiving missing required account information h O Unable to obtain joint spouse signature in time O Unable to access BSA E•filing system z O Other (please provide explanation below) 423151 05.01-14 EFTA00619505  FinCEN Form 114 REPORT OF FOREIGN BANK 1 This report is for calendar Department 019p Treasury OMB no. 1506-0009 AND FINANCIAL ACCOUNTS year ended 12/31 e- Septemtor 2013) Do NOT file with your Federal Tax Return 2014 Do not use previous editions of this form Mflded Arne I Part I I Filer information PLBLLC20140001 2 Type of filer a0 Individual b 0 Partnership c 0 Corporation d IM Consolidated e Fiduciary or other • Enter type 3 U.S. Taxpayer Identification Number 3a TIN type 4 Foreign identification (Complete only if item 3 is not applicable) 5 Individual's date of birth MWDDNYVY 300751322 SSNATIN a Type' 0 Passport CI Foreign TIN 0 Other If filer has no U S Identification BN number complete item 4 b Number c Country of Issue 6 Last name or organization name 7First name 8 Middle initial 8a Suffix PLB, LLC C/O ELYSIUM MANAGEMENT LLC 9 Mailing address (number. street. and apt. or suite no.) 10 City 11 State 12 ZIP/Postal Code 13 Country • 14 a) Does the filer have a financial interest in 25 or more financial accounts? .1SA Yes 0 Enter number of accounts Do not complete Part II or Part III, but maintain records of the information. No IM b) Does the filer have signature authority over but no financial interest in 25 or more financial accounts? Yes 0 Enter number of accounts Comp. Part IV, items 34 through 43 for each person on whose behalf the filer has sign. authority. No IX] I Part III Information on financial account(s) owned separately 15 Maximum value of account during calendar year 15a Amount 16 Type of account aU Bank bL_I Securities cl I Other • Enter type below unknown 17 Name of financial institution in which account is held 18 Account number or other designation 19 Mailing address (number. street. apt. or suite no.) of financial institution in which account is held 20 City 21 State. if known 22 Foreign postal code, if known 23 Country I Signature 144a Check here LXJ if this report is completed b a third party preparer and complete the third oarty preparer section. 44 Filer signature 45 Filer title, if not reporting a personal account 46 Date (Iv1M/)p 1r, report nal be electronically leis will au f lone levo n the elgnee *non died Fenn Is ekrttronMessned 47 Preparer's last name t — 48 First name 49 MI 50 Checks Id 51 TIN 51a TIN type PTIN TURRIN HOMAS self-employedP00850244 SSWMN 0 Foreign Third Party 52 Contact phone no. 52a Ext. 53 Firm's name 54 Firm's TIN 54a TIN type LXJ EIN Preparer 212-944-4433 RAICH ENDE MALTER & 11-2336434 0 Foreign Use Only 55 Medina address (number. street, apt. or suite no. 6 Cit li tate 8 ZIP Postal Code 59 Country US This form should be used to report a financial interest in, signature authority, or other authority over one or more financial accounts in foreign countries, as required by the Department of the Treasury Regulations 31 CFR 1010.350. No report is required if the aggregate value of the accounts did not exceed $10,000. See instructions for definitions. PRIVACY ACT AND PAPERWORK REDUCTION ACT NOTICE Pursuant to the requirements of Public Law 93-579 (Privacy Act of 1974), notice is hereby given that the authority to collect information on FinCEN Form 114 in accordance with 5 USC 552a (e) is Public Law 91-508; 31 USC 5314; 5 USC 301; 31 CFR 1010.350. The principal purpose for collecting the information is to assure maintenance of reports where such reports or records have a high degree of usefulness in criminal, tax, or regulatory investigations or proceedings. The information collected may be provided to those officers and employees of any constituent unit of the Department of the Treasury who have a need for the records in the performance of their duties. The records may be referred to any other department or agency of the United States upon the request of the head of such department or agency for use in a criminal, tax, or regulatory investigation or proceeding. The information collected may also be provided to appropriate state, local, and foreign law enforcement and regulatory personnel in the performance of their official duties. Disclosure of this information is mandatory. Civil and criminal penalties, including in certain circumstances a fine of not more than $500,000 and imprisonment of not more than five years, are provided for failure to file a report for failure to supply information, and for filing a false or fraudulent report. Disclosure of the Social Security number is mandatory. The authority to collect is 31 CFR 1010.350. The Social Security number will be used as a means to identify the individual who files the report. The estimated average burden associated with this collection of information is 60 minutes per respondent or record keeper, depending on individual circumstances. Comments regarding the accuracy of this burden estimate, and suggestions for reducing the burden should be directed to the Financel Crimes Enforcement Network, P.O. Box 39, Vienna, VA 22183, Attn: Office of Regulatory Poky. 425141 05-01.14 Rev 5.7 • 6/3/2013 EFTA00619506 Part V Information on financial account(s) where filer is filing a FinCEN Form 114 consolidated report Page Number Complete a separate block for each account 2 of 10 Add an additional Part V page as many times as necessary in order to provide information on all accounts I Filing for calendar 34 Check appropriate identification number 6 Last name or organization name year al Taxpayer Identification Number PLB, LLC 2014 0 Foreign Identification Number C/O ELYSIUM MANAGEMENT LLC Enter identification number here: 300751322 15 Maximum value of account during calendar year 15a Amount 16 Type of account aLXJ Bank bLi Securities cLi Other Enter type below unknown 4,492,426. 17 Name of financial institution in which account is held BANK OF SCOTLAND 18 Account number or other designation 19 Mailing address (number. street. apt. or suite no.) of financial institution in which account is held 00152847 THE MOUND 20 City 21 State. if known 22 Foreign postal code, if known li2 R34 Country EDINBURGH EH1lYZ ITED KINGDOM 34 Organization name of account owner 35 Tax identification number of account owner 35a TIN type 0 EIN 0 SSWITIN PHAIDON PRESS LTD 0 Foreign 38 Mailing address (number, street, apt. or suite no.) 18 REGENTS WHARF, ALL SAINTS STREET 39 City 40 State 41 ZIP/Postal Code 42 Country LONDON N19PA ITED KINGDOM 15 Maximum value of account during calendar year 15a Amount 16 Type of account aLXJ Bank bLJ Securities c Other Enter type below unknown 3,568,777. 17 Name of financial institution in which account is held BANK OF SCOTLAND 18 Account number or other designation 19 Mailing address (number. street. apt. or suite no.) of financial institution in which account is held 12112892 THE MOUND 20 City 21 State. if known 22 Foreign postal code, if known 23 Country EDINBURGH EH1lYZ UNITED KINGDOM 34 Organization name of account owner 35 Tax identification number of account owner 35a TIN type 0 EIN 0 SSWITIN PHAIDON PRESS LTD 0 Foreign 38 Mailing address (number, street, apt. o suite no.) 18 REGENTS WHARF, ALL SAINTS STREET 39 City 40 State 41 ZIP/Postal Code 1(4 11 24Country LONDON N19PA ITED KINGDOM 423144 0543144 EFTA00619507 Part V Information on financial account(s) where filer is filing a FinCEN Form 114 consolidated report Page Number Complete a separate block for each account 3 of 10 Add an additional Part V page as many times as necessary in order to provide information on all accounts 1 Filing for calendar 34 Check appropriate identification number 6 Last name or organization name year al Taxpayer Identification Number PLB, LLC 2014 0 Foreign Identification Number C/O ELYSIUM MANAGEMENT LLC Enter identification number here: 300751322 15 Maximum value of account during calendar year 15a Amount 16 Type of account aLXJ Bank bLi Securities cU Other Enter type below unknown 1,130,145. 17 Name of financial institution in which account is held BANK OF SCOTLAND 18 Account number or other designation 19 Milling address (number. street. apt. or suite no.) of financial institution in which account is held 59115516 THE MOUND 20 City 21State. If known 22 Foreign postal code, if known lig T Country EDINBURGH EH1 lYZ ITED KINGDOM 34 Organization name of account owner 35 Tax identification number of account owner 35a TIN type 0 EIN 0 SSWITIN PHAIDON PRESS LTD 0 Foreign 38 Mailing address (number, street, apt. or suite no.) 18 REGENTS WHARF, ALL SAINTS STREET 39 City 40 State 41 ZIP/Postal Code 42 Country LONDON N19PA ITED KINGDOM 15 Maximum value of account during calendar year 15a Amount 16 Type of account aLXJ Bank bU Securities c Other Enter type below unknown 688,824. 17 Name of financial institution in which account is held BANK OF SCOTLAND 18 Account number or other designation 19 Mailing address (number. street. apt. or suite no.) of financial institution in which account is held 49110183 THE MOUND 20 City 21State. if known 22 Foreign postal code, if known 23 Country EDINBURGH EH1 lYZ UNITED KINGDOM 34 Organization name of account owner 35 Tax identification number of account owner 35a TIN type 0 EIN 0 SSWITIN PHAIDON PRESS LTD 0 Foreign 38 Mailing address (number, street, apt. o suite no.) 18 REGENTS WHARF, ALL SAINTS STREET 39 City 40 State 41 ZIP/Postal Code 42 Country LONDON N19PA JNITED KINGDOM 423144 05-0144 EFTA00619508  Part V Information on financial account(s) where filer is filing a FinCEN Form 114 consolidated report Page Number Complete a separate block for each account 4 of 10 Add an additional Part V page as many times as necessary in order to provide information on all accounts I Filing for calendar 34 Check appropriate identification number 6 Last name or organization name year al Taxpayer Identification Number PLB, LLC 2014 0 Foreign Identification Number C/O ELYSIUM MANAGEMENT LLC Enter identification number here: 300751322 15 Maximum value of account during calendar year 15a Amount 16 Type of account alL Bank bLi Securities cLi Other Enter type below unknown 92,325. 17 Name of financial institution in which account is held BANK OF SCOTLAND 18 Account number or other designation 19 Mailing address (number. street. apt. or suite no.) of financial institution in which account is held 48110090 THE MOUND 20 City 21 State. If known 22 Foreign postal code, if known 23 Country EDINBURGH EH11YZ ITED KINGDOM 34 Organization name of account owner 35 Tax Identification number of account owner 35a TIN type 0 EIN 0 SSWITIN PHAIDON PRESS LTD 0 Foreign 38 Mailing address (number, street, apt. or suite no.) 18 REGENTS WHARF, ALL SAINTS STREET 39 City 40 State 41 ZIP/Postal Code 42 Country LONDON N19PA ITED KINGDOM 15 Maximum value of account during calendar year 15a Amount 16 Type of account a Bank b Securities c Other • Enter type below unknown 189,864. 0 17 Name of financial institution in which account is held BANK OF SCOTLAND 18 Account number or other designation 19 Mailing address (number. street. apt. or suite no.) of financial institution in which account is held 40110946 THE MOUND 20 City 21 State. if known 22 Foreign postal code, if known 23 Country EDINBURGH EH11YZ ITED KINGDOM 34 Organization name of account owner 35 Tax Identification number of account owner 35a TIN type 0 EIN 0 SSWITIN PHAIDON PRESS LTD 0 Foreign 38 Mailing address (number, street, apt. o suite no.) 18 REGENTS WHARF ALL SAINTS STREET 39 City 40 State 41 ZIP/Postal Code 42 Country LONDON N19PA ITED KINGDOM 423144 05-01.14 EFTA00619509  Part V Information on financial account(s) where filer is filing a FinCEN Fenn 114 consolidated report Page Number Complete a separate block for each account 5 of 10 Add an additional Part V page as many times as necessary in order to provide information on all accounts 1 Filing for calendar 34 Check appropriate identification number 6 Last name or organization name year al Taxpayer Identification Number PLB, LLC 2014 0 Foreign Identification Number C/O ELYSIUM MANAGEMENT LLC Enter identification number here: 300751322 15 Maximum value of account during calendar year 15a Amount 16 Type of account alL Bank bLi Securities cLi Other Enter type below unknown 70,788. 17 Name of financial institution in which account is held BANK OF SCOTLAND 18 Account number or other designation 19 Mailing address (number. street. apt. or suite no.) of financial institution in which account is held 35110384 THE MOUND 20 City 21 State. if known 22 Foreign postal code, if known li g T Country EDINBURGH EH11YZ ITED KINGDOM 34 Organization name of account owner 35 Tax Identification number of account owner 35a TIN type O EIN 0 SSWITIN PHAIDON PRESS LTD 0 Foreign 38 Mailing address (number, street, apt. or suite no.) 18 REGENTS WHARF, ALL SAINTS STREET 39 City 40 State 41 ZIP/Postal Code 42 Country LONDON N19PA ITED KINGDOM 15 Maximum value of account during calendar year 15a Amount 16 Type of account a Bank b Securities c Other • Enter type below unknown 34,276. 0 17 Name of financial institution in which account is held BANK OF SCOTLAND 18 Account number or other designation 19 Mailing address (number. street. apt. or suite no.) of financial institution in which account is held 06050438 THE MOUND 20 City 21 State. if known 22 Foreign postal code, if known 23 Country EDINBURGH EH11YZ UNITED KINGDOM 34 Organization name of account owner 35 Tax Identification number of account owner 35a TIN type O EIN 0 SSWITIN MARYLEBONE RETAIL LIMITED 0 Foreign 38 Mailing address (number, street, apt. o suite no.) 18 REGENTS WHARF ALL SAINTS STREET 39 City 40 State 41 ZIP/Postal Code 42 Country LONDON N19PA ITED KINGDOM 423144 05-01.14 EFTA00619510 iThriaV1 Information on financial account(s) where filer is filing a consolidated report FinCEN Ram 114 Page Number Complete a separate block for each account 6 of 10 Add an additional Part V page as many times as necessary in order to provide information on all accounts 1 Filing for calenda 3.4 Check appropriate identification number 6 Last name or organization name year Taxpayer Identification Number PLB, LLC 2014 Foreign Identification Number C/O ELYSIUM MANAGEMENT LLC Enter identification number here: 300751322 15 Maximum value of account during calendar year 15a Amount 16 Type of account aLXJ Bank bLi Securities cLJ Other • Enter type below unknown 3,005. 17 Name of financial institution in which account is held LA CAIXA 18 Account number or other designation 19 Mailing address (number. street. apt. or suite no.) of financial institution in which account is held 700094760 DIAGONAL-CARLES III, AV DIAGONAL 621-629 20 City 21 State. if known 22 Foreign postal code, if known 23 Country BARCELONA 08028 SPAIN 34 Organization name of account owner 35 Tax identification number of account owner 35a TIN type EIN SSN/ITIN PHAIDON PRESS LTD Foreign 38 Mailing address (number. street. apt. or suite no.) 18 REGENTS WHARF, ALL SAINTS STREET 39 City 40 State 41 ZIP/Postal Code 42 Country LONDON N19PA UNITED KINGDOM 15 Maximum value of account during calendar year1 15a Amount 16 Type of account aLXJ Bank bt_l Securities c I Other • Enter type below unknown 172,285. a 17 Name of financial institution in which account is held COMMERZBANK AG 18 Account number or other designation 19 Mailing address (number. street. apt. or suite no.) of financial institution in which account is held 191913300 16 KAISERSTRASSE 20 City 21 State. if known 22 Foreign postal code, if known 23 Country FRANKFURT AMAIN GERMANY 34 Organization name of account owner 35 Tax identification number of account owner 35a TIN type EIN SSN/ITIN PHAIDON VERLAG GMBH 0 Foreign 38 Mailing address (number. street. apt. or suite no.) SCHONLEINSTR. 31 39 City 40 State 41 ZIP/Postal Code 42 Country BERLIN 10967 ERMANY 423,44 05.01.14 EFTA00619511  Part V Information on financial account(s) where filer is filing a FinCEN Form 114 consolidated report Page Number Complete a separate block for each account 7 of 10 Add an additional Part V page as many times as necessary in order to provide information on all accounts 1 Filing for calendar 34 Check appropriate identification number 6 Last name or organization name year al Taxpayer Identification Number PLB, LLC 2014 0 Foreign Identification Number C/O ELYSIUM MANAGEMENT LLC Enter identification number here: 300751322 15 Maximum value of account during calendar year 15a Amount 16 Type of account alL Bank bU Securities cLi Other Enter type below unknown 628,375. 17 Name of financial institution in which account is held SOCIETE GENERALE 18 Account number or other designation 19 Mailing address (number. street. apt. or suite no.) of financial institution in which account is held 2041053277 BERCY ENTR 10 AVENUE LEDRU ROLLIN 20 City 21 State. If known 22 Foreign postal code, if known 23 Country PARIS 75012 FRANCE 34 Organization name of account owner 35 Tax identification number of account owner 35a TIN type El EIN O SSN/ITIN PHAIDON PRESS LTD El Forel n 38 Mailing address (number, street, apt. or suite no.) C/ MR.JEAN FRANCOIS DURANCE,7 AVE RACHEL 39 City 40 State 41 ZIP/Postal Code 42 Country PARIS 75018 RANCE 15 Maximum value of account during calendar year 15a Amount 16 Type of account a Bank b Securities c Other Enter type below unknown 34,468. O 17 Name of financial institution in which account is held COMMONWEALTH BANK OF AUSTRALIA 18 Account number or other designation 19 Mailing address (number. street. apt. or suite no.) of financial institution in which account is held 11869242 48 MARTIN PL 20 City 21 State. If known 22 Foreign postal code, if known 23 Country SYDNEY NSW2000 AUSTRALIA 34 Organization name of account owner 35 Tax identification number of account owner 35a TIN type 0 EIN 0 SSWITIN PHAIDON PRESS PTY LTD 0 Foreign 38 Mailing address (number, street, apt. or suite no.) PO BOX 956 39 City 40 State 41 ZIP/Postal Code 42 Country CASTLEMAINE 3450 AUSTRALIA 423144 05-01.14 EFTA00619512  Part V Information on financial account(s) where filer is filing a FinCEN Form 114 consolidated report Page Number Complete a separate block for each account 8 of 10 Add an additional Part V page as many times as necessary in order to provide information on all accounts 1 Filing for calendar 34 Check appropriate identification number 6 Last name or organization name year al Taxpayer Identification Number PLB, LLC 2014 0 Foreign Identification Number C/O ELYSIUM MANAGEMENT LLC Enter identification number here: 300751322 15 Maximum value of account during calendar year 15a Amount 16 Type of account aUri Bank bU Securities cU Other Enter type below unknown 30,555. 17 Name of financial institution in which account is held BK OF TOKYO-MITSUBISHI UFJ LTD 18 Account number or other designation 19 Mailing address (number. street, apt. or suite no.) of financial institution in which account is held 2137270 1-22-8 NISHI-IKEBUKURO TOSHIMA-KU 20 City 21 State. if known 22 Foreign postal code, if known 23 Country TOKYO 1710021 JAPAN 34 Organization name of account owner 35 Tax identification number of account owner 35a TIN type EIN O SSWITIN PHAIDON K.K.AD HOMES Foreign 38 Mailing address (number, street, apt. or suite no.) 3-28-18 YUSHIMA 15 Maximum value of account during calendar year 15a Amount 16 Type of account a Bank b Securities c Other Enter type below unknown 36,703. 17 Name of financial institution in which account is held BK OF TOKYO-MITSUBISHI UFJ LTD 18 Account number or other designation 19 Mailing address (number. street, apt. or suite no.) of financial institution in which account is held 2137301 1-22-8 NISHI-IKEBUKURO TOSHIMA-KU 20 City 21 State. if known 22 Foreign postal code, if known 23 Country TOKYO 1710021 APAN 34 Organization name of account owner 35 Tax identification number of account owner 35a TIN type EIN O SSWITIN PHAIDON K.K.AD HOMES Foreign 38 Mailing address (number, street, apt. or suite no.) 3-28-18 YUSHIMA 423144 05-01-14 EFTA00619513  Part V Information on financial account(s) where filer is filing a FinCEN Form 114 consolidated report Page Number Complete a separate block for each account 9 of 10 Add an additional Part V page as many times as necessary in order to provide information on all accounts 1 Filing for calendar 34 Check appropriate identification number 6 Last name or organization name year al Taxpayer Identification Number PLB, LLC 2014 0 Foreign Identification Number C/O ELYSIUM MANAGEMENT LLC Enter identification number here: 300751322 15 Maximum value of account during calendar year 15a Amount 16 Type of account a Uri Bank bU Securities cU Other Enter type below unknown 69,052. 17 Name of financial institution in which account is held CREDIT SUISSE AG 18 Account number or other designation 19 Mailing address (number. street. apt. or suite no.) of financial institution in which account is held 1862183-31 POSTFACH 357, 20 City 21 State. If known 22 Foreign postal code, if known 23 Country ZUG 6301 SWITZERLAND 34 Organization name of account owner 35 Tax Identification number of account owner 35a TIN type El EIN O SSN/ITIN PH ART AG CI Fore 38 Mailing address (number, street, apt. or suite no.) C/O BDO AG INDUSTRIESTRASSE 53 15 Maximum value of account during calendar year 15a Amount 16 Type of account a Bank b Securities c Other Enter type below unknown 1. 17 Name of financial institution in which account is held BK OF TOKYO-MITSUBISHI UFJ LTD 18 Account number or other designation 19 Mailing address (number, street, apt. or suite no.) of financial institution in which account is held 0095573 1-22-8 NISHI-IKEBUKURO TOSHIMA —KU 20 City 21 State. if known 22 Foreign postal code, if known 23 Country TOKYO 1710021 JAPAN 34 Organization name of account owner 35 Tax Identification number of account owner 35a TIN type EIN O SSWITIN PHAIDON K.K.AD HOMES El Foreign 38 Mailing address (number, street, apt. or suite no.) 3-28-18 YUSHIMA 423144 05-01-14