EFTA01269548.pdf

I First Bank Document Checklist for Business Accounts File Together we are one Important note: Please refer to the Account Opening Procedures for pecific information on the various types of documents required at account opening. Account Tide:) - Account NumberS ( \ Cf Date Opened: 11)\;:j.- t Signature Cards V Customer Due Diligence for Business - Entities (eff. 611112010) . /- V Customer Due Diligence for Additional signers or Authorized Signatures on Business i Entities Accounts (eff. 6111/2010) V Observations at Place of Business OFAC/PLC (print evidence of verification) (611112010 for new account clients without an active deposit account at the lime d account opening) DocumentiChecklist for Business Accounts File -NNNS-2464-0711R ECR Checklist Individual Account for Personal Purposes NNNS-2544 (ft 611112010) ECR Individual Account for Commercial Purposes NNNS-2540 (ett. 06/ I 1/2010) i 1 ECR Checklist for Unincorporated Association cr Organizations Account (league, Club, Class. Fund rasing, religious. civic, etc) NNNS-2538 (0. 61111210) 0 t -\kt: \ ECR Checklist for Corporate Accounts (Fa-profit or not4a-prot) NNS-1281 (eft. 6/1112010) ;•\kn ECR Checklist for Special Partnership ACCiduril (for profit and not-for-prolit) NNNS- 2539 (eff. 6/1112010) V Covered Person Cerifmation NNNS-1303 (eff.611112010) i1.1El Appropriate W-8 Form or W-9 Form (if non-U.S. entity) (eff. 611112010) Vc Disclosures that must be given to client Rates and Fees Schedule Account Agreement FDIC Insuring Your Deposit Brochure (USVI only) Notice of Negative Information Disclosure v Check 0 if is completed Other Documents or Remarks N/A II not a Doable rt t,-;Xi....,t0.., t"- ..... Certificate of Incorporation or Certificate of Cuakficabon (i a U.S. based =proton) Business/Trade License (current) Certificate of Good StaNfmg Articles of incorporation (stamped by the Office of the lieutenant Governor I USN and the Registrar of Companies in We BVI) Certificate o' Trade Name Corporate Resolution (with Corporate Seal) Corporate Resolution and Corporate Authorization and Indemnity Agreement for TelephoneffelexiFacsimiieNrritten Instructions (This document is only required if client requests hind transfers by phone, fax a messenger) Partners* Lotter and Sea* Agreement Business/Trade License (current) , , Palters* Agreement (d it exists) Certificate of Trade Name (t applicable) Certificate of limited Partnership (it applicable) Resolution where Partnershp °detains Cordoraten as a Partner (it separable) Partions*Conta'ns Lnued Liability Company as a Partner (d applicable) Partnership Contains Trust as a Partner (if applcable) Partners* Contains Joist Venture as a Pater (if applicable) Security Procedure Agreement for TetephonefFax Issuance at Payment Orders or Request for Internt.:mai Drafts (if requested) SONY GM_000t3738 C .—.— —. . _. .. CONF1D NTIAL irstttan EFTA DD 24381 EFTA01269548  Cer:ficats of Trade Name (if epiglottis) Coma* Pesoluton or Unincorporated Association Resolution Certificate of Incorporattn or Gestate* of Authority for Foregn and Foreign Non-Pmfil Corporation (I incorporated) Midas of Incorporation (4 ircontrated) Certikat of Good Standing (if BVI corporation for more than tivetre months) (if incorporated) Corporate Resolution and Corporate Authorization and Indemnity Agreement for Telephone/Telex/Facsimile/Written Instructions. (This document is only required if client requests fund transfers by phone, fax or messenger) - if incorporated Security Procedure Agreement for TeteFyne/Fax Issuance of Payment Cyders or Request for International Drafts d tested - if at rated Limited Liabiky Company Letter and Security Agreement Business/14de License (current) Operating Agreement Ankles of Organization or Certificate of Formation (non-bast form- If the PLLC ea 'nett RIC Certificate of Existence Security Procedure Agreement for Telephone/Fax Issuance of Payment Orders or Request for International Drafts (if requested) - if unincorporated Limited Lebilty Company Contains Corporate Membanlilenager (if appitable) Limited Liability Company Contain Limited Likely Company as a fdemdeftlibfidilef (f applicable) limited Liability Company Contains Limited Liability Partnership as a Merriceilkiallager (if applicable) Limied Uabaty Company Contains Partnership as a Member:Manager (4 appicable) Limded Lietkiy Company Contains Tnist as a Membedlanager (if appleade) Lknied Liability Company Unincorporated Association as a Menteotanager (if applicable) titled May Company Contains Joint Venture as a ItemboviManager Of appricade) Corporate Resolution Certificate of Incorporation& Certificate d Cualfication Of a U.S. based kip:ration) Articlesof Incorporatien (stamped by the Office of the Lieutenant Governor) Businessffrade License (current) Corporate Resolution and Corporate Authorization and Indemnity Agreement for Telephone/Telex/Facsimile/Written Instructions. (This document is only required if client requests fund transfers by phone, fax or messenger) limned Liabiky Company Letter d Security Agreement ../ Businessffrade License turren Certifies* of Trade Name (if applicable) C1 0;1' Operating Agreement st Articles of Organization or Certificate of Formeton (non-bank form-required if the LLC is a 'neve LLC) V Cerfificar of Efintence Security Procedure Agreement for TeEphonelFax Issuance d Payment Orders or Request for International Draft (if requested) V Limited Liability Company Contains Corporate Member/Manager (if appleatta) .1.11,;c1 Limited Liability Company Conteit Limited Liability Company as a territenManager (i appicabis) t1`1-1 Limited Liabiity Company Contains Limited Liabilty Partnership as a Member/Alan-9ga (4 applicable) CA\ F") Limited Leto* Company Contains Partnership as a mentermaneger f4 apcticaitie) X,A Limited Liability Company Contains Trust as a MemberfManager (if applicable) (kW') Limited Liability Company Contain Unincorporated Association as a Member/Manager (4 ape/table) (\\,'. , Limited Lebity Company Contains Joint Venture as a Member/Manager (if amicable) .- i\.i,',—\ Limited Liability Partnersh*Letbar and Security Agreement Cedicale of Limited Parbieship (Limited Partnership) - Not required when opening accounts for law firrns or security brokerage houses Carta* of Existence BusinessITrade License (arrant) Operating Agreement Statement of ()talent:ion or Statement of Foreign OLdaficaeon Cenlicate of Trade Name (il appricable) SONY_ GSA _00013739 Security Procedure Agreernent for Telephenefax I noe est C '—' — "—' ' ifs an EFTA_00124382 EFTA01269549  business entities IOLTA Account Notice of Financial Institution VILAF Aocomt Notice of Financial denim'Ion Business License (current) Certificate of Trade Name if acolicablel Refer Sc. the Account Opening Procedures for additional documents required for different types of business enanas A legal document(s) Si *tech d states the nano of the person fang as administrator. tutor. executor or Muds and establehes h sine'. a.:ttrities -c4-.i;. . • .2.7:2,. ftir - puoit.....h ''. . -.....:_. .f the PAC is an Unincorporated Associatbe Men a letter signed by the president of the association stating the associates' purpose and an Unincorporated Associslon Resolution Is required. II the PAC is a Not lot Profit Corporation, a CerWicate of Incorporation for a Non-Sbek Corporation is required. A centration from the Virgin Islands Board of Elections Chick la If Is obtained or Remarks Additional Documents (supporting documents) WA If not applicable Income Vedficaton Piefessbnal association dreztm Marketrig bnxbuteshusiness Web site and cedar market mach Sae IThobs. Miles InvoiceEtrater. electricity, telephone) Sample of entity stationery (presents:km card, letter head paper. envelopes...) Other: Other Other: Ot her. SDNY_GM_00013740 CONFIDENTIAL CONFIDENTIAL FirstBankPR000903 EFTA_00124383 EFTA01269550  \st First Bank Checklist for Special Pirtnership Account (For profit and not-for—profit) Together we are one Branch Number Account Number: (13-ax-o\ cri Initials andReview Date Document Action Comments e R rt Reviewer Date 1 Date \\7)\ \:: t ‘ Basiodocuments for ALL types of accounts Customer Due Diligence Commercial/Entities I Account file Complete for business entity. NNNS-I307 Customer Due Diligence Authorized Signatures I Account file One per each signer NNNS-I306 Account Referral Shed Only when the client is not I Account file NNNS-I272 present Observation at Place of Business (OPB) I Account file NNNS-2464 Partnership Bylaws or Articles of Incorporation E Account file Copy Partnership, LIC, LLP Security Agreement 4INNS-2 I98-0410R.or NNNS-2 190-0802 1 Account file NNNS-2200-0802. or NNNS-220I-0604R ID Verification Results Summary (ID CHECK & One per entity and one per J am', 0EAC) or evidence of the verification used in I Account file each signer, if applicable contingency. CHEXSYSTEM Report Result I Account file One per entity and one per each signer, if applicable „Iv (' Photocopy of original Business License E Account file (S ./ document Applies to candidates for government elective Territorial Election Commission Certification E Account file positions. Photocopy of (\0 original document. Cardholder: one c, fl p-o (...ik Digitalize for checking Signature cards M alphabetical and one accounts numerical Deposit Account Agreement NNNS-2092-0508R IlSVI P Provide to client NNNS-2377-I 104 BVI Additional documents for CHECKING ACCOUNTS Rates and Fees Schedule Disclonne NNNS-2091-I006R USVI NNNS-2132-I206 IIVI I 1 Provide to client Additional documents for CERTIFICATES OF DEPOSIT . • Certificate of Deposit Agreement Al One for tile and one NNNS-0958 for client Only if there was a special I Account file Evidence of Negotiated Interest Rate, if applicable quote. Legend: P - Purchasing M = Mostiic I - Intranet E External (s) Spanish e) English `539-0611R SONY_GM_00013741 CONFIDENTIAL CONFIDENTIAL FirstBankPR000904 EFTA_00124384 EFTA01269551  Account Type: Account Number: Sign. Req. Date: Commercial Checking 9S2-2tO1loll 1 5/3113 Address: 6100 Red Hook, QTR B3 Tel: 340-775-2525 St. Thomas, VI. 00802 Name: LSJE, LLC EIN: 66-0776615 Name: Ha Beller SSN: 081-52-0727 ID Tr e.U5 r Pct55 h+ ., .e.c. No Nam : SSN: ID Type: No: Name: SSN: ID Type: No lAaie hereby acknowledge having received prepared by: the Deposit Account Agreement, the First . Bancorp Information sharing and Privacy Authorized by Policy, and the product rates and lam COM NA 101E 712002 NNS-0001 Superseding-Current-Reason o4- N Date Initial Instructions for sompletioo Please print this form 3 times and complete in triplicate in blue or black ink. Please insert the name of the company or the account title under account name. Please print the name of each authorized signatory to the account together with a sample of their signature in each field under name. If there are more than four signatories please use additional signature cards as necessary. The Bank will complete the remaining fields. *Important* Please provide each signature card in triplicate with the original signatures (no photocopies). Fors:Sank is a abradtaryofFust Bancorp (NYSE: NIP SDNY_GM_00013742 CONFIDENTIAL CONFIDENTIAL FirstBankPR000905 EFTA 00124385 EFTA01269552  Account Type: Account Number: Sign. Req. Date: Commercial Checking 431 3 13a 9.001704 1 Address: 6100 Red Hook, QTR B3 Tel: 340-775.2525 St. Thomas, VI. 00802 Name: LSJE, LLC EN: 66-0776615 Name:.Jeanne Brennan SSN: 150-46-4746 ,--7/4“ .., L41_4_4c. ID Till 111azit ad- No: Name: SSN: ID Type: No: Name: SSN: ID Type: No: I/We hereby acknowledge having remised prepared by: the Deposit Account Agreement. the First Bancorp Infoinkatioa Sharing and Privacy Authorized b ic Lc._. , - Policy. and the product rates and fees. k ,; \ I NA 10lE 7/2002 NNS-000I Cbch Superseding-Current-Reason Sil? d Warne oaten Initial' Instrucdons for comnletiog Please print this form 3 times and complete in triplicate in blue or black ink. Please insert the name of the company or the account title under account name. Please print the name of each authorized signatory to the account together with a sample of their signature in each field under name. If there are more than four signatories please use additional signature cards as necessary. The Bank will complete the remaining fields. simponants Please provide each signature card in triplicate with the original signatures (no photocopies). FiroBank Is a subsidiary of Firs: Bancorp (NYSE: FBP SDNY_GM_00013743 CONFIDENTIAL CONFIDENTIAL FirstBankPR000906 EFTA_00124386 EFTA01269553  Account Type: Account Number: I Sign. Req. Date: Commercial Checking 1 1522OO11th 51.313 Address: 6100 Red Hook, QTR B3 Tel: 340-775-2525 St. Thomas, VI. 00802 Name: LSJE, LLC EIN: 66-0776615 Name: Jeffre tein SSN: 090-44-3348 ID Type: LIG ri--DX14e2* Lltesis° No:C.- OOOOcOO2.9413 N e: SSN: ID Type: No: Name: SSN: ID Type: o: I/We hereby aclaxsaledge having received prepared by: the Deposit Account Agreement, the Fint ,. Stomp Infomuaion Sharing and Privacy Authorized by: Policy, and the product rates and fees. i NA 10IE 7/2002 NNS-000I Superseding-Curtent-Reason Want Date*gia.lnitlai• Instructions for comnletio0 Please print this form 3 times and complete in triplicate in blue or black ink. Please insert the name of the company or the account title under account name. Please print the name of each authorized signatory to the account together with a sample of their signature in each field under name. If there are more than four signatories please rise additional signature cards as necessary. The Bank will complete the remaining fields. •Important• Please provide each signature card in triplicate with the original signatures (no photocopies). FirstBank u a subsidiary cfFirst Bancorp (NYSE: FBP SDNY_GM_00013744 CONFIDENTIAL CONFIDENTIAL FirstBankPR000907 EFTA_O0124387 EFTA01269554  Account Type: Account Number: Sign. Req. Date: Commercial Checking I ai,i cdici 1322001101 13 Address: 6100 Red Hook, QTR B3 Tel: 340-775-2525 St. Thomas, VI. 00802 Name: LSJE, LLC EIN: 66-0776615 Name: Darren Indyke SSN: 098-54-8596 ID Type:u6-Pcospokt Name: SSN: ID Type: No: Name: SSN: ID Type: No: inve hereby acknowledge having received Prepared by: • the Deposit Account Agreement, the First t Bancorp Information Sharing and Privacy Authorized by . vt r / Policy, and the product rates and fem. — NA 101E 7/2002 NNS-000I Sup erse dina-Current•Reason Date:a 1 Ja Initial: haloctions for consoletio Please print this form 3 times and complete in triplicate in blue or black ink. Please insert the name of the company or the account title under account name. Please print the name of each authorized signatory to the account together with a sample of their signature in each field under name. If there arc more than four signatories please use additional signature cards as necessary. The Bank will complete the remaining fields. °Important' Please provide each signature card in triplicate with the original signatures (no photocopies). FirnBank is a subsidtory ofFin:Bona, (NYSE RIP SDNY_GM_00013745 CONFIDENTIAL CONFIDENTIAL FirstBankPR000908 EFTA 00124388 EFTA01269555  Ckskcy-D1- •-rupwi xi -wigs-yin iviii-rwealM. • • -.' ' - — 1 First Bank ,tik Customer Due Diligence for Business - Entities Date. S Mills tol t Existing Account Number ir ' New Account Number erteraCOne 0 ft 1 Chem I iftirot,ttItir, Business or Entity name: Employer Identification or Social Security Number LSJE. LLD 66-0776615 DBA Name (if applicable): Social Security Number (if applicable): Physical Address: Mailing Address: 6100 Red Hook Quarter` B3 Same as physical address St. Thomas,_USVI 00802 Business Phone: 340-775-2525 ' Email: 2. Business/Entity Description I i Type of Business: _. Household HAMS: ** 4 kIn Annual Sales: Date Established: 3/1.3/20.13 Number of Employees: ' 10 Number of Offices: 1 O DBA O Corporation O Nonprofit Corporation O Partnership O Government Agency O Unincorporated Association or Entity t'.3 Limited Liability Company Type of Entity O Other, 3.T • • Of Product E Certificate of Deposit S Checking O Saving III Erin OOentr, specify 4. Accoum Purpose 0 Payroll • Operational III Trust O Public Funds • ATM Machine • Escrow 0 Transfer Funds O Corresponsal O Investment 0 Other: 5. Expected Transactions Monthly Transactions Transact ions 0 t -10 ,8 11 -20 O 21 or more. Total Amount • $1 -stool) 0 $tool -$25.000 • $25,001 o more. Credits • Cash 0 Payroll Account Transfers O ACH o Checks O POS Transaction Type El Electronic Transfers • Other. Transactions • 1 -10 0 11 -20 O 21 or more. Total Amount M S1 - S5,000 IC! $5.001 - $25,000 O 525.001 o more. Debits Cash Pi: Payroll =4 Account Transfers • ACH .14 Checks O PDS Transaction T . CI Electronic Transfers • Othec • International Transactions —Wire Trans's,' fl Incoming Transfers III Outgoing Transfers in Daily O Weekly O Monthly. 0 Doty Weekly • Monthly. O Transactions 0 1 -10 l:. 11- 20 O 21 -50 O 51 or more. Transactions M 1 -10 0 11 —20 O 21 -50 O 51 or more. Total Amount • S1 -$25.000 $23001. 3300,000 O $500.001 o more. Total Amount 0 St -125,000 4 $25,001 - ssoo.000 0000.001 o more. El Countries Countries --.--- 6. Initial Deposit and Origin of Funds Initial Deposit: i ___.„.. Origin of Funds: If the initial deposit is greater than 5500000; indicate the source of wealth: 7. Client Classification • it the awe,is yes to at least one of the blowing, The dent Ind be concriered high risk and futlher &den is needed as estalish Lithe Due °Nance Checkest- Gudance For inithilusfs or Entities Consdered as High Risk. • IIthe answer to D. E, crF yes, then authorization from the Comptance Department-BSA Division is rewired. Yes No A. Is the NAICS selected high risk? E 0 O 0 B. Does the business have a private ATM machine on site? C Is the business a nonprofit Organization? O 0 D. Is the business a political committee or organization? --- --— - — • O 0 E. Is the business related to an officer of a foreign government? Indicate the type of relationship; F. Is the business e a in activities relat i SDNY GM 00013710 ffd CONFIDENTIAL FirstBankPR000909 EFfA_00124389 EFTA01269556  Customer Due Diligence For Additional 1 First Bank Signers on Individual Accounts or Authorized Signatures on Business Entities Accounts Existing Account Number Account Number which Is attached to the Signer 1. Authorized Signer Information Name: Jeanne Initial: Lest Name: Brennan Date of Birth: 9/2/1960 Place of Birth: NY Social Security: 150-48-4748 Citizenship: USA Home Phone: 340-779-1738 Other Physical Address: Mailing Address: BL Cabrita Point 6501 Red Hook Plaza Ste 201 St. Thomas, USVI 00802 St Thomas, USVI 00802 Place of Employment: Financial Trust Company, Inc. Employment Address: Occupation: CPA 6100 Red Hook Plaza Ste 201 Work Phone: St. Thomas. USVI 00802 Email: ID Type Number Country Expiration (MMVONYVY) 1st Passport USA 05/19/2018 2nd Ptipiet, taceti5C. U 2O%-i Recurrent Source: 0 Own Business 0 Private 0 Government El Other. specify: Annual Income: 0 S0.01 - 550.001 0 $50,001 - 5150.000 0 $150.001- S250,000 0 Over $250600 3. Client Classification • the answer ism for A and C of the fatneng quosbons. the ceent eV be consiosredhigh nsk and tenet erten is needed as estahasli nn Ire Duo augence Checklisf4tdance For Ind:yr:Nets a Entities Considered es High Risk. , . If the answer keels yes then e‘thorizahe. hem the Comdex. Oepartnerr-8SA DhSsion is requited. Yes No A. Indicate whether the client is a nonresident alien: (NAICS #100000) S. Indicate whether the client is a resident alien: (NAICS #200000) IR s7„.. C. Indicate whether the client is related to an officer of a foreign government and document the type of relationship: 0 ICY (NAICS #400000) 4. Verification System- For use only as Contingency Plan if CHEXS YSTEM was called Nome of the Representative who attended your call: Response to Social Security: Year: State: Other: Response on Industry Behavior: Response on ID: 5. Account °penult] Authorization tW Approv ID Denied Name Signature OltintrNo. Oab Comments, If applicable: Interviewed ) Now superseding- WINS-13064410 Date initial: SONY_GM_00013747 CONFIDENTIAL CONF EN AL I FirstBankPRO00910 EFTA_00124390 EFTA01269557  Customer Due Diligence For Additional 1 First Bank Signers on Individual Accounts or Authorized Signatures on Business Entities Accounts Existing Account Number Account Number which is attached to the Signer 1. A1111100/0t1 Signer 111f0(111111 011 Name: Harry initial: I Last Name: Beller Date of Birth: 519/1956 Plate of Birth: NY Social Security: 051-52-0727 Citizenship: USA Horne Phone: Other. Physical Address: Mailing Address: 12 Golar Drive 6100 Red Hook Quarter B3 Monsey, NY 10952 St. Thomas, USVI 00802 Place of Employment HBRK Associates Employment Address: Occupation: Accountant 301 East 661" Street Ste 1OF Work Phone: 614-862-4814 New York, NY 10085 Email: ID Type Number Country Expiration (1140D/VYYY) 1st Passport USA 1W04/2014 2nd t_th 5 DA Recurrent Source: 0 Own Business 0 Private 0 Government 0 Other, specify: Annual Income: 0 S0.01 - $50,001 0 $50,001 - 5150.000 0 5150.001- $250,000 0 Over $250.000 3. Client Classification . Rue renter is yes for A and Ccrlbefibleveng quedions the teer vie.' be consicBred high risk and further action is needed as °smash in the Cte Diigente CheckOst-Gudance For Ince&fue ofRates Considered es Hiet, Risk. . lithe answer to cis yes, Men aikrorization from the CColdwoce DeeartmaMigSA aWskm is leeMet Yes A. Indicate whether the clients a nonresident alien: (NAICS#100000) 0 B. Indicate whether the client is a resident alien: (NAICS #200000) 0 C. Indicate whether the client is related to an officer of a foreign government and document the type of relationship: 0 (NAICS 0420000) 4. Verification System- For use only as Contingency Plan If CHEXSYS TEM was called Name of the Representative who attended your call: Response to Soctal Security: Year: