EFTA00299832.pdf

Pnnr Rccrt ,0401,11.3, Questions? Go to or call 800-544-6666. • Fidelity Certification of Trust Use this form to certify your trust to Fidelity. This form is for domestic trusts only. Do NOT use this form for foreign trusts. If your account is in the name of a foreign trust, or if you prefer not to complete this form, certify your trust by providing pages of the trust document that include the full name of the trust, trust date, name of the trustee(s), and all signatures. Do not include the entire trust document. Trustee signatures must be notarized. Type on screen or fill in using CAPITAL letters and black ink. If you need more room for information or signatures, make a copy of the relevant page. 1. Trust Information ALL fields are required unless indicated otherwise. Name of Trust BUTTERFLY TRUST Provide the tax reporting Trust Account Number Dated Trust 0O rev Trust TaxpayerIDISooal Socunty Number number for the trust. AR fields are required Name of Grantor(s) unless indicated otherwise. JEFFREY EPSTEIN Name of Trwt c If there are more than two trustees, make RICHARD KAHN AND ERIKA KELLERHALS copies of this page. Name of Go•Tnssteo Requeed debar.> a mom than ono wu co Provide the name(s) of the pcnonfshrho can AMEND the Trust REOLIIRE0 Write "none" on each line if there RICHARD KAHN AND ERIKA KELLERHALS are no person(s) Provide the name(') of the pecan's, v.ho can REvOKE the Trust REOURED who can AMEND or REVOKE the trust. RICHARD KAHN AND ERIKA KELLERHALS 2. Trustee Certification ALL Trustees must sign and date on the next page. Each Trustee must sign and have his or her signature notarized. Make copies of this page and the next as needed. By signing on the next page, you certify as Trustee that: • Every trustee (whether you are the sole trustee • You agree to indemnify us (jointly and Fidelity may have under any other agreement or there is more than one) has signed below severally) from and hold us harmless for with you. and is authorized to make these statements. any and all losses, liabilities, claims, and • We may verify all information provided in • The trust has not been revoked, modified, or costs (including reasonable attorneys fees) connection with this form and account, amended in any manner that would cause the resulting from our effecting any transaction and may obtain credit or other financial statements contained in this trust certification or acting upon any instruction given by you responsibility reports with respect to the trust, to be incorrect. or any authorized agent, advisor, or any the trustees, and any authorized individuals; third party you authorize on your account, and you have the express consent of all • The trust exists under applicable state laws. or from your action or inaction, whether individuals who may be the subject of these • You have the authority under the trust and intentional or not, including losses resulting reports. If requested in writing, we will provide applicable law to enter into transactions, issue from the action or inaction of any authorized instructions on this account for, and at the risk the name and address of the credit reporting agent, advisor, or any other third party you agency used. of, the trust, and agree that all transactions authorize on your account You further agree and instructions will be in full compliance with • You will inform us in writing of any changes that the indemnifications in this bullet are in the trust. to these certifications (such as a change of addition to, and do not limit, any rights that trustees). Trustee Certification continues on next page. 1 . 900844 .107 Page 1 of 2 022770701 ■ EFTA00299832 2. Trustee Certification, continued • PRINT TRUSTEE NAME PRINT TRUSTEE NAME TRUSTEE SIGNATURE DATE MM/DO/TYYT TRUSTEE SIGNATURE DATE W. /DOPIYVY Important Note: CA Notaries are permitted to submit a separate page notary document. If used, it must identify the document being notarized. Notice to CA Residents: A Notary Public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. Certificate of Acknowledgement of Notary Public Must Certificate of Acknowledgement of Notary Public Must be a U.S. Notary. Foreign notary or consular seals may NOT be substituted. be a U.S. Notary. Foreign notary or consular seals may NOT be substituted. State of in the County of State of in the County of subscribed and swom to subscribed and sworn to before me by the above-named trustee who is personally known to before me by the above-named trustee who is personally known to me or who has produced me or who has produced as identification, that the foregoing statements were true as identification, that the foregoing statements were true and accurate and made of his/her own free act and deed, on and accurate and made of his/her own free act and deed, on I I PRINT NOTARY NAME PRINT NOTARY NAME NOTARY SIGNATURE DATE MM/DDMYYY NOTARY SIGNATURE DATE MM/D0MYYY "Or NOTARY SEAL / STAMP "Ily "Or NOTARY SEAL / STAMP "Iir My commission expires My commission expires Use the postage-paid envelope, drop off at a Fidelity Investor Center, OR deliver to: Did you sign the form and attach any necessary documents? Send Regular mail Overnight mail the ENTIRE form and any attachments to Fidelity Investments. Fidelity Investments Fidelity Investments Questions? Go to or call 800-544-6666. M. Box 770001 Account Reregistration Services Cincinnati, OH 45277-0039 100 Crosby Parkway KC1C Covington, KY 41015 On this form, "Fidelity" means Fidelity Brokerage Services LLC and its affiliates. Brokerage services are provided by Fidelity Brokerage Services LLC, Member NYSE, SIPC. 532335.7.0 (11/16) L 1.900844.107 Page 2 of 2 022770702 • EFTA00299833