EFTA01362341.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: J. EPSTEIN VIRGIN ISLANDS FOUNDATION, INC., A 501(4X3) PRIVATE FOUNDATIONIUSVI 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: Name I Date of Binh Legal Actress 1 Fe' U.S. POCSOIS: Fit NcrpU.S.Persans SOCial Security (See Icootnate 110f alternatives! ---f Number to Socia!Seority Niger:be') NOT APPLICABLE 1 • NoMIS. Persona, in addition to a Seed Security ['Jumbo( or a Neap°, f Plumper witn Country of ;sewn,* an alien ioef f Mention caw number. Or earnest and country of inuance eSonY ofilOf gave:enrolDM -feefed docunfent evident:fey n4E:maw or latiOence and tearing a ahocoar on or telt/nerd eheob be provided. (ft na inthvidUal meets tni$datinalon. please write 'Not AoPhoobfe." 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 Name Date of NW, I Leaol Ad 'rose Pot U.S. Fanatn: I Fot Non-U.S. Amos: Social Sorority i (See footnote a for allunartasi 1 Momper I foSocialSetcrity NUMMI* I I --r --- I 6100 RED HOOK QUARTER, 83 l JEFFREY E. EPSTEIN i 1/20/53 ; i i ST. THOMAS, USVI 00802 _ I1 • card wear, • For Nan-tl.S. Persona in addition to a Soc.a Security Nemec oi a Pncport Number with Cocoon). of Issuance, en alien Idantificanan end muntry of 4.41.011Ce of any atm: gavot nment-faueif document twining nationality or mildews or ramiber and beefing a Oh010VaDn or ' ,mar slieaurd shout be Dravidsni. IN a of natural person opening the account)• hereby certify, to the best of is complete and correct. Signatur 7/24/18 Na 'apt Entky identifier (Optional) Tale: Dote: e 4 srplitc.044 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0051719 CONFIDENTIAL SDNY_GM_00197903 EFTA01362341