EFTA01480833.pdf

Introduction Type Net Worth of client(S) Source Of Wealth / Financial Information Details Source Of Wealth -Identify he Clients Source of Wealth from followini list of • • Ions ECi Party Type Party Name Last KYC Status Report Type Relation Powers Percent Completed Type Owned Search Date Individual HARRY Fur Signor Full 0.0 BELLER Primary Information for HARRY BELLER Client Type Indivkluel Generation Client Status Client Active Indicator Yes Front Office Restricts? Normal Marital Status Single Confidential Names? Country of Primary Domicile UNITED STATES Primary Domicile State Prefix/Titte Insider Code (Reg. O) First Name HARRY Full Name HARRY BELLER Middle Name Gender Last Name BELLER Date of Birth Suffix Primary Country of Assets PreviousName/MMN/Ahas Citizenship Employer Name High Risk Jurisdiction Occupation Industry Code (NAIC) Years at Occupation Secondary Industry Code (NAIC) Address(es) Type Notes Address Country Tools Entered by Date of Preferred U e Map it SYSTEM 05/12/2011 Yes r hone(s)/Fax(s) Notes Phone Number Tools Preferred Verify to Nol SYSTEM 05/12/2011 Yes Call' List Cost Center 8, Hierarchy Client Status Client A' Individual Client S nsor Cost Center 118313 - IVT OT CENTER Client Service Team Identification Withholding Federal Status Withholding SSNRIN Certification Date SSNiTIN1EIN Form of government issued Drivers License Identification obtained for the files Primary Identification Number Issued By UNITED STATES Nee: Yofk Date Issued Ex •Iration Date 2019 Confidential Treatment Requested by JPM-SDNY-00003061 JPMorgan Chase CONFIDENTIAL SDNY_GM_00272259 EFTA01480833