EFTA01583343.pdf

Apr•M-2013 (1,9:06 AM JPhiergan Chase 307•Ci34-4580 r) It] Special Consideration Form T.P Morgan Instructions: For Consumer and Business Card, fax C0Mpeted tort and apollcation to 1414404744108i For ConsumeoBusiness Cards for al Ladn Arnerktan Chests, promo c- -rail the competed form and applicabon le rfsbtution list: 'SrAscial SW/Zeta NY' Section 1: Line of Business: (select one) J.P. Morgan Private Bank C JP. Morgan Private Wealth Management Q Chase Private Client J.P. Morgan Securities C J.P. Morgan Law Erm Program Section 2: Type of Inquiry (Oleos me from oast section below) A) 0 Domestic 0 triternstional 8) ['Consume, Fl Business C) CINew Application Reconsideration 0 Credit Limit Increase (Account * 4116315 7060810" mitt) Credit fiat Requested: 4140.000 Section 3: Banked' information: {con:Oita all fields} Today's Date: 028/2013 Requester Janet F Yourg E-Ma I Address ph-sentx13 8 Phone Number. Standarc II) Section 4: Applicant Information: (canplese ell reteart (its) ECI- CAS ID: Nan* of App icart Authoriang Cificer Jeffrey Epstein Business Mayne: I-SJ. LLC Social Scanty Number or MN: Tax idoritifcaticm Number mar USA Patriot Mt (USAP) I' no Social Sosurtty Numbs, or Inn, Chars* Can ScrvInti IS **ins -O to cosecs the rollatsing man's: Identification Type r:s. Idenliltatim Cart or abbea apperaped Gyonnyerd Itx,ed Prot.; Or • IdeMfficetIon Number: ' Country Issued By: Issued Dale: Expiration Date: ApplicantsiComporyi physical address (it ciffiesnt or ins appleatcd); Present Empbyer. Occupation I Pusilion: Tyne wit Present Employer: yrs. mantis 'Gross Annual Income: $ Business Income' S stallecry. supnan. Gs separate meintenaeop ner4 ncA be irnaidea It yru abed with 19 cagy on b. Cron ittetali Won is 'WWI. ltd you an able it usaa wt rePtYrr9 Jetils Ourriuss tiny OW* inouro erne) teem saImes, ..fl. natal Sioaairbes, Sods Seca/ berets sea ntremert ocaeLnas Net Worth (cisuelre Pernora Reladence; S Investable Assets 3 Section 6: Depository/Investment Relationship Information: emits u matt Math rce as wank waxen Wan r needed) Account Number Type Balance Open Date • Indicates Raw& Confidential Treatment Requested by JPMorgan Chase JPM-SDNY-00062992 EFTA01583343