EFTA01480642.pdf

Full Legal Corporate Darren K. Indyke PLLC Name: 0 (No P.O. Box address. Must be a physiCal address.) Primary Corporate Address Name: Darren K. Indyke PLLC Attention: Address Line 1: 457 Madison Ave. Address Line 2: City: New York State: NY Province: Postal/Zip Code: 10022 Country: UNITED STATES Tax ID C : 300503849 Remember to collect W-8's or other applicable tax forms for each jurisdiction. Business Phone: O- State of Domicile: NY Where is the Company Incorporated' What document did you obtain to Articles of Organization evidence state of domicile? Articles of Incorporation, Partnership Agreement, etc Introduction / Financial Information Introduction Type: Related Client NC Specific Information: Jeffrey Epstein is a longstanding client. (Please identify referral source, etc.) Have you met with the Principal/Authorized 0 Yes r No Individual? Legal Entity: Limited Liability Company Limited Liability Corporation What is the purpose for forming the LLC? To provide legal services to Jeffrey Epstein. Princpal Beneficial Owner(s)/Shareholder(s) Identify the principal beneficial owner(s)/shareholder(s). If the entity is owned by an intermediate legal structure (e.g. LLC or Partnership), list the ultimate individual beneficial owner(s). A beneficial owner is any person on behalf of whom the account is maintained. Last Name: First Name: % of SSN DOB Form of Govt Issued Citizenship Ownership ID Obtained Indyke Darren 100 drivers license UNITED STATES Source of wealth of the beneficial Executive Management/Professional owner(s)/shareholder(s): Source of wealth of the Partners: Executive Management/Professional What Is the client's current executive attorney management position? (Include any former positions, if significant to source of wealth) List the approximate number of years in current 15 position. (Include any former positions, if significant to source of wealth) Approximate yearly $1.7mm income/salary/bonus/distribution and other compensation history (accumulated earned Income) Confidential Treatment Requested by JPM-SDNY-00002851 JPMorgan Chase CONFIDENTIAL SDNY_GM_00272049 EFTA01480642