EFTA01370747.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, SOLE MEMBER b Name of Legal Entity, Type of Legal Entity, and Address of Legal Entity for which the Account is Being Opened: PLAN CI, LLC, A USVI LIMITED UABIUTY COMPANY 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 arrangement understanding, relationship or otherwise, owns 25 percent or more of the equity interests of the legal entity listed above: Name Dale el Seth I Legal Addles Fot US. Parsons: For Non-US.Passont &Mal SeCor;IV (Sae 100liKet tier 011elnativPS Mambo to Sscial San—day Number) ...4 6100 RED HOOK QUARTER, 63 JEFFREY E. EPSTEIN 1120(53 St THOMAS, USVI 00802 i For Non-US. Persons. in aciaipon co a SOCialSaCtrey Number or a Pasrpon Number with and county of issuance of anyother gevotnment -issued tfolanerri evidenci-v noticnarxtyCountry a! Issmante. an etien Went-ace:ion rani nerd:et, or numner or residence Jett Warkng a pitotonrada or Seaialt sateguart show tre provided. fit no :nal:Of:bat meets tnis deli:Ikon. please write `Not Applicata:a., d. The following information for one individual with significant responsibility for managing the iegal 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 (d)). Name Oats of Bonn I ttgalAdaress For U.S. Poisons: I For Non-t1S. Portent Soebl SettraY (See footnote? for aitenuelvasi Number j to Soc:al Security Number) i I ABOVE JEFFREY E. EPSTEIN SEE For Non•US. Persons in addition ton Social Security Number or a Pain= Nombef VA, Country 0! ISSuanCe, an ater) and teurgry of Issuance Many goer s.cereennlanWee0e4 CCCunlenl eveleneing nationality c, itlaetilitaaarlMC Melte:. or mmbet residence and beating ahaeo(aapil or SinetvaileWatei should to Provided. rat person opening the account), hereby certify, to the best of QVe is complete and correct. 7124118 Dolt Legal840:y !Snuffer(Optional) Sp/juke eid CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0063759 CONFIDENTIAL SDNY GM_00209943 EFTA01370747