EFTA01345170.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: MORT, INC., A USVI 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 arrangement understanding, relationship or otherwise, owns 25 percent or more of the equity interests of the legal entity listed , above: Name Date of 8:t th ilatuel Adage For U.S. Parsons: For Non-U.S. Pocono.- ! Social Security iSco footnote 1 for aitenstkesi Rumba, to Social Security Nurnoer) ! 6100 RED HOOK QUARTER, B3 JEFFREY E. EPSTEIN ST. THOMAS, USVI 00802 I I. Far Non-U.S. Persons in acithtion too Social Security Number oe a Passport Number with Country of Inc nce, an alien identircodrin cow nines:, or numb*, and count:y1)g issutoce of any other goveinment-istved document evideving notionally or residence ono tweedy o photograph or siniikr safes:tore shoina be ocovided. (If no in dividual:Deets this detnition. **rev:roe 'Not apOcable.") 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 (d)). i Nom Date of aim i Ley& Memos For US Persons: I For Non-U.S. Penontt Social SenuntY I (Sea Iota note for one:native/ Mantic I to Social SCtutity Number.). ABOVE 1JEFFREY E EPSTEIN I SEE • I , Poe Non.U.S. Parsons. ;n addition too Social Security Rundle, or a Passport Nominal stun Country of IStuAnce, on al:an itientificai ion card manor. CA nunibot one country of issuance of any ether governmentossued document ovidenciitgn,nonalityxresidence Ana Ceti DhOtailMDh Of Sitaaf Wrer.sdrti shoolt DO PrOViCed. (name of natural person opening the account), hereby cern best of providactabome is complete and correct. Signature Veri 7/24/18 Date Name (Print) Legal Entity Identifier (Optician Title rt.!!..) stavidtAre CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0031356 CONFIDENTIAL SONY GM_00177540 EFTA01345170