EFTA01269598.pdf

I First Bank Document Checklist for Business Accounts File Together we are one Important note: Please refer to the Account Opening Procedures for pecific information on the various types of documents required at account opening. Signature Cards Customer Due Diligence for Business — Entities (eff. 611112010) vf Customer Due Diligence for Additional sigers or Authorized Signatures on Business Entities Accounts (eff. 611112010) ..../ Observations at Place of Business OFACIPLC (print evidence of verification) (6/1112010 for new account clients without an active deposit WMint al the time of account opening) 4. \elf Document Checklist for Business Accounts File -NNNS-2464-0711R n; ECR Chmkist Individual Account for Personal Purposes NNNS-2544 (Eft. 6/11/2010) c\t cc\A ECR Individual Account for Commercial Purposes NNNS-2540 (eff. 06/11/2010) C\ ECR Checklist for Unincorporated Association or Organizations Account (league, Club, Class. Fund raising, religious. civic. etc) NNNS-2538 (elf. 6/11/2010) (lki:\ ECR Checkist for Corporate Accounts (For-profit or not-for-profit) NNS•1281 (eft 611112010) l'\\O1 ECR Checklist for Special Partnership Account (for profit and not-for-profit) NNNS. 2539 (eft 6/1112010) N./ Covered Person Certificatim NNNS-1303 (eft 611112010) Cl\C; Appropriate W-8 Form or W-9 Form (if non-U.S. entity) (eff. 6111(2010) Disclosures that must be given to client Rates and Fees Schedule Account Agreement FDIC Insuring Your Deposit Brochure rUSVI only) Notice at Negative Information Disclosure Check 0 if is completed Other Documents or Remarks WA It not a ..4. ;cable Certificate of Incaperalion or Certificate of DualicaLign (Ka U.S. based oorporalkn) Business/Trade License (arren0 Certificate of Good stabling Articles of Incorporation (stamped by the Office of tbe Lieutenant Governor if USVI and trio Registrar of Companies in ire 8VI) Certificate c: Trade Name Corporate Ftesolutior (with Corporate Seal) Corporate Resolution and Corporate Authorization and Indemnity Agreement for Telephone/Telex/Facsimile/Written Instructions. (This documents only required if client requests fund transfers by phone. fax or messenger) .ft X.T..:::::::;:i Se. ._. kr li ft ---- .— — • l'allaniVifi.-". ,i L " _;. ldititlis;;?..}:fi);:iI.C.a; — Pannersrsp Letter and Security Agreement Businessrfrade License (current) Partnership Agreement (rf it exists) Certificate of Trade Name fir apple-able) Coruscate or Limited Partnership (it applicable) Resokreon where Paroorshp contains Cscooraton as a Partner (it applicable) Partnership Contains Lnniteri Liability Company as a Partner (if applcabe) Pamersnip Contacts Trust as a Partner (l am/table) Pamersnip ConrshsJont venture as a Partner (it semi:shim Security Procedure Agreement kr TelecticaeiFax Issuanos of Payment Orson or Request for Interne:Iona' Draf's fit requested) .._._ _. ._. .. CONFID I •L SONY _GM_00013788 C ifs an EFTA_DO I 24431 EFTA01269598  Certificate of Trade Name (4 applicable) Corporate Resolution or Uninwporated Association Resolution Certificate of IncapotaBon or Certificate of Authority for Foreign aid Foreign Nan-Profit Corporation (it ncoroorated) Articles of incorporation (4 inc.:Mcrae:0 Certificate of Good Standing (48A corporation kr nue than Neve months) (i incorporated) Corporate Resolution and Corporate Authorization and Indemnity Agreement for Telephone/TeleyJFacsimilePAhitten Instructions. (This document is only required 4 ciient requests fund transfers by phone. fax or messenger) - if incorporated Searity Procedure Agreement to Tetephoneifax issuance of Payment Orders or Request for led -if • r• t• t. t • IrdernationalDes a ., ..,.i. ± ,,Lajnzyff,..?,....t, cill' - ...:-2/1,:s.s.-6'at.zto2:N:-. ....__Ie..2:c. -.7 a .., _ ...., no . Limited Laity Company Letter and Security Agreement Business/Trade License foment) Operating Agreement Articles or Organization or Cogitate of Formation (non-bank form-if No PLC is a 'noel PLC Certificate of Existence Secures Procedure Agreement fix TelaPhaegFez Issuance of Payment Orders or Request ter International Crafts@ requested) - if unincorporated Lirneed Lability Company Contains Corporate Mamba/Manager (If applicateet Limited !Silty Compeny Contains Limited Liability Company as a Memberftrianager (A applicable) Limited Liabity Company Contains United Liability Pannell* as a Membegmaraler (4 appicabk) - Limited Stiffly Company Contains Partnership as a Member/Manager (4 appicable) bonded Liability Company Contains Trust as a Membentrianager (4 applicable) Urnted Liability Company Unincornorated Association as a Memberitrianager (if applicable) Untied Liability Company Contains Joel Venture as a Wernberglareger (4 applicable) il, iallii..4.?2,- - j.;:kiift;15-S. :-el' -.1fUi lij: --IiZaite W — 'lllg .A. 'iJ:i;:"..riii-f ill 'ail.9",4i tL_'T`:i?J T Corporate Resolution Certificate of Inarporabon cc Corti:Med Qualification Of a U.S. beam corporation) Articles of Inwporation (stamped by the Office of We Lieutenant Governor) BusnessrTrade License (cumin!) Corporate Resolution and Corporate Authorization and Indemnity Agreement for TelephonelletedFacsimile/Wertten Instructions. (This document is only required it client requests fund transfers by phone, fax or messenger) Limited Getty Company Letter a Secunty Agreement Business/Trade License (current) Th\iPt of Trade Name (it apaioabb) 1\A Operating Agreement Miles of Organization or Certificate of Formation (non-tank forninaquIred if the LLC is a -nevi LLCI V V Certificate of Existence Security Procedure Agreement br Telephone/Fax Issuance of Payment Orden or Request la i International Drat Of requested) Limited Natty Company °miens Corporate 1A3mberNenager (4 appicabb) Ignited LIMAN Company Contains Limited Liability Company as a Iriembereranager (i applicable) limited liability Company Contains Limited Liability Periwig* as a thembenlitanager (if applicable) Unuted Liabiity Company Contains Partnership as a Membedmarteger Of applicable) Limited Lea* Company Contains TWA as a iriemberrilrianager al apple-able) United led* Company Cedars Urincorocrated Associate) as (I1 applicable) United Liability Company Contains Joint Venture as a MerntienManager (4 applicable) • . ":::?&4(c:ti, ''_;<1. /,. ...;;' ji r.iej —2: ''. , .4 i c... , -..- tr- c Lilted Liability Partnership Letter and Security Agreement Certificate of Lirrited Partnership (Limited Partnership) — Not required when opening accounts for law firms or security brokerage houses Certificate a Existence 8usinesslTrade License (current) Operating AgreemeN Statement of Quartet° or Statement of Foreign Qualification Certificate of Trade Name (if amicable) SONV.Stieftalrano C Secunti Procedure Agreement kr TelepbonelFax ts curincArm Al ce I. NTIAL rst ankPRO00952 EFTA_00 24439 EFTA01269599  tvs:nass entibos. c•ilt :: . % --'cy'lriterest erailivinilS Trust Accounts IOLTA - USLI only ar IOLTA A xount Notice of Frencel u :n PILAF Account Notice of Fenorciai !nstluticti Business License (current) Cent/tale of Trade Rare PI applicable) Refer to the Account gamic Procodues ler additional documents requrod tr Cetera* types cr business entities. A bgal document(s) El *filch It Mates the none of the peace acting asadathisayilor. NW executor of and estabishes *Aar althorns If the PAC is an Unincorporated Association, then a letter signed by the posiient of be associatbn stating the &sex:lobe purpose and an Unincorporated Association Resolution is mired. II the PAC Isabel for Profit Corporation, a Certificate of Ireociperation for a Nceithodc Corporation s required. A certification from the Virgin bards Board of Becton, Check 0 it le obtained or Remarks Additional Documents (supporting documents) WAR not applicable Income Verification Prolamine'sl association d" y Marketing brochures, business Web site and ober market media She Photo, Utes invokes (Mater, electritity, telephone) Sample of entity stationery (presentation card. letter head paper, envelopes...) Other: Other: Other: Other: Other: Othe omr SO NY_GM_00013790 CONFIDENTIAL CONFIDENTIAL FirstBankPR000953 EFTA_00 1 24433 EFTA01269600  • First Bank Checklist for Special Partnership Account (For profit and not-for-profit) Together we are one Branch Number Account Num Initials andReview Date Document Action Comments I" Reviewer ri Rexityfc ,,, --:Datc: 14 /.V:_2. Daica..nk Basic documents for ALL types of accounts Customer Due Diligence Commercial/Entities I Account file Complete for business entity. NNNS-I307 Customer Due Diligence Authorized Signatures I Account file One per each signer NNNS-I 306 4 C Account Referral Sheet Only when the client is not I Account file NNNS. 1272 present ,fa.-, Observation at Place of Business (OP13) Account file I NNNS-246q Partnership Bylaws or Articles of Incorporation E Account file C4 Partnership, LLC, LLP Security Agreement e NNNS-2 198-04 IOR or NT:NS-2'99-0802 I Account file NNNS•22004802 or NTNNS-2.201-0604R -r ID Verification Results Summary BD CHECK .@ One per entity and one per OFAC) or evidence of the verification used in I Account file 11 each signer. if applicable .4.„ /q. c\ \E contingency. One per entity and one per CIIEXSYSTEM Report Result I Account file each signer. if applicable Al ie ()4W\ Photocopy of original Business License E Account file document „, 74,4. i\\Ci Applies to candidates for government elective Territorial Election Commission Certification E Account file positions. Photocopy of original document. ti lts n P, Cardholder one Digitalize for checking Signature cards hi alphabetical and one accounts ?If,' ( ii ---' numerical Deposit Account Agreement NNNS-2092-0508R USVI I' Provide to client NNNS-2377- I 104 BVI X (3- --- Additional documents forCHECKING ACCOUNTS Rates and Fees Schedule Disclosure ..4 _, NNNS-2091-1006R USVI I Provide to client ilk NNNS-2132.1206 MI , ..Additional - documents for CERTIFICATES OF DEPOSIT , .,:: :•i ,e., -,. . w , %, '44;i4Hc Certificate of Deposit Agreement M Onc for file and one NNNS-0958 I for client Account file Only if there was a special A/774 '11 a Evidence of Negotiated Interest Rate, if applicable quote. legend. P - Purchasing M - Mosaic I - Intranet E External Is) Spanish e) English NNNS-2539-061lFt SDNY_GM_0001379t CONFIDENTIAL CONFIDENTIAL FirstBankPR000954 EFIA_00124434 EFTA01269601  Account Type: Account Number: Sign. Req. Date: Commercial Checking I 1 4/563 Address: 6100 Red Hook, QTR Tel: 340.775.2/ 25' St. Thomas, VI. 00802 Name: LSJE, LLC EIN: Name:1 nne Brennan SSN: 7 Name: /7 4--- LA--a-,AAti.. tant-A-a- ID Type: UsrPote.Wolist No: SSN: ID Type: No: Name: SSN: ID Type: No: Me hereby acknowledge having restved prepared by: the Depodt Account Agreement, the First Flancccp Information Sharing and Privacy Authorized b Policy. and the product rates and roes. jr\ NA 101E 7/2002 NNS-000I Superseding-current-Reason Date.a. Jodie Insmuctions for comoktion Please print this form 3 times and complete in triplicate in blue or black ink. Please insert the name of the company or the account title under account name. Please print the name of each authorized signatory to the account together with a sample of their signature in each field under name. If there are more than four signatories please use additional signature cards as necessary. The Bank will complete the remaining fields. 'Important* Please provide each signature card in triplicate with the original signatures (no photocopies). FirnBcmk is a subsidiary of Fint &mow (NYSE: PBP SDNY_GM_00013792 CONFIDENTIAL CONFIDENTIAL FirstBankPR000955 EFTA 00124435 EFTA01269602  Account Type: Account Number: Sign. Req. Date: Commercial Checking 1 5/N i3 Address: 6100 Red Hook, QTR B3 Tel: 340-775-2525 St. Thomas, VI. 00802 Name: LSJE, LLC EIN: ?ry Beller Name: H SSN: eiA-- ID T No: , Name: SSN: ID Type: No: Name: SSN: ID Type: No: VWe hereby achnowledir having received prepared by: the Deposit Account Agreement, the First Bancorp Information Sharing and privacy Authorized by Policy, and the product rates and fees. -...1: NA 101E 7/2002 NNS-0001 Superseding-Current-Reason Date. G instructions for completion Please print this form 3 times and complete in triplicate in blue or black ink. Please insert the name of the company or the account title under account name. Please print the name of each authorized signatory to the account together with a sample of their signature in each field under name. If there are more than four signatories please use additional signature cards as necessary. The Bank will complete the remaining fields. °Important* Please provide each signature card in triplicate with the original signatures (no photocopies). Piratical& is a subsidiary ofFira Bancorp (1s1M: FBP SDNY_GM_00013793 CONFIDENTIAL CONFIDENTIAL FirstBankPR000956 EFTA_00124436 EFTA01269603  Account Type: Account Number: Sign. Req. Date: Commercial Checking I q 31 13 Address: 6100 Red Hook, QTR B3 Tel: 340-775-252 St. Thomas, VI. 00802 Name: LSJE, LLC Name: J ern __ Name: \--__--------2 ID Type: No: Name: SSN: ID Type: No: we hereby seknewisd8e having ^leaved Prepared by: the Deposit Account Agreement, the Fun Bancorp Information Sharing and Privacy Authorized b ,--• Policy, and the product rates and fees. -4 NA 101E7/2002 NNS-0001 Superseding-Current-Reason Date: Initial: Illgrlictions for completion Please print this form 3 times and complete in triplicate in blue or black ink. Please insert the name of the company or the account title under account name. Please print the name of each authorized signatory to the account together with a sample of their signature in each field under name. If there are mom than four signatories please use additional signature cards as neeessady. The Rank will complete the remaining fields. important* Please provide each signature card in triplicate with the original signatures (no photocopies). First:lank is a subsidiary ofArst Bartcotp (NYSE: FBP SDNY_GM_00013794 CONFIDENTIAL CONFIDENTIAL FirstBankPR000957 EFTA_00124437 EFTA01269604  Account Type: Account Number: Sign. Req. Date: Commercial Checking 1 .5 13 0 Address: 6100 Red Hook, QTR B3 Tel: 340-775-2525 St. Thomas, VI. 00802 Name: LSJE, LLC me: Darren Indyke Name: SSN: ID Type: No: Name: SSN: ID Type: No: I/We hereby acknowkdge having received Prepared b e *a the Deposit Account Agroanent, the Fins Bana'ap Information Sharing and Privacy Authorized ij gr Policy. and the product rates and fees. NA 101E7."2002 NNS-0001 Superseding-Current-Reason Date Initial Instructions for completion Please print this form 3 times and complete in triplicate in blue or black ink. Please insert the name of the company or the account title under account name. Please print the name of each authorized signatory to the account together with a sample of their signature in each field under name. If there arc more than four signatories please use additional signature cards as necessary. The Bank will complete the remaining fields. •Important• Please provide each signature card in triplicate with the original signatures (no photocopies). Fir:Rank u a subsidiarycfFmt &tramp (NYSE: FBP SDNY_GM_00013795 CONFIDENTIAL CONFIDENTIAL FirstBankPR000958 EFTA 0(1124438 EFTA01269605  1 First Bank Customer Due DtivJence for Business - Entities Existing Account Number 7322001709 1. Client Information Business or Entity name: Employer Identification or Social Security Number LSJ Employees LLC Operating_Account DdA Name (If applicable): Social Security Number (It applicable): ..) Physical Address: Mailing Address: Little Saint James Island 6100 Red Hook Quarters B3 St. Thomas. USVI 00802 St. Thomas, USVI 00802 Business Phone: (340)775-2525 Fax: Emelt 9 Type of Business: Household NAICS: 4)2 t4 Annual Sales: N/A ,O 1 ‘ Date Established: --7 -- c .:\ 1 Number of Employees: 10 Number of Offices: 0 O O Corporation O Nonprofit Corporation O Partnership O Government Agency O Unincorporated Association or Entity 0 Limited Liability Company Type of Entity O Other 3. Type Of Product , O Certificate of Deposit 0 Checking ❑ Saving O Loan 00ther, specify 4 Account Pur O Payroll 0 Operational O Trust O Pubic Funds O ATM Machias) O Escrow ❑ Transfer Funds O Corresponsal O Investment O Other 5. Expected Transactions Monthly Transactions Dansni Ions a 1 -10 O 11 - 29 O 21 or more. Total Amount 0 $1 - $5,000 0 $5.001 - $25,000 O $25,001 o more. Credits O Cash O Payrol O Account Transfers O ACH O Checks ❑ POS Transaction Mope O Electronic Transfers O Other. Transactions O 1 -10 0 11 • 20 O 21 or more. Debits Total Amount $1 -$5,000 0 $soel - sxs,00e 0 $25901 o 0 Cash O Payroll O Account Transfers 0 ACH O Checks Transaction Type O Electronic Transfers O Other. 0 International Transactions - Wire Transfers Q Incoming Transfers O Outgoing Treaters • Daily O Weekly 0 Monthly. O Daly E Weekly O Monthly. Transactions 0 1-10 • 11 -20 O 21 - 50 • 51 or more. Transactions O 1-10 O 11 - 20 • 21 -50 O 51 or more. Total Amount O St - Sss.000 O mom .$500,000 • 3500.001 o more. TOM/ Amount O at - *25.000 O $25 001-$50900D OS500,0010 more. Countries Countries 6. Initial Deposit and Origin of Furth, Initial Deposit: 5.000.00 Wain of Funds: If the initial deposit is greater than $500.000: Indicate the source of wealth: 7. Client Classification • if the 00SWOOS yes to et least one of the Worm,. the cliental,be tenderedhigh risk and further scion is needed as estethsh tin the Due Mena Cheeklisl- Guidance ForMails& orEnbties Conskiereel as Kph Risk. . ti the am-merle 0. E. or F is yet then aothorizaeon from the Compfisnce DePirlmenf- RSA Deis& is Weed Yes No A. Is the NAICS selected high risk? O El B. Does the business have a private ATM machine on site? C. Is the business a nonprofit organization? D. Is the business a political committee or organization? E. Is the business related to an officer of a foreign government? Indicate the type of relationship: a in activities rolat DNY_GM_00013 F. Is the business e CONFIDENTIAL FirstBankPR000959 EFTA_00124439 EFTA01269606  Customer Due Diligehce For Additional Bank Signers on Individual Accounts or Authorized Signatures on Business Entities Accounts - Existing Account Number Account Number which is attached to the Signer 1. Authorized Signer Information Name: HARRY Initial: I Last Name: belier Date of Birth: Place of Birth: NEW YORK Social Security: Citizenship: US Nome Phone: 212-750-1176 Other: N/A Physical Address: Mailing Address: 12 GOLAR DRIVE 61oqRED HOOK QUARTER B3 MONSEY, NY 10952 ST. THOMAS. VI 00802 Plan of Employment HBRK ASSOCIATES Employment Address: Occupation: ACCOUNTANT 301 EAST 66Th STREET, STE 10F Work Phone: 614-862-4814 NEW YORK. NY 10065 Email: Relation Account Title: ACCOUNTANT ID Type Numbs. 1st I D/LICENSE 2nd US PPT Recurrent Source: O Own Business El Private O Government O Other, specify: Annual Income: El $0.01 - $50.001 ❑ $50,00t - $150,000 O $150.001- $250.000 O Over 5250000 3. Client Classification . If the answers ws for A and C ofMe • quesfions. Me cash aiaDe considered high rsk aMfutheradim s needed as esfMitjshin du Due Ottgente ChecintstGuidence For individuals or Entities Considered as IVA Risk • If the answer lo C is yes, Mel euMorizefion kali The Camphoric° Department-BSA Dimon Is rebate° A. Indicate whether the client is a nonresident (NAICS X100030) B. Indicate whether the client is a resident alien: (NAICS #200000) C Indicate whether the client is related to an officer of a foreign government and document the type of relationship. (NAICS X400000) 4. Verification System- For use only as Contingency Plan if CHEXSYSTEM was called Name of the Representative who attended your call: _ Response to Social Security: Year: State: Other: Response on Industry Behavior: Response on ID: 5. Account Opening Authorization E Approved Lj Denied i h .11 4/ Name ." Signature Officer No r)- Comments. if applicable: Interviewed by LEONA MALONE 1/2312012 Name Stristure Deb 5NNS-f 305-1tit SO NY_GM_00013797 CONFIDENTIAL CONFIDENTIAL FirstBankPRO00960 EFTA 00124440 EFTA01269607  Customer Due Diligence For Additional First Bank Signers on Individual Accounts or Authorized Signatures on Business Entities Accounts Existing Account Number Account Number which is attached to the Signer 1. Authorized Signer Information Name: JEFFREY Initial: E Last Name: eps(eibi C `Ts1C k'1 Date of Birth: 1/20/1953 Place of Birth: NY Social Security: Citizenship: US Home Phone: 340-775-8100 Other: N/A Physical Address: Mailing Address: LITTLE SAIINT JAMES ISLAND 6100 RED HOOK QUARTER 83 THOMAS, VI 00802 ST. THOMAS, VI 00802 - _ Place of Employment: FINANCIAL TRUST COMPANY, INC. Employment Address: Occupation: FINANCIAL CONSULTANT 6100 RED HOOK QUARTER 83 Work Phone: 340-775-2525 ST. THOMAS, VI 00802 Email: [email protected] Relation Account Title: LAI.' \ ID Typo Number Country Expiration (MMINVYYYY) 1st D/LICENSE USVI 01/20/2015 US 10/10/2012 2. Income Recurrent Source: S Own Business O Private O Government O Other. specify: I Annual Income: O $0.01 - $50.001 IZ $50,001 $150,000 O 5150001- 3250.000 O Over 5250.000 3. Client Classification • IIthe answers yes lora and C of the foricraW9 queskons, the clientwife. considered high risk and Whet action is needed as establish in the Due atone? Check -Guidance Fa Inottiduat or Entaies Considered as high Risk. • lithe answer lo C is yes then eutorizatton from the Compliance DepaittnentaM Cahoon is reclined. Yes No A. Indicate whether the client is a nonresident alien- (NAICS #100000) B. Indicate whether the client is a resident alien: (NAICS #200000) C. Indicate whether the client is related to an officer of a foreign government and document the type of relationship: (NAICS #400000) 4. Verification System- For use only as Contingency Plan if CHEXSYSTEM was called Name of the Representative who attended your call: Response to Social Security: Year: State: Other Response on Industry Behavior: Response on ID: 5. Account Opening Authorization Wrred ❑ Denied Luton Mum Officer No. Comments. if applicable: Interviewed by: LEONA MALONE - .,--si-. . 01/23/2012 Name Sign/furs NNNS-1306-1111 SDNY_GM_00013798 CONFIDENTIAL CONFIDENTIAL FirstBankPR000961 EFTA_OOI 2444 I