EFTA01379573.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: I J. EPSTEIN VIRGIN ISLANDS FOUNDATION, INC., A 501(cX3) PRIVATE FOUNDATION/USVI CORPORATION 6100 RED HOOK QUARTER, 83 St THOMAS, USVI 00802 c. The following information for each individual, if any, who, directly or indirectly, through any contract, understanding. relationship or otherwise. owns 25 percent or more of the equity interests of the legalarrangement, entity listed above: i Name I Date of Savo Legal Address 1 For U.S. PeffalS4 So: NemiU.S. Persons: soda Security (See lootnots 1 for alternatives/ I I Number to Sotineneity Nuirteri I ----- 4 I I NOT APPLICABLE I 1 I • Nort.u.S. Persona. in addition to a Sued Sorority Number ore Pauper, t Plumper witn Country of &sun* an alien identification care and country of nuance of °mon ier tiouornmunt4ccied document recimutuv thiarnaUty number. Of Nano& or losidence and tearing a nhnC0 DenPn or elfrlar be provided. eatetnelt lhaub thisLictinnlon. alcase mite 'Not r14/ 0PkteUe.-) (11n3 indent/eat meets d. The following information for one individual with significant responsibility for managing the legal entity listed such as: above. • 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 (Cl)). r Name 1 Date of Bete I Legg Address Fot U.S. Persons: I For Non-U.S. %%nom Social Security 1 (Sea footnote a ref ileoUnafiViSI letauDer ' to Serial SeCufey r1Unite* i 6100 RED HOOK QUARTER, B3 JEFFREY E. EPSTEIN I St THOMAS, USVI 00802 • rer Non-VS. Parson, in ftrWatien to a SoC33iSectulef Menthe: W a Pessozrt Monte: with Country of IssoanCe. en alien idontilication card nunfar. Of nunibef and country of is of any otne: govolnment-issuen document evicsistring nationality et residence and mowing a ohotovaon M ' ,mar salegoard sNaoid be Drauefen. FREY E. EP TEIN me of natural person opening the account h reb ri ' I y knowledge, that tie info is complete and correct. Sig 7124118 Date Da Natre:__2AyAa: Legal Entky Identifier (0fltroneD Title i. srpifrut Oat CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0077178 CONFIDENTIAL SDNY_GM_00223362 EFTA01379573