EFTA01480626.pdf

ECI Party Type Party Name Last KYC Status Report Type Relation Powers Percent Completed Type Owned Search Date 0241469053 IIICINithlal HARRY Ft( .le. ' •; O01111.1 500 BELLER Primary Information for HARRY BELLER Client Type Individual Generation Client Status Proved Active Indicator Yes Front Office Restricted? Normal Marital Status Confidential Names? Country of Pnmary Domicile Prefix/Title Insider Code (Reg. 0) First Name HARRY Full Name HARRY BELLER Middle Name Gender Male Last Name BELLER Date of Birth Suffix Primary Country of Assets PreviousName/MMN/Mias Citizenship Employer Name HERK Associates High Risk Jurisdiction Occupation Financial Advisor Industry Code (NAIC) Years at Occupation Secondary Industry Code (NAM) Address(es) Type Notes Address Cfty, State, Country Tools Entered by Preferred Postal Code Work NEW YORK UNITED Map it DANIELA 10/07/2013 Yes New York. STATES GARIN 100656298 Phone(s)/Fax(s) E ir al Notes Phone Number Tools Entered Date of LI ate Preferred Work Verify 'Do Not SYSTEM 04/13,2012 Yos Car List Cost Center & Hierarchy Client Status Pros.- O Individual Client S . • nsce Cost Center 008634 • COBS Client Service Team Identification Withholding Federal Status Domestic Codified Withholding SSNMN Certification Date SSNITIN/EIN 0 Form of government issued None Identification obtained for the files Source Of Wealth / Financial Information Details Confidential Treatment Requested by JPM-SDNY-00002831 JPMorgan Chase CONFIDENTIAL SDNY_GM_00272029 EFTA01480626