EFTA01480792.pdf

Identification Withholding Federal Status Withholding SSNMN Certification Date SSNMWEIN Form of government issued identification obtained for the files Primary Identification Number Issued By Date Issued Expiration Date Source Of Wealth! Financial Information Details Source Of Wealth -Identify the Clients Source of Wealth from following list of o • Ions Hntroduction Non individual Entity Type Corporation • For Profit For Profit? Yes -.1 Locations Served? Both a. If International or both. please describe: To conduct its business in the Virgin Islands and elsewhere in the United States and foreign countries and to have offices within or outside the Virgin Islands and to hold. purchase. mortgage and convey real and personal property within or outside the Virgin Island. Public or Private Private Are beneficial owners/principal shareholders associated with Yes this business? Who owns this entity? Inca/dual Please Provide ownership details Jeffrey Epstein is the sole owner of the corporation • Jeffrey Epstein DO • SS citizen ni Tates Gov't ID: US Virgin Islands - CI 0000025574 - Issued 1/15/2010 • Expires - 1120)2015 Ownership is not equal to 100.? No Are there any authorized signers or any other Individuals No with authority over the entity? What independent background check, In addition to the JPMC Network Global Corporate Security ("GCS") background check, has been carried out? Check all that apply and provide the date In which the background check was conducted. (at least 1 must be selected) JPMC Network Date 121CU3/2(111 JPMC Network Comments This is another pan of an existing client relationship with Jeffrey Epstein. An ECI was created for this entity in the Retail Bank but no account number was ever assigned. We are moving this ECI from Retail to Private Bank to open an asset/brokemeo account. Politically Exposed Person Are any of the beneficial owners/authorized signers or other No Individuals with authority over this entity a current or former Senior United States or Non-USA Political Official also known as a Politically Exposed Person (PEP) or related to one? Source of Wealth/Financial Information Client Cat - • o for SOW For Profit Source of Wealth- identify the clients source of wealth from Other the followi • list of options Provide detailed and specific information. The source of wealth will derive from the personal assets of ,:ef' E• stein. Jeff E • stein is self- . •.• - • in vestob'entre•runeul Which countryfies)is(are) the Client's primary Source of UNITED STATES Wealth or Income derived? I I I nO• rat n Com No Confidential Treatment Requested by JPM-SDNY-00003014 JPMorgan Chase CONFIDENTIAL SDNY_GM_00272212 EFTA01480792