EFTA01384795.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, SOLE MEMBER b. Name of Legal Entity, Type of Legal Entity, and Address of Legal Entity for which the Account is Being Opened: LSJE, LLC, A USVI LIMITED LIABILITY COMPANY 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 Dote of Binh Legal Address rot US. Persons: For Nomi).S: Peso Social Security I (See footnote I for alternatives Number to Social Setwey atkenbei) 6100 RED HOOK QUARTER, 63 JEFFREY E. EPSTEIN ST. THOMAS, USVI 00802 1 For Non-IAS Person& in adohion to a Social Security aimbo:or a Pampa Nude°, With Counlry ['lasso not. on ellen identircorion card numbs:. or molar and county? of issuance of any olive government-issoW WO-event e-:idenzingi natiractafity Or Tesidenet and tearing a pholograort or similar safeguoto shoutc: 0 orovreieu. Of no individuat meets this clefirlition, please:vita Wet Aopticah:O.1 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. Of appropriate. en individual listed under section (c) above may also be listed in this section (d)). i Nam* Date of Beth i Legal Address t For U.S. Penons: For Nan-u.s.Pcsons Soetet Security Met footnote I for atleditIWS Nomad 10 Satiol Security Number) ABOVE 1 !JEFFREY E. EPSTEIN I SEE For Non.U.S. Person& in addition to a Social Security Number or a Passport Number with Country of Issuance, on alien identlficat iOn cord numbr. a number Sid COUIWY iSSUtrott of any other government-Sewed document ear.onemil nonfat lily as residence am hearing a oho:3gram or sinutte sokpare should ho provided. REY E. E TEIN ne of natural person opening the account), hereby ce to the best of m knowledge, that t information pve Is complete and correct. Signature 7/24/18 Signs Da:C. 77 14. IT C Name Lego: Entity Identifier tOMoetel) Tale: Date: Srprivre CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0085318 CONFIDENTIAL SDNY_GM_00231502 EFTA01384795