EFTA01386247
EFTA01386248 DataSet-10
EFTA01386249

EFTA01386248.pdf

DataSet-10 1 page 430 words document
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AGP LP 519 Alpha Group Capital Paul Barrett II. ADDITIONAL INFORMATION Indicate the category which best describes the New Limited Partner (and provide the documents indicated below that correspond to the appropriate category): ❑ Individual ❑ Fund of Funds or Other Entity that Invests on Behalf of Third Patties ❑ Trust ❑ Privately Held Entity (other than a Fund of Funds, Entity that Invests on Behalf of Third Parties or Trust) ❑ Publicly Held Company The following materials must be provided to the Administrator: (a) For Individuals and Participants in Individual Retirement Accounts, Keogh Plans and Other Self-Directed Defined Contribution Plans ❑ A government issued form of picture identification (e.g., passport or drivers licence). Identification must be current (i.e., non-expired) and legible. ❑ Source of Funds (please complete Annex A). ❑ A bank reference letter from the Wring Bank or a bank or broker-dealer located in a FATE- member country (A sample letter of reference is attached hereto as Annex F). ❑ United States IRS W8/W9 form (as applicable). Please refer to the official IRS website, www.irs.qov, for the appropriate form. (b) For Fund of Funds or Other Entity that Invests on Behalf of Third Parties ❑ A copy of the entity's organization or charter documents filed with the jurisdiction of organization. ❑ An incumbency certificate attesting to the title of the individual executing the Anti-Money Laundering Supplement on behalf of the prospective New Limited Partner (a sample Incumbency Certificate is attached hereto as Annex 8). ❑ A completed copy of Annex C certifying that the entity has adequate anti-money laundering policies and procedures in place that are consistent with all applicable anti-money laundering laws and regulations, including the USA PATRIOT Act and OFAC (as defined below). ❑ A completed copy of Annex D listing the name of each person who directly, or indirectly through intermediaries, is the beneficial owner of 10% or more of any voting or non-voting class of equity interests of the prospective New Limited Partner, and the names of the entity's directors, general partners, or members, as applicable. (You must complete Annex D regardless of whether there are any 10% beneficial owners.) ❑ Source of Funds (please complete Annex A). ❑ A bank reference letter from the Wring Bank or a bank or broker-dealer located in a FATF- member country (A sample letter of reference is attached hereto as Annex F). ❑ United States IRS W8/W9 form (as applicable). Please refer to the official IRS website, www.irs.qov, for the appropriate form. Appendix G-2 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0087859 CONFIDENTIAL SDNY_GM_00234043 EFTA01386248
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EFTA01386248
Dataset
DataSet-10
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document
Pages
1

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