EFTA01373044.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: PLAN CI, LLC, A USVI LIMITED UABIUTY 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: I Nan* Dote el Birth Legal Address Foe U.S. Parsons: I For Non-US.PIIISOnt Sadlail Seen6 IV (Set fOOMOW tier DMnausea Number E to Sxial Stioday ithenter) 6100 RED HOOK QUARTER, 63 JEFFREY E. EPSTEIN ST. THOMAS, USVI 00802 Fo: Non-U.S. Persons. in aciainon Co e Social Semite Number or a Passport Number with and country OS isrAsance of any other gevetnment -issued destnerri evidenci-v noticnahneCountry et Usual:CO an ellen a:until-catkin oud norriast, or numner or residence and Warkng a oii0tO(pann or senher Saftetiate should be provided. (If no meIheXival meets tnis deli:Ikon. please write `Not ApplicatIe.1 d. The following information for one individual with significant responsibility for managing the iegal 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. (If appropriate, an individual listed under section (c) above may also be listed in this section (d)). Name Oats of Binh I Legal Address For U.S. Perla*: I For Non-U Portent Soebl Settnhy (See feel:Mel for aitenuelvasi Number I to SQC:111 Securhy Number) I ABOVE JEFFREY E. EPSTEIN SEE Fe, NbruUS. Persons in eehlition to a Social Security Number er a Passport NOMbra ?AI Country c! Issuance, an atm and <vinery of Issuance Many otnor c.c.vefrullefil4SSOC4 Casement evithNlying nationality ci itlentificatianCWC nurabse. or rarnbet residence amt bearings 1:Plagetirapil or SintrtVialtwarci should bc Provided. rat person opening the account), hereby certify, to the best of QVe is complete and correct. 7124118 Dalt Legate:xi:it !Snuffer (Optional) crijime Ond CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0067035 CONFIDENTIAL SDNY_GM_00213219 EFTA01373044