EFTA01379575.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: IJEFFREYE.EPSTEIN,PRESIDENT b. Name of Legal Entity, Type of Legal Entity, and Address of Legal Entity for Which the Account is Being Opened: 6100 INC.,ADELAWARCORPORA JEGE,RED EB3, TION HOOK St THOMAS, QUARTER USVI00802 c. The following information for each individual, if any, who, directly or indirectly, through any understanding, relationship or otherwise, owns 25 percent or more of the equity interests ofcontract. arrangement the legal entity listed above: Mae Date of Beth Leal Addams ForUS.Pirsons IFFe: Nve•UPJ.P SoveI Srztlivi 3. sons: ag (Soo footnote lot alternatives! Number n to Social Setway Number) JEFFREYE.EPSTEIN 6100REDHOOKQUARTER83, ST. THOMAS,USVI00802 Fat Non-U.S. Persons. m addition to a Socol Semany thenber or. Passport Number with Country of Issuance. en alien ceonneatiOn we bombe,. 0, number, be ant Couture 0' ilnane•of any other goveurneni-issued doti.onemevitArneingnahoneew or esidenot provided. and Waring a ohotnara pa or simkar tasked should (If no incividual meets this definition. 01.13$0 veito "Not Appoco*10.1 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. (If appropriate, an individual listed under section (c) above may also be listed in this section (d)). Name 041e of Birth I Legal Address I For U.S. Persons: For teon.U.S. Persons: Social Securely I (See fdo:ootc for alternatives! Number i _toScciat Security Number) JEFFREYE.EPSTEIN SEE I ABOVE Re Non-U.S. Persons, in addition too Social Security Novae: or a Passport Number with Country of Issuance. sue country of UptuanCe 01any other ocvueirrent-issued document eadencl nanoeli!vot res;stoce en aben iOtrUification Caro Nancy. or nuerbe bo provided. a ant beacino a ahotorir aph or seei,or Ogegua•O Monks I JEFF N (name of natural person opening the my k emorovidecfeb0ve • complete and correct. Sig 7124118 SiUn3t re Date Legal Entity Identifier (Optional) Date: craw Cad CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-OO7718O CONFIDENTIAL SDNY GM_OO223364 EFTA01379575