EFTA01298375.pdf

IL 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, PRESIDENT b. Name of Legal Entity. Type of Legal Entity. and Address of Legal Entity for which the Account is Being Opened: J. EPSTEIN VIRGIN ISLANDS FOUNDATION, INC., A 501(cX3) PRIVATE FOUNDATION/USVI CORPORATIO N 6100 RED HOOK QUARTER, 83 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: None I Data of Seth Legal Address rFor !LS. Persons: Fe Mon.U.S. Persona: I , Social Secutity (See loot0ft i tor alternati. I Number to Soda! Satiny Number) I i NOT APPLICABLE I I I I i i I ' For Non-US. Persons.In odeWact to a Social Security Nutmeat ore Pateprxt Iltatiftr wrtn Country of Issuance. et alier. t000rilleation we narrow. Di owned/ ono country Di ;nuance of any eine government-10mM document evidencing nationality or residence and bearing a olvtograpn a simile safeguard stral be provided. (Ii no kb:lin:kat meets this dotinition. ukase write "Not AnoticablOn cl. 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 managing Member, General Partner, President Vice President Treasurer); or Officer, • 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)). Nam* Date of Sire, Legal Az.o. toss Foi U.S. Pylons: I For Non.U.S. Persons: Social Set.utity I (See foomoza for altenarivar Number ! to Social seamy Nuarder) 6100 RED HOOK QUARTER, 83 JEFFREY E. EPSTEIN ! 1/20/53 ST. THOMAS, USVI 00802 Fa Non-US, Parsorc, in addition to a Social Scatrey Numuc: to a Passport Number t0l. Country of issuance. an Aticti Wt.:nits:anon ann country o1itrurnyto of any otne: gore nment-issued document eviciencIns nationakynr resrctmee and bearing card number- or number a c?rotogrann at sinter Seenuard rokluit be provided. EFFREY E. EP EIN me of natural person opening the account). hereby certify, to the best 01 knowledge, that t le info is complete and correct. Signalur 7/24/18 gn Date Na nnl):a Legal Entity Idenolnir (00001) Dale: SrplfAtt 04-( SDNY_GM_00062720 1DENT1AL DB-SDNY-0025545 CONFIDENTIAL - PURSUANT TO FED. R.QPN(F EFTA_00173228 EFTA01298375