EFTA01369143
EFTA01369144 DataSet-10
EFTA01369145

EFTA01369144.pdf

DataSet-10 1 page 403 words document
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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: t JEFFREY E. EPSTEIN, MANAGER i b. Name of Legal Entity Type of Legal Entity, and Address of Legal Entity for Which the Account Is Being Opened: (SOUTHERN FINANCIAL, LLC, A USVI LIMITED LIABILITY COMPANY 16100 RED HOOK QUARTER, B3 i St THOMAS, USVI 00802 I 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 Date or Birth Legal Address For (LS,Persons ' For tion-Lt& Persons: Such Security (See footnote 1for alternatives Number to Social Seam Martel ---ii 6100 RED HOOK QUARTER, B3 i JEFFREY E. EPSTEIN 1/20/53 St THOMAS, USVI 00802 L I For Nen-U.S.Parses, in addition to a Social Socunty Number or a Passport Number with CountryOf issuance. an alien roentikation and country of issuance of any other guvemmentiisaired do:to:tent evidencing nationality or card number, or number residence and beefing a photograph or similar safeguard should be rausvided. (If no individual meets this deratibort ideate write "Not Amicable) 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)), Date of Sins I Legal Address €FoeU.$. gyros. , P0.- Non-U.S. Persons: Socivatl,er S ny (See footnote I for alternetioesi to Social Security Number) I ABOVE JEFFREY E. EPSTEIN SEE 1 For Non4JS. Persons. in addition to a Social Security Minder or o Passport Number with Country or Issuonce, en alien identification Care number. or number aryl enuntry of iS2.43flet Cd anyother governmenolseued document eater-icing nationality or !riddance and bearing a olorograph or simaar safeguard snaitl be provided. FFREY E. STEIN me of natural person opening the account), hereby certify, to the best of knowledge, the the informat ed above is complete and correct. 7/24/18 Signature Dote Legal &Way Identifier (Optional) CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0061252 CONFIDENTIAL SDNY_GM_00207436 EFTA01369144
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EFTA01369144
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DataSet-10
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