EFTA01480540.pdf

Source Of Wealth I Financial Information Details Source Of Wealth -Identify he Clients Source of Wealth from Other followln list of o• Ions ECI Party Type Party Name Last KYC Status Report Type Relation Powers Percent Completed Type Owned Search Date 0241469053 Individual HARRY Full Sone' col C0 BELLER Primary Information for HARRY BELLER Client Type Individual Generation Client Status Prospect Active Indicator Front Office Restricted? Normal Marital Status Confidential Names? No Country of Primary Domicile Fierntrritte Insider Code (Reg. 0) First Name HARRY Full Name b:RRy BELLER Middle Name Gender Lf:ri, Last Name SELLER Date of Birth - SuRi■ Primary Country of Assets PreviousName/PAMNIAl s Citizenship UNITED STATES Employer Name HBRK Associates High Risk Jurisdiction Occupation Financial Advisor Industry Code (NAIC) Individuals [999940) Years at Occupation Secondary Industry Code (NAIC) Address(es) Tyne Notes Address City. State, Country Tools Entered by Date of Preferred Postal Code U•date 301 E 66TH NEW YORK. UNITED Map it DEBRA P1:13,2012 Yes ST APT 108. New York. STATES WHITE 100656298 Phone(s)/Fax(s) Notes Phone Number Tools Entered Date of U ate Preferred Work 2123270131 Verify To Not SYSTEM 04:13/2012 Yes Calr List Cost Center & Hierarchy Client Status ritarl!!!! Individual Client S • •nsor PAUL V MORRIS Cost Center 008834 -CHBG Client Service Team Identification Withholding Federal Status Domestic Certified WMMIldngSMMN 0411312012 CoftlicationMite SSN/11WEIN 081424727 T1 Form of government issued None Identification obtained for the files Confidential Treatment Requested by JPM-SDNY-00002726 JPMorgan Chase CONFIDENTIAL SDNY_GM_00271924 EFTA01480540