EFTA01370741
EFTA01370742 DataSet-10
EFTA01370743

EFTA01370742.pdf

DataSet-10 1 page 409 words document
P17 V15 V11 V16 P23
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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: 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 CORPORATION 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 understanding. relationship or otherwise. owns 25 percent or more of the equity interests of the legalarrangement. entity listed above: Name I Date al auto Legal Address 1 Fe, U.S. Parsons: he Ncrl.U.S. Persons: I Social Seounq (See leo:natal for ttternaobeiI . Number to SotialSetwity Nutter) ---- 4 I I. NOT APPLICABLE I 1 I • NO:WAS.Personi. in addition CO a Social Scattily aturnbar or a Pitapat Plumper witn Country of issuin‘A en alien ieentificallen caw number. Or *WV& and country of nuance c1any oilier gOvermrneng-imed documenteviCtkatv net:matey or sniOence and tearing a ahcceprapn eimilar safeguard ineob be provided. naindandual enacts this fttinnion. Please wale 'Not AoPlab4a.-) 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 atso be listed in this section (Cl)). Name Date of Sinn Lica:A Address Pot U.S. Persons: I Fo Non•U.S. Anent; Social geounty i (Sea femme a tar tarenartvasi Nurnaar ' to Satiaf StearitY Number) I 6100 RED HOOK QUARTER, B3 JEFFREY E. EPSTEIN 11/20/53 ST. THOMAS, USVI 00802 • For Nen-V.S. Parsons, in addition to a Sobai SeCurity Mumbo: u, c Pasipon Mamba: %%id, Country of Issuance, on alien Idantificanon card wear. or *miter end (raillery al is of any otne: gavot mbent-iabed deburnent ovtogreing et:venality Of resident* and among a 011010QmOn or,ritar be Dravided. 511Ncara abOub FREY E. EP TEIN me of natural person opening the acsount)• hereby certify. to the best of y knowledge, that tie info is complete and correct. 7124118 SI Date Na rint):a tesoi Entky identifier (Optional) Title: Deno: er srpifruta4 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0063751 CONFIDENTIAL SDNY_GM_00209935 EFTA01370742
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c2dd731fbf8d7a882696d2022894e50f38635cf6cfc8fc963a51c6f87d69b773
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EFTA01370742
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DataSet-10
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document
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1

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