EFTA01379157.pdf
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li. Certification of beneficial owner(s)
Persons opening an account on behalf of a legal entity must provide the following information:
e. Name and Title of Natural Poison Opaning Account'
Pr-frei ‘.. C-firi-eo" 1 (tk.‘_,...46 -4 V
b Nara of t.cog t nOty. Type 7 E lot A.:COI:lilt is Being Opne.
Ts. oskj 4-4 t; at, 1, 4..r (.04.0.ecuAr-t
or to 0 k.kock Oucork•etr g 3
Visa 4 a.s, L.1SQ ta5i.
c. The fogowing inforMatiOn for each indlIrtioa14/ f eiTy. WhO, rilrecdr or indirectly, through eny contact, rangement
otwfltystdrto ot en:65e. (),,,n5 25 oei,:ent 'y more of the equity interest of the legal entity listed above:
co, t.I.S.Permes kit tion.0 S Petwets
SocIS -9Thlrir'21 clIes lacerotel lc/
SMAA Sh-OtICOVV»rolti
I () 0(s-3 Lao 1241-kirbeiL Cl.).44e)
S$. TGa3 S &ft C.x.)80
Os MO:•-;33, ViOt: %IA SbAsiit(..4:111t. V 4 01.1.2>P0it kiewwwitn COW,ITY (If ;40004, at. y4r4i- 'yew:L=4..44cm ryjet.,•1
and -).:Dntrr. of issri4nr;# 41Vrt ,the gOVVAII1Wit.otiseel trizionirtat rrirdenting nationallw or rewierreetird be oteg a plcrtotazah et smitu tafewall thorird
sl no Atksual meats chit oefineitr, ma Se Mite '140t, APO:13NC,
o The following information for one individual with significant responsibility for marleginQ the legal ernity listed above.
SUCK 8s:
• An executive officer or serther nranagerfeg , Chief Ftteee Offer
Off Chief Financial
c Officer. Chief Operating Officer,
Managing Member. General Pdrtne.I, President. Vice President, Treasurari: or
• Any Citttqf 'rho regularly rxrfotras &miler functions.
of appropriate. an individual listed under motion (c) above may also b listed in this section (d1).
1)Ni,It earn Fn!U.. k'nfeln rtor ticort.t.S. itrirattt
fACIAi f3fel 4iVer•tves
PAIRIbe >rozsciol Sterility N,serttit
14-4s)0, ..sz
Fof --or Switate kiirr?Ar r: Pitsyrw..n RiertneWgr. etilft1Of '4C-ithrza an xeierriitrotitir.b1h-e:4.7St.dnbze. rtiRitbit:'
ft.yrscrai. t *r... rrorr re 4 $a:-.
and ;rout., n..”inze c.! zaw *thin Licniennert.isose:, dew/vent evidencing ontinmliwnr mfatittroe.ted be 10114 a illretycirapir or Jager salcgi.ercl Omni°
Protij
of natural person opening the eccounti, hereby cooly, to the bast of
‘cmplere and tweet.
LOOM 5n7:n, (Cptinr )4/
ti; 201S Mr:tic:NJ Oft.* ers, AC NM*. ituler•tti. WhIgoe;64 enstkostass
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0076472
CONFIDENTIAL SDNY_GM_00222656
EFTA01379157
ℹ️ Document Details
SHA-256
c8f141389470ef9ea8cf79a09a1457552d25036c199aec99067274f9e483ab2e
Bates Number
EFTA01379157
Dataset
DataSet-10
Type
document
Pages
1
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