EFTA01373041.pdf

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, SOLE MEMBER b. Name of Legal Entity, Type of Legal Entity, and Address of Legal Entity for which the Account is Being Opened: LSJE, LLC, A USVI LIMITED LIABILITY COMPANY 6100 RED HOOK QUARTER, B3 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: Name Gate at Birth Legal Address For US. Penont: For Non-11.S Petems: Social Security I (See footnote I for alternatives Number to Social Stowe). fatenbei) 6100 RED HOOK QUARTER, B3 JEFFREY E. EPSTEIN ST. THOMAS, USVI 00802 1 For Non-US Persons, in aatation to a Social Security Number or a Paoport Nude°, With COuntly of lase not. on arse, ieentircorioe taro numbs:. or author wt countyy of issuance of any other vavarnment-issoto Oct:wren, et:Wending natiractafity oe Tesidenet anc aaaringa phelograan of sirtoler sateguero shoatc: 0 oroVeieu. no indlekluat meets this deified* pleat:emit° "Not Atpticab:e.1 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. Of appropriate. en individual listed under section (c) above may also be listed in this section (d)). i Nam* Mateo( Beth Legal Address t For U.S. Penons: I For Nan-u.s.Pczecnr. Satial Security Mdt footnote l for aftemadva lettendef 10 SXMISecurtly Number) ABOVE 1 !JEFFREY E. EPSTEIN I SEE re, thon.U.S. Person& in addition to a Social Security Number or a Passport Number with Country of Issuance, on alien identlficat ien card numbe. of number Sf•4 chtentrY Of inutnet of any other government-Sewed dacurrenr &adobe/Ail r•atichaley as residence am hearing a oho:3gram or lemur eakparo should ho oroviaed, REY E. E TEIN ne of natural person opening the account), hereby ce to the best of m knowledge, that t information eve Is complete and correct. Signature 7/24/18 Stela Da :C. 77 14. IT C Name Lego: Entity Identifier tOPticael) Tale: Date: Srprivre CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0067031 CONFIDENTIAL SDNY_GM_00213215 EFTA01373041