EFTA01380831.pdf

IL 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 I 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: Fla INC., A DELAWARE CORPORATION 8100 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: i Name t Ock of Beth LegalAddress For US:Pe:sans: Fee Non-US Persons: Social Security (See footnote l for alternatNes Number In Social Seconty Nunibe) • 8100 RED 1100K QUARTER, B3 ' JEFFREY E. EPSTEIN 1/20/53 ST. THOMAS, USVI 00802 ' For Non-U.S.Fleisons, inaddition to a Social Securty fturnbes or a Passport Number with Coin;of issuarce, an Mien identiltatkra and country of Issuance of any other government.issued document evidencing nationaky or residence ant bearing a F.:not:pion cart tint. or number at safeguartl indult 1 be prodded, Of no individual meets this deRnition. Please write -Not Anoilralbirai d. The following information for one individual with significant responsibility for managing the legal entity listed such as: above. • 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)). Name Oats of Sinn I Legal Acorns roc US:Persons: I Frac NtimU S. Penonre I Social Stour sty (Sea fcratroie blot alternatives Number to Social Seramly Number) ?ABOVE !JEFFREY E. EPSTEIN j SEE %For Non-u.S, persons. in addition toe Social Seantty Number ore Passport Number with Country of Issuance: an alien tentifioaticri and country of trance:mot any other goveinetent-issted document trader-ling nationality or tesidence and bearing a photograph Of card number, or number be provided. similar safeguard Sramid (name of natural person opening the account), hereby certify, to the best of KurprOCidedabove ' complete and correct. legal Entity Identifier (Optional) CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0079392 CONFIDENTIAL SDNY_GM 00225576 EFTA01380831