EFTA01362345.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: PLAN CI, LLC, A USVI LIMITED UABIUTY 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 Dale el Sinn I legaiAddres$ For US. Parsons: For Non-U.S.Passont Social Security (See footnote1ler Dee+ rldtniPS Maniacs to Social Sticday No'nber) 6100 RED HOOK QUARTER, 63 JEFFREY E. EPSTEIN H 1120(53 St THOMAS, USVI 00802 :090.44.3548 i For Pion-US. Persons. in aciaipon co I Social Semite Number or a Pasrpon Number with of and counny of issuance of anyother gevotnment -issued tiolanerri evidenci-v noticnarxtyCountry issmante. an Sion Went-ace:ion raid norrees, or numner or residence Jett Warkng a pitotoorada or Seaialt safer:met should be provided. fit no :nal:Of:bat meets tnis deli:Ikon. please write `Not Apolicat:e.1 d. The following information for one individual with significant responsibility for managing the iegal 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 also be listed in this section (d)). Name Oats of Bonn I tcgalAckwess For U.S. Poisons: For Non-U S. Portent Soebl SttraY e I (See footnote for aitenualvaS Number j to SQC:01 Security Number) i I ABOVE JEFFREY E. EPSTEIN SEE For Non•US. Persons in 'Edition to a Social Security Number or a Pain= Nombef ?Jell Country 0! ISSuanCe, an alto and tountry of Issuance Many goer s.cereennlanWee0e4 CCCunlenl eveleneing nationality c, itiletilitaaarlMC Melte; or :umber residence and beating ahaeotaapil a SinetVaileWatei should to Provided. rat person opening the account), hereby certify, to the best of QVe is complete and correct. 7124118 Dalt Legal840:y !Snuffer (00twassi) crijime Ond CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0051727 CONFIDENTIAL SDNY_GM_00197911 EFTA01362345