EFTA01480846.pdf

Introduction Type Net Worth of client(S) Source Of Wealth I Financial Information Details Source Of Wealth -Identify the Clients Source of Wealth from follovAn. list of • • Ions ECI Party Type Party Name Last KYC Status Report Type Relation Powers Percent Completed Type Owned Search Date Individual HARRY Ful Signer Full 0.0 BELLER Primary Information for HARRY BELLER Client Type Individual Generation Client Status Client Active Indicator Yos Front Office Restricted? Normal Marital Status Single Confidential Names? Country of Primary Domicile UNITED STATES Primary Domicile State Prefix/Title Insider Code (Reg. 0) First Name HARRY Full Name HARRY BELLER Middle Name Gender Last Name BELLER Date of Birth allill Suffix Primary Country of Assets PrevlousNamenAMNiAllas Citizenship Employer Name High Riek Jurisdiction Occupation Industry Code (NAIC) Years at Occupation Secondary Industry Code (NAIC) Address(es) ;Pk Notes Address Tools Entered by Date of Preferred U to Work Map it SYSTEM 0&12/2011 Yes Cost Center & Hierarchy Client Status Client Individual Client S nsor Cost Center 118313 IVT OT CENTER Client Service Team Identification Withholding Federal Status Withholding SSNII1N Certification Date SSNMWEIN Form of government issued Drivers License Identification obtained for the files Primary Identification Number Issued By UNITED STATES New York Date Issued 05.09/1956 Ex • !ration Date 05/092019 Confidential Treatment Requested by JPM-SDNY-00003077 JPMorgan Chase CONFIDENTIAL SDNY_GM_00272275 EFTA01480846