EFTA01384793.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, PRESIDENT b. Name of Legal Entity, Type of Legal Entity, and Address of Legal Entity for Which the Account is Being Opened: J. EPSTEIN VIRGIN ISLANDS FOUNDATION, INC., A 501(cX3) PRIVATE FOUNDATION/USVI CORPORATION 6100 RED HOOK QUARTER, 83 St THOMAS, USVI 00802 c. The following information for each individual, if any, who, directly or indirectly, through any contract understanding. relationship or otherwise. owns 25 percent or more of the equity interests of the legalarrangement. entity listed above: Name I Date of Bath Legal Addicts 1 Fe' U.S. PerS0.13: Fns NcroU.S. Persons I Social Seettnq (See leo:note .1 for Otternatmal . Number to Soria: Security Mennen --- 4 I I. NOT APPLICABLE I 1 I • NoMIS.Personi. in addition 10 a Social Sorority Number or a Naval( Plumper wan Country of issuani* an alien ieentificalion caw number. Of not Der and country of nuance e1 any oilier 00aommang-fmed document erviCUP‘dry nadenaldy or residence and tearing a ahotopropn aimilar or takaguerd gloub be provided. naincrfmthlal meats this fttinnlon. please wale 'Not AoPhooafe." 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. (If appropriate, an individual listed under section (c) above may also be listed in this section (Cl)). Name Dote of Seto Leool Address For U.S. Persons: I Fo: NOn-U.S. Portant: Social Seturity (See foomote a for altarnarivasi Pamper ioSeelarSectkity Number) 6100 RED HOOK QUARTER, B3 JEFFREY E. EPSTEIN ST. THOMAS, USVI 00802 For Non-tf.S. PerSond in addition 10 a Socui Security Number di a Past:part Murata: Country of Issuance. en alien Idontificatoon card number. or /anther and country of iarunnoe Or any °Indr aGoeintnentristuad document dddgMting nationality arrest/rents and Willing a ohetoVoon Dr Omar sab‘auard yfaeta be Dravided. FREY E. EP TEIN 'ne of natural person opening the account)• hereby certify. to the best of y knowledge, that t ie info is complete and correct. 7/24/18 SI Date Na rint):a 'AO Entky Identifier (Optional) Title: Dale: er srpifruta4 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0085314 CONFIDENTIAL SDNY_GM_00231498 EFTA01384793