Case File
efta-01375825DOJ Data Set 10OtherEFTA01375825
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DOJ Data Set 10
Reference
efta-01375825
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'temaer [creme
II. Certification of beneficial owner(s)
Persons opening an account on behalf of a legal entitymust Grovice the followng information:
A. Ni) roe dad Titte Of Naturar Person Open ng Aceount.
TcR,-, i c
Sk-et uj‘2,-e
•.oum is Beina Opened.
c. The foilowing information for each inididual, eny, tArho.
,
enntraCt, arni)n9-3rnii:41, undørstanding, fliclailarlShip lir otherwise, *syns 25 percent or mo of the eout,:r. i:1, ;Es of r he !egal entior listad ab-)ve:
D.:x ...--ait )
• Li?c,a kiczni,
',,, v.s. ri.per.,:s.. : T.:,,, tzrf.:.V.S.P.".its:
S.-)ciw 5:wP.....,,,,,,
' ;F:Itt ;:l1cltreal i rr% gleiradla3
1 rtiorecher , ti) Satal Etcoety?..iisi)bbr.
Sat 6- 4aramk. LI> ot cz3.
Fr% n.^.% rtrtanaiit•iidaler,
Scelr‘d Sin:natt Fairlla% ttl r. FittWerl utnat! u4lØ P.CJney nt kzg. :non an øglen (intif Logi«, Car Cl ramby,. natubi,e
led country ol ntuld,cd el %fly 00‘if SiutaciltrIWIISad Sats:~ %talt %ting altieatAP.12 c% klakk:11C% and babling J P4P »XiMiLitthor~ib* ,Wf
tn,:;;Ile
r•
th4 roJtinat9n. putre orig;1nt za. ,C40.1 d, The following informdtion for one individual with signiticant responsibility for n idnag;ng the hmal entily tisted »eve.
such as:
• An ekecutive affk.er or ee4ViOr manager fe. S., C liaf ExClit..^.,41 Offiser. Chief Financiai offient chief operatni, Officer.
ManegIno Member, General Partner, President, Vice President, Treasuren; or
• An', °the( Ind;VidU81 who reguiar ly perfc-nns &mila( Funotrons.
Fli appropriate. an individual iiSteti under sec0on (c) above may aiss be irsted in (his gection (g)),
).5)gtvÅskRis:
Sec 441-0,Ja_
TePf-r..
iuls3
Fot U.S. N!tras.
&att Salcark:c fr.t.if.%). Å frt anatral.r.84
Phinsber tr• Stoa' Sx:nkr ,:umbor)
•:,,•," Saud >a:44V ,,agraa :Ir i riii,!%)a •Fuirctx# *ititt.ount”soi 'Ly/mfl:e en sirent. entlficglåetan!rlunale,l. Gr ra:~
• • ',c, r, o-ifsninlint-it;duOti aczunn tri:k/lata 911,ltat,Nary C rnSnlUnte Al1G bVPilit,R 3 1.1hOttigiralil,
.Lafer,al smolt!
(name of natural person opening the account). horeby eertify. to the best of
pl te correct
I s-
':;MI&KIrril )1.‘•:,9.19.Qi
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
DB-SDNY-0071448
CONFIDENTIAL
SDNY_GM_00217632
EFTA01375825
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