Case File
efta-01375829DOJ Data Set 10OtherEFTA01375829
Date
Unknown
Source
DOJ Data Set 10
Reference
efta-01375829
Pages
1
Persons
0
Integrity
Extracted Text (OCR)
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II, Certification of beneficial owner(s)
Persons opening an account on behalf of a legal entity must provide the foliong information:
a. Name and Title of Natural Parmh Operiin Account;
Te.fg.,...r
-1:iit:ry for Which tj-..e Act. ;cunt is 8s3in.2 or.,_tmed;
AL,
Coto° Iga 4 go oV.Qty
eg
s.k•
j US°
CDC) Sona_
c. Trat. Joao:Ann/3 ;El fen
IOT each indh..4jual. ?I any, who, dircctiv oi indirectly. througn any cc.ritr
i., arriencerwwit
understanding, ceia,i:nshin
other, ?ise owns 25 percent or inure cA the equity interests of the legal entity listed above:
',At° Vf gi,ir
.
AC!CketS
z
c
ant E , .1i4eki,,
+ lc
vs
GA oo 4it a,c,se ",.4-tr,
sk-11-4. s JQS* 00 5 ea_
gor
PlistAtie; : PO( 4cr•LiS, NiSen€:
Ek, e:PIS.nate
!Sep kotrcara t ix;r'tar:_r;6-rF
tidtufitl, %
i)
' For HorE.ti.S. Pei ,r,"4..r,
t•us $:ekd Ses'ziriti;N:Ptiber 2:r
tif kJ:Lint C..tri Adirr: aateieakx, cm,
AtliaDdl
taitl eCtirlfy of Ism/ante 9f orNegl.
gNeennetne.-•titierffklAkMerl
11119011:Wirfar ItlititaCt :11la a..111A9 a rhixergait of Wnilp saavaie therwlei
irtrAndita
fil r ebautal n•Nit: 1M atlial1)n.
d. The following Information for one individual with significant rospontibillor for managing the Irani entity listed abage,
such as-.
• An (r<etutiVe Oft-CET or senar manager (tg.. Chief Evocurn..e Weer, Chief Financier. Officer. Chief Operating officer,
Managing Member. General Partner. President, Vice President. Treasurer): or
• Any Other .rretividual who regularly performs skihr function-a
(If appropi late. an individual tistad under section (c) above may also be listed in this section {d)).
: Nave
a
art S,544..‘
• rOz
attr,,S.
Ja(i.k4, tO A SOCMI St4.;Wil ?".:E~ rst 4 Da3aFgt %robe w:a.C.:x.w:;ricieekan-x..Iti
amileake
esti.e.:‘,
ar.0 ..-atray
hwaem
celNieee,maz,..a,:141 g4-anent t.gealefiG ranit-a .att v acelae..... ara (»mini; A reetnui.azt <Ir ?irrillit yIN19aIKI e.asel
of Nab
Liaal itgera",
F,! US Rtrai=ai:
g3r Nac•US. ikann
SC.Vsits
50«it21: te4 J;M:Vittic
»ffitikm
S.S.scsalSemsty `2Jelte7
\bo t g3
-40—ce_
(Paine of natural person opening the account). hereby 0Pt td`y. ta the bast or
•-•,,;,9 complete and correct.
ttnja infer alenriea
oaose iatieme eank AO. as ciaat:• pestrti. w,4
CONFIDENTIAL - PURSUANT TO FED. R. GRIM. P. 6(e)
DB-SDNY-0071452
SDNY_GM_00217636
CONFIDENTIAL
EFTA01375829
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