Case File
efta-01375831DOJ Data Set 10OtherEFTA01375831
Date
Unknown
Source
DOJ Data Set 10
Reference
efta-01375831
Pages
1
Persons
0
Integrity
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II. Certification of beneficial owner(s)
Persons opening an account on behalf of a legal entity must provide the following information:
h. Name and Title of Natural NM')ri Opening Anct,gmt-
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Type of !.egad Entity, i.nel Address 0t Legal Entity for Which the Accaum iS Reing0pene.d.
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A..% \co wt gerl• FL ) ii1/41 1/4? ) N] c..r1w. fdlawcno information ro, each individual. if any . who. ci :cell;: or indimotty. through any contract, arranarnent,
understanding., relationsnip et otherwise. owns 25 percent or more of the equity interests of the legal entity listen atma:
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-,i0t '1%16146061 d. The following information for One intliVeriU el with significant responsibility for menacing tha legal entity listed Gboie,
such a9
• An. exe..-,A;thre serioy manager (ea,. Chief Executive Officer, Chief Finfeicial ("freer. Chief Creating Oflitor,
;vtanaging Member, General Partner. President. Vice President. Treasurer): or
• :4'41y other individual who regoiadv performs sender !unctions.
(If appropriate, an individual NAPA under section (c) abort may also be OSteri in this SeelkAl Kfn,
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(name of natural pia( 'Son opening the account). hereby certify, to die best of
do
COMPlett and ter1901..
(O1 Bel k2' f) 101a Demute 0101 Ms. As fitte:t roat„,ir j. wsilsoim 016619.0:; len
CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e)
DB-SDNY-0071455
CONFIDENTIAL
SDNY_GM_00217639
EFTA01375831
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