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efta-efta01362343DOJ Data Set 10Correspondence

EFTA Document EFTA01362343

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DOJ Data Set 10
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EFTA Disclosure
Text extracted via OCR from the original document. May contain errors from the scanning process.
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, SOLE MEMBER b. Name of Legal Entity, Type of Legal Entity, and Address of Legal Entity for which the Account is Being Opened: LSJE, LLC, A USVI LIMITED LIABILITY COMPANY 6100 RED HOOK QUARTER, B3 ST. THOMAS, USVI 00802 c. The following information for each individual, if any, who, directly or indirectly, through any contract, arrangement. understanding. relationship or otherwise, owns 25 percent or more of the equity interests of the legal entity listed above: Name Dote of Binh Lepel Address rot US. Penont: Social Security Number Fcr Non-11.S Pe arts I (See footnote I for alternatives to Social Setwey fakenbei) JEFFREY E. EPSTEIN 1/20/63 6100 RED HOOK QUARTER, B3 ST. THOMAS, USVI 00802 1 For Non-U.S. Person; in acketinn to a Social Security hieniee: or a Pas0Cet NufTeer With C0WIlly at Issu nce. en arse, identircerinn card nuneaor. or nuttier and county? of issuance of any other vorarnment-issoto document C.:Wen:Mg natiractafity Or T eSiCienee anC nearing 0 p0Werann O sinfiter soteguero O effninea. no ineivickne mews this dalwwtgn, please wit° "tact Atpticah:e.1 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. Of appropriate. en individual listed under section (c) above may also be listed in this section (d)). i Nam* !JEFFREY E. EPSTEIN I SEE Mateo( Beth i Legal Address t For U.S. Penons: I For Nan-u.s.Pcsons Sotial Security Mee footnote I for agenneliva lewnoei 10 $0601 &Wanly :lumber) ABOVE 11 F0r lean.U.S. Person& in addition to a Social Security Number or a Passport Number with Countryof Issuance, on alien identlficat KAI cord numbe. of number Sf•4 COteerY d inSutnet Of any other govenvnent-issued documenr eetoeffeeffi netinneley ore residence am hearing a oho:3gram or sinew eakpare should bo provided, m REY E. E TEIN knowledge, that t information Sire Legal Entity Identifier tOPtfamet) ne of natural person opening the account), hereby ce to the best of pve Is complete and correct. 7/24118 Da:C. Srpriv re Signature Name Rae: 7 714 —.C T CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0051723 SDNY_GM_00197907 EFTA01362343

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