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efta-efta01480773DOJ Data Set 10Correspondence

EFTA Document EFTA01480773

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efta-efta01480773
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EFTA Disclosure
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Trust Tax ID # You must ensure that a copy of an IRS application for tax id has been received from the client as evidence per Private Bank Policy. Trust / Estate Situs (Domicile): NY JPM Executor or Trustee? r Yes • Sole r Yes - Joint 0 No Fiduciary Manager Non JPM Trustee(S) / ExetutOr(S): Complete this section for Non-JPM trustees / executors. Primary Non 3PM G Individual Trustee/Executor is an r Organization List the following information for the Primary Non JPM trustee / executor.If an Organization, please list under -Last Name section and mark "First name" with a dash (-). Last Name : Epstein First name : Jeffrey Middle Name/Initial: Address Line 1: 6100 Red Hook Quarter B3 Address Line 2: City: State XX XX Province: St. Thomas Country: VIRGIN ISLANDS (U.S.) Postal/Zip Code: 00802 Contact Phone: Date of Birth :(mm/dd/yyyy) 01/20/1953 What form of goverment issued identification document did you obtain for the files? Driver's License Tax ID / Social Security Number Passport/Drivers License 4ir United States Virgin Islands D/L - DD C-000000029913 - CI - 0000025874 List any additional Non )PM trustees / executors In the following table. Name Date of Birth (mm/dd/YYYY) Form of Govt Issued ID Obtained Passport / DL Tax ID Darren K. Indyke Driver's License Grantor of Trust / Estate Assets: List the following information for the grantor. Grantor Is an 1 Individual r Organization If an Organization, Please list the legal name under "Last Name" section and mark "First name" with a dash (-). Is the Grantor Deceased ? r Yes 0 No Last Name : Epstein First name : Jeffrey Middle Name/Initial: Address Line 1: 6100 Red Hook Quarter B3 Address Line 2: City: XX State: XX Province: St. Thomas Confidential Treatment Requested by JPMorgan Chase CONFIDENTIAL JPM-SDNY-00002995 SDNY_GM_00272193 EFTA01480773

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