EFTA Document EFTA01291968

WARNING: PRINTED VERSIONS OF THE BSA E-FILING FORMS ARE NOT FOR SUBMISSION AND WILL NOT BE PROCESSED BY FINCEN. Currency Transaction Report OMB No. 1506-0064 Filing Name 152-5423 Version Number 1.1 9 Type of filing Z Initial report E Correctiamend prior report K FinCEN directed Backfiling Document Control Number / BSA Identifier I Save Validate Print Under penalties of perjury. I declare that I have examined this transmittal, including accompanying documents, and to the best of my knowledge and belief it is correct and complete. In the case of documents without recipients identifying numbers, I have complied with the requirements of the law in attempting to secure such numbers from the receipts. I declare that this filing represents all Documents filed during this reporting period except for those transactions reported on paper. Sign with PIN SDNY_GM_00049894 CONFIDENTIAL — PURSUANT TO FED. R.CON(F IDENTIAL DB-SONY-0012718 EFTA_00 I 60502 EFTA01291968 WARNING: PRINTED VERSIONS OF THE BSA E-FILING FORMS ARE NOT FOR SUBMISSION AND WILL NOT BE PROCESSED BY FINCEN. Part I Person Involved in Transaction 1 of 2 00 '2 Person conducting Flo Person conducting a 11 - K transaction on own behalf b law transaction for another 3 O Multiple transactions ri Person on whose behalf b I—I transaction was conducted d O Courier Service (Private) Check K If entity '4 Individual's last name O Unknown or entitys legal name •5 First name O Unknown 6 Middle name Suffix 7 Gender 8 Alternate Name 9 Occupation or type of business 9a NAICS Code '10 Address O Unknown '11 City O Unknown •12 State O Unknown '14 Country O Unknown •15 TIN Indyke Darren LK. Male Attorney; owner of law lirm 2 Kean CT Livingston NJ US K Unknownil 18 Contact phone number Unknowl. •17 Date of birth K 19 E-mail address '20 Form of identification used to verify identity '13 ZIP/Postal Code 0 Unknown 16 TIN type Ext. SSN4TIN 07039 Number OUnknown ig Drivers kcense/State ID O Passpon O Alien Registration O Other Country US 21 Cash in amount for individual or entity listed in Item 4 Account number Issuing State NJ 22 Cash out amount for Individual or entity listed in Item 4 $ 16.991 Account number [ 0 0 • Page 2 of 5 SDNY_GM_00049895 CONFIDENTIAL - PURSUANT TO FED. R.QPN(F IDENTIAL DB-SONY-0012719 EFTA_00 I 60503 EFTA01291969 WARNING: PRINTED VERSIONS OF THE BSA E-FILING FORMS ARE NOT FOR SUBMISSION AND WILL NOT BE PROCESSED BY FINCEN. Part I Person Involved in Transaction 2 of 2 00 Person conducting Person conducting '2 n - transaction on own behalf b ri transaction for another 3 O Multiple transactions ro., Person on whose behalf O Courier Service (private) c la d' transaction was conducted Check O If entity '4 Individual's last name O Unknown or entity's legal name '5 First name O Unknown 6 Middle name Suffix 7 Gender 8 Alternate Name Epstein Jeffrey 9 Occupation or type of business 9a NAICS Code '10 Address O Unknown •11 City O Unknown •12 State O Unknown '14 Country O Unknown •15 TIN 0 Unknown '17 Date of birth 0 Unknown 18 Contact phone number 19 E-mail address President of SouthemElnanclal 6100 Red Hook Quarter, B3 St. Thomas '13 ZIP/Postal 16 TIN type Ext. Code 0 Unknown VI loc.2 US SSN4TIN F 1112011963 '20 Form of identification used to verify identity Number OUnknown IX Drivers license/State ID O Passport O Mien Registration O Other Country US 21 Cash in amount for individual or entity listed in Item 4 Account number Issuing State VI 22 Cash out amount for IMNidlial or entity listed in Item 4 $ Account number 16.991 0 0 Page 3 of 5 SDNY_GM_00049896 CONFIDENTIAL - PURSUANT TO FED. R.QQN(F IDENTIAL DB-SONY-00 12720 EFTA_00 I 60504 EFTA01291970 WARNING: PRINTED VERSIONS OF THE BSA E-FILING FORMS ARE NOT FOR SUBMISSION AND WILL NOT BE PROCESSED BY FINCEN. Part II Amount and Type of Transaction(s). Check all boxes that apply. '23 Date of transaction 12/19/2017 24 O Armored car (FI Contract) 0 ATM 0 Mail Deposit or Shipment O Night Deposit 0 Aggregated transactions '25 CASH IN: (in U.S. dollar equivalent) a Deposit(s) • Payrneal(s) c Currency received for funds transkri(s) out d Purchase of negotiable instrument (s) e Currency exchanges) Currency to prepaid access g Purchases of casinos Gilts, tokens and other gaming instruments h Currency wager(s) ncluding ninny PleYs I Bills inserted inlo gang devices • Other (specify): $ .00 .00 .00 .00 00 .00 00 .00 .00 .00 Total Cash in 26 Foreign Cash in 28 Foreign Cash out 7,000 .00 '27 CASH OUT: (In U.S. dollar equivalent) a Vathdrawal(s) • Advance(s) on credit (ncluding markers) c Currency pad horn funds trans( (H(s) in d Negotiable instrument(s) cashed e Cunonry exchango(s) f Currency horn prepaid access a h Z Other (specify) .00 .00 .00 7,500,00 9,491.00 .00 Redempien(s) ot casino chips. tokens. TITO tickets end other earning instruments Payments) on war(s) (Inducing race and OTB or scats pool) Travel and complimentary expenses and took gaming Incentives Payment for tournament. contest or other promotions Total Cash Out Foreign Country Foreign Country 00 .00 .00 BE .00 .00 15,99100 O 0 O 0 Page 4 of 5 SDNY_GM_00049897 CONFIDENTIAL - PURSUANT TO FED. R.CON(F IDENTIAL DB-SONY-0012721 EFTA_00 I 60505 EFTA01291971 WARNING: PRINTED VERSIONS OF THE BSA E-FILING FORMS ARE NOT FOR SUBMISSION AND WILL NOT BE PROCESSED BY FINCEN. Part III Financial Institution Where Transaction(s) Takes Place 1 of 1 0 0 17 Type of financial institution Other (specify) /9 Primary federal regulator Depository institution Federal Reserve Board (FRB) 38 If 37a - Casino/Card Club is checked, indicate type (chedc only one) K State licensed casino Tribal authorized casino Card dub '30 Legal name of financial institubon 31 Alternate name, e.g. trade name, DBA 12 EIN *33 Address '34 City *35 State K Other IDeutsche Bank Trust Company Americas 346 Park Ave New York NY '36 2IP Code I10154 39 Financial institution ID type ID number '40 Contact ofhte '41 Phone number '42 Date Filed DB PB AML Ext. (Dale filed wal be auto -populated when la, form is signed.) Page 5 of 5 SDNY_GM_00049898 CONFIDENTIAL - PURSUANT TO FED. R.CON(F IDENTIAL DB-SONY-0012722 EFTA_00I 60506 EFTA01291972