EFTA Document EFTA01369136

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, PRESIDENT b. Name of Legal Entity, Type of Legal Entity, and Address of Legal Entity for Which the Account is Being Opened: FIE-EPERS, INC., A USVI CORPORATION 6100 RED HOOK QUARTER, B3 ST. THOMAS, USVI 00802 c. The following information for each individual, if arty, 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 Date of Birth - 1120/53 Legal Address 1 For US. Persons: I Socha Security 1 Number For Non-US. Persorue (See footnote'. for alternatives to Social Smelly Number) JEFFREY E. EPSTEIN 6100 RED HOOK QUARTER, B3 ST. THOMAS, USVI 00802 1 I .... I 1 For Non-U.S. Penn M addition too Social Sceurdy Number or a Paseport Number with Country of issuance. An alien identification card number, or number and Canary of ISsunnee of anyother government-Lauded document evidencing nationality or residence and bearing e photograpn a Simi% utleguard should be c.-elcted, (If AO Lndlyidual arms this dellnitkin. please WI he 'Not Aopticapice) 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 Presklent, Treasurer); or • Any other individual who regularly performs similar functions. (If appropriate, an individual listed under section (a) above may also be listed in this section OD. Nome Date of SW) Least Address 1 ABOVE !JEFFREY E. EPSTEIN I SEE ' For Non-U.S. Persons. in addition too Social Security Number or a Passport Number:4*h Country of Esser nce, on alien idenhficatton card number. or number and =miry ol issuance of any Ober gbeerterent-Nsued document ovioenciog cuiticoeity ce residence and Luring a pilot-avow, or singer safeguard should bo Orovkted. For U.S. Persons; t For Non U.S. Person: Social Security I (See Footnote 1 for akernative4 **robe? to Social Security Number) JEFF Y E. EPSTEIN LLgaii':ntity (eption3C) oral person opening the account), hereby certify, to the best of to and correct. 7/24118 Date CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0061244 SDNY_GM_00207428 EFTA01369136