EFTA Document EFTA01370747

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: PLAN CI, LLC, A USVI LIMITED UABIUTY 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 JEFFREY E. EPSTEIN Dale el Seth Legal Addles 1120(53 6100 RED HOOK QUARTER, 63 St THOMAS, USVI 00802 I Fot US. Parsons: For Non-U S. Passont &Mal SeCor;IV (Sae 100liKet tier 011elnativPS Mambo to Sscial San—day Number) ...4 i For Non-US. Persons. in aciaipon co a SOCialSaCtrey Number or a Pasrpon Number with Country a! Issmante. an etien Went-ace:ion rani nerd:et, or numner and county of issuance of anyother gevotnment -issued tfolanerri evidenci-v noticnarxty or residence Jett Warkng a pitotonrada or Seaialt sateguart show tre provided. fit no :nal:Of:bat meets tnis deli:Ikon. please write `Not Applicata:a., d. The following information for one individual with significant responsibility for managing the iegal 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. (If appropriate, an individual listed under section (c) above may also be listed in this section (d)). Name JEFFREY E. EPSTEIN Oats of Bonn I ttgalAdaress SEE I ABOVE Portent For Soebl SettraY (See footnote? for aitenuelvasi U.S. Poisons: I For Non-t1 S. Number j to Soc:al Security Number) i For Non•US. Persons in addition ton Social Security Number or a Pain= Nombef VA, Country 0! ISSuanCe, an ater) itlaetilitaaarl MC Melte:. or mmbet and teurgry of Issuance Many goer s.cereennlanWee0e4 CCCunlenl eveleneing nationality c, residence and beating ahaeo(aapil or SinetvaileWatei should to Provided. Legal840:y !Snuffer(Optional) rat person opening the account), hereby certify, to the best of QVe is complete and correct. 7124118 Dolt Sp/juke eid CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0063759 SDNY GM_00209943 EFTA01370747