EFTA Document EFTA01372911
7/15:2019 KYC Print One sheet must be established for EACH INDIVIDUAL PARTY In Section 2. Account Ownership Summary 3A. Individual Details (for all parties) Indom duors Name: Richard D. Kahn - 00000486407 Date of Birth: 12/6/1972 Country of Residence: USA Country of Citizenship: USA Address of primary residence: 130 E 75th St, g7E New York NY 10021 United States Has client resided outside of hit/her country of nationality for 5 years or more> L....) yes 1. No Profession/Occupat
Summary
7/15:2019 KYC Print One sheet must be established for EACH INDIVIDUAL PARTY In Section 2. Account Ownership Summary 3A. Individual Details (for all parties) Indom duors Name: Richard D. Kahn - 00000486407 Date of Birth: 12/6/1972 Country of Residence: USA Country of Citizenship: USA Address of primary residence: 130 E 75th St, g7E New York NY 10021 United States Has client resided outside of hit/her country of nationality for 5 years or more> L....) yes 1. No Profession/Occupat
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Account Type: Account Number: n. • Anwitamai Chula A (OICID.Re4 Hook QU.11/(+eri34 arTh0rrICIS Sign. la Req. Te oo Date: 2 Name: Southern Trust Company, Inc. EIN: Nal=rejnan / A6c-c-te--00-- SSN: ID No. Name: SSN: ID Type: No: . . SSN: ID Type: o: vw• bereby ack.o•rledp brat mend tbc Depasit &awn Aroma tho PS Bacon lekcsable Skim. aid piney Policy. ad die proact rain tad kn. Prepared by Authorized CLOSED ACCOUNT 10)8bi CONFIDENTIAL SDNY_GM_00013623 L CONFI
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Command ---> RMCS Action I CYPRESS, INC CUSTOMER REMARKS 66-0776879 Remarks Add Employee Add Date Expiration Employee Expiration Date CERTIFICACION BENEFICIAL OWNER RECIBIDO DE LA CUENTA7211096816 00253 02/26/2019 00/00/0000 04/02/19 10:20:09 Cust Init? N PF2-Bkwd 2F6-CustRel PF9- SesSetUp PF13-RemFwd PF15-Cust PF20-CustName PF5-AcctRel PF8-CustAddr PF11-CustSvc PF14-RemBkwd PF19-Top PF21-LstMaint RMPCC8S1 RM3004 I: LAST PAGE LAST CONFIDENTIAL CONFIDENTIAL FMBankPRO00707 S
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