EFTA Document EFTA01379155

II. Certification of beneficial owner(s) Persons opening an account on behalf of a legal entity must provide the following information: J. Name and Title Neo.iral Person f7.9aning Account: 7:••-4 *a C. --I,/ b. Nemecf fro 7 - 4.....C)&42%;:r...-it • I r3/439%) Cancnic•i-(td 1/4-Nc.4:44 Caogss-61 (CR tar. osvt CoVti Tne Vicwirg infOinlazion for each irdiVidU9 v.; • I mcw,,urifling. relationship or otherwise, °Wile: 2 Oew Nee. ,..egelAckeee, ES14‘g 01r., • throLigh any ccntr