EFTA Document EFTA01379573

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: I J. EPSTEIN VIRGIN ISLANDS FOUNDATION, INC., A 501(cX3) PRIVATE FOUNDATION/USVI CORPORATION 6100 RED HOOK QUARTER, 83 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: i Name I Date of Savo Legal Address 1 For U.S. PeffalS4 soda Security I Number So: NemiU.S. Persons: (See lootnots 1 for alternatives/ to Sotineneity Nuirteri I ----- 4 I I NOT APPLICABLE I I 1 I • Nort.u.S. Persona. in addition to a Sued Sorority Number ore Pauper, t Plumper witn Country of &sun* an alien identification care number. Of Nano& and country of nuance of °mon ier tiouornmunt4ccied document recimutuv thiarnaUty or losidence and tearing a nhnC0 DenPn or elfrlar eatetnelt lhaub be provided. (11 n3 indent/eat meets this Lictinnlon. alcase mite 'Not r1/40PkteUe.-) 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 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 (Cl)). r Name 1 Date of Bete I Legg Address Fot U.S. Persons: I For Non-U.S. %%nom Social Security 1 (Sea footnote a ref ileoUnafiViSI letauDer ' to Serial SeCufey r1Unite* i 6100 RED HOOK QUARTER, B3 JEFFREY E. EPSTEIN I St THOMAS, USVI 00802 • rer Non-VS. Parson, in ftrWatien to a SoC33iSectulef Menthe: W a Pessozrt Monte: with Country of IssoanCe. en alien idontilication card nunfar. Of nunibef and country of is of any otne: govolnment-issuen document evicsistring nationality et residence and mowing a ohotovaon M ' ,mar salegoard sNaoid be Drauefen. FREY E. EP TEIN y knowledge, that tie info Legal Entky Identifier (0fltroneD srpifrut Oat me of natural person opening the account h reb ri ' I is complete and correct. Sig Date 7124118 Da Natre:__2AyAa: i. Title CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) CONFIDENTIAL DB-SDNY-0077178 SDNY_GM_00223362 EFTA01379573