EFTA Document EFTA01380170

II. Certification of beneficial owner(s) Persons opening an account on behalf of a legal entity must provide the following information: a. Herne end Titie of Natural Parson Opening Account; 17c '""`"" Cr icet tba•-•-i t 4S s41-4 kt- t--b.-Tir-,SA- -se..., ,r......... 3-01 wcalitv Logei Entity. Type of Legal Entity, and Address of Legal EnV;y1nr Wilith the Account is Being Opened usu{ (c 0-th (, -4/ Ca to, er..A too ea at e Q‘ao.vie4v-i 63 - \ 31 O Ca--- ) Tha fcenyling information