EFTA Document EFTA01380172

H. Certification of beneficial owner(s) Persons opening an account on behalf of a legal entity must provide the following information: a. Name anti Title of Natural Person Cipent.3 Account: -Terry., b. Warne Mi Legal Type of Lego' Entity. and Address ur Legal Entity fte- Which the Acro. unt is Being Opened, 1 9. L vs,r\c•In., N V X^ Is to, ,=.4G Sol c, erivaAti-e_ Va'i...41LANie-, I k Cot e:, ena kkteig. ast iSt •-ktiata•siit, 1-.1 .') I OO% Tre. . follnr!int.; informatkm for each indiv!duaj, it any, who directly nr .a-niketail. through titg contrwl, Mrarr9+Ylent understanding, relationship or Otherwise owns 25 percent or more of the equity Interests of tie legal entity ilsted above: NU& Cå; e Ser.4,, Fnr9.5. P.dannt: Car i.13. 1: S,,,f4,13"..o.eih, *et era.;rgen I le aInnna Net Nufffn !fl StftfW it/ eidrAare R)r ff-ff Vint e, ifd4tilfr ft: a '≥•,:.&*, SCrijht? (APPSW,Ct, 'VTI:t.Wf 'fah r;IfUlffIT 41i:twang» nr aSn Vall',Ofi-f•trt,n CNN,: ;,tfli)0. ø rOffg;;if and ,:t..rnt1), arp flo,-egniller.!-15"fd dneund.ne 4vIdener 9<:1:icaal@y 0! ftfitlenet and ddatc t nnotoendli M tiellilbr r.ft,04.4,1 E)tiktZd. (II :In nmaralf C•f!)frk.C;(1, riblO!.i!nnin hat Adcbtainat d, The i'oilowing information for one individual with significant responsibility rot managing the legal entity listed above *uch • An eifectilive officer Or senior manager (e.g., Chief Executive Ofiker. CWel Financial Urteer, Chief Operating Offg:ar, Managing Member. General Partner, President, Vice President. Treasurer); or • Any Uifttaf irOdiVidOal Who regule?Ey perfervid; siniiief hiretians. (If appropriate. an individtut! liBted Wider section (o) above !flay ;den be tinted in this aoc,firm: (o)l. t!.:3 i f,t; Addn.5;{ ; Fe? U.S. f,f•NW'S. 2.0,O,a4 SOCVet' nim darntze. Pedc,. iS•a Ern, dre aaefnen.et l4 9acptl Ulf'; Minn 0,O Tti4-etki 1/),,I (i..akee) te4as D",L, 49}0 aS 4 a ast. Tko O•S•liOBSGi a.,0 f;;; ,•,1,-;; 1)9 lkith i.rAftf t.f,f, Or; Oinin t~ti!kl:,';r: ;Me!: riFfIbF. Cc na.o?,t.,or Of "'cf.'', N ',mfr., : NICOf; f;f:" 01 fef.11,,C4 knd e.if•Op Oltgelfr.Kfff leONEE.Ni.W.,Ild snout! I, St lett n y knowledge. t .at fi 64-ve e m •. - . prove< Ltglti ( ..;dand) 2CiJN neutiehe iNd 0150,Wa, ,,ffm16,..».'")6 (name 01 nativer person opening the aceetird). hereby certify. to the best of eznipiete add correct. ~lslt~ CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0078390 CONFIDENTIAL PROT1 PROT0