EFTA Document EFTA01381084

II. Certification of beneficial owner(s) Persons opening an account on behalf of a legal entity must provide the following information: a. twine and Title c£f Neo.iral Person r.7.9ening Account: 7 :4.-C4 *a C. SA -4? --I b. Name of ft; 7- 4.....P&-4253:7....-it • a Cancnic•4-(td (too £a Cao.s.rkve (CR osvt CoVti :J. Trt)i owir.q informazion for each irdeolduy relationship or otherwise, °Wile. Pe."'cou "s Ewing Onso; through arty coni.r3cr. arrangement. I C4 the equity interests of the legal entity listed above: ! !dt!s aarn£(iY Avs,xs: Se:Lai:Sae:0V; ; :SetOr:4W Ou'aistrod taimbto StaidBeturifo fithrocla C. t (201c 3 41 1 OP ea& \-'604e...Q.0..,. stior v it ' v.`11 38 kite kwHo:143S Nolant. tstasiss Sco4 FieC;Ifily 'A/Mtg. at NI:MX.It wi:P CA'Ner tr, of illoorwo. se oPos i rsalogiss SAW r4elltIN rosnbcr .isel.u.04:, igne.plooM other wissitiroors • 44440 atuorneat estarmasirsnian'tio?ar rtudoese and besting ti phssoc.saph Or *tellile sitht4as iSsuld tr4 wos!aed. (If na tOU.0 tatins fait soi.lt:,, e.ilinJ1•,,scite "sot .st•Vti:r.,k4fs.'1 d. The following information for one individual with s;gnifcant responsibility for managing the legal entity fisted above. such es: • An executive officer or :.•.;eic>or 'nonage! (e.g.. Clt ,et EXEC.,..itiVe Officer, Chief Pinanciai Ott-cot. cruet Operating Omar, Managing Member, Genet al Pechter, President, Vic.e Pre4Ident, Treeeuren: or • Any other ;iviivklual who ieguloriy .3rtottris eirniar functions. OF appropriate. :an Mthvidual listed under savhort (6 above. may gest) be listed in this section rd)) Oats s: LeTa Assess itC41-4--k' E-1.44,n S -c 0 --et: VS. Pecw•:•t Sipr.Ft",. r.ilfribUr P:061.).S. hurt: 0): flP)thrgif So<ail Shanty Sar Warr U.S. gerwsr, -6 ..> StsurasSionw.or Pstw"...21 SPontswutliCerott 31 4riad Ira en ii.ne-entllitathr sore:I:so:Ow. nouber ate moray of frulant.. • ,.,.i.".141Prtoss.at dytuttintli ,pviSiltinc411:1I;On4hi'i nr gondOlgA d tWatOin) a f'hutugrsrals: HnlWI safeei-na ihr•ge iE pardat i. ior.i feAlctlat the • Igo Uotaa'.4 '14/1S olive aersibe (Carlaroll: nam , (hided at.ove is co. 2.111,31.:socichs Sent JU.i. Ail tqllus : or Se. WM1O.W..1 0.25gliAS 1 1 - atural person opening the account), hereby, certify, to the best of :there ar,d co• rect. told CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0079831 CONFIDENTIAL PROT1 PROT0