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EFTA01380170

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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 for each individeal if any, who, !!:redlyit,' indirectly, thry..mh any minicar!, air:Irv-men% reiaticne.,n v r.:!ne•:"e. owns 25 Percenr 0:. more of the equity interests of the legal entity listen above: 4O • ! ri•!. •t uGt. Pen•oro. 74,ORE %%vibes Tex...16.4(4n, ,1,O1,--z cotoo ieth Reavawke,; 0% tag 6k- Clot ootoa 3s 48-. q ta7 For Voo•Lie..?Nelot, t: dyeffroIrcla 1 to en.. th.r > &twits tanner ::taciaL 3.1.7.;c:4 rlf or 4 Pltr:541f, ".fari:V*ttheMintr 0.1 irtsrsiine 4it, flirt c.M:ndlt.:16.10 Cat4 rumbh_,,t 11;xygritt and wuovy*, is.uoince eon/Whet clovenunon-atured dobion.O±vtdontley Ot /*Wane end terstog 4 oho:moot or airOur pm•tivt5. of ro .nzpviclu-v ntcon th•G fletrititet. Orate write' Hot Argitvtati d. The following information for uneindividuai with significant responsibility for managing rho legal entity listed above. such as: • An executive 'Weer or Senk:ir manager (e.g., Chief Executive Officer. Chief Financial Officer, Chief Operatin Ofliter. Managing Member. General Partner, President, Vice President, Treasurer); or • Any other individual who regularly mforms S;51a5 functions. (If appropriate, an individual listed under section (c) above [nay also he listed in this iectinn Horn. 040 ti of auht • Logy Maresv ZAiewne Say.K4- 4,kustig Avis at. Qt For;O:o.0;:: : xlcidlon to e favtillSNiii:`; %mile or a Oaysy.r. !iambs Ceentreol!ri“MV:. VP ft "lid" ,,' • p ,Ooc. rof tl.s. Peg ars. Sobal cud", K umber to For hoo.t).S. Porto

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