Epstein Secrets

(for all parties) Individual's Name: Jean Anne Brennan W.ebracht Date of Birth: Country of Residence:

gn Assets Control (OFAC)? Does the dent or related party have any financial or other associatoV interactions within high risk 0 yiN 2 No countnes? I. Corporate Documentation Attached (Legal Entities Only) @Yes O No • Not Applicable J. Unclsdosed Principal Form Complete (Intermediaries Only) OYis O No 2 Not Applicable K. If Lex

Financial LLC Jeffrey E. Epstein Jean Anne Brennan Wiebracht Darren K. Indyke Account Holder U

ioned of (OFAC)? It Does the client or related party have any financial or other associadort/ interactions within high risk 0 Yes 2 No counties? I. Corporate Documentation Attached (Legal Entities Only) @Yes 0 No 0 Not Appkable I Undisclosed Principal Form Complete (Intermediarlit Only) 0 Yes 0 No 2 Not Applr_able K. If Led

shareholder of Southern Tont 4 O CI " lCIndyke O O O O • O • O O O 5 O O Reny Beller u O O O O OO O O O 6 O O Manna Brennan • • O • 0 • O • O O SDNY_GM_00039850 https://dbforcepb.my.salesforcCuNErilE/EgriatiAL000000D9Di&e... 7/30/2019 CONFIDENTIAL - PURSUANT

s Control (OFAC)' H. Does the tient or related party have any financial or other association/ Interactions within high risk D yes 2 do countries? I. Corporate Documentation Attached (Legal Entities Only) 10 yes Duo U Not Appkable I. Undhcbsed Principal Form Complete (Intermedkwies on*) ❑yes K No 2 Not Applicable K. If Levis/W

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OFAC)? Does the client or related party have t_J any financial or other association/ interactions r—, H. Yes R No within high risk countries? I. Corporate Documentation Attached (Legal Entities Only) RI Yes 0 No 0 Not Applicable J. Undisclosed Principal Form Complete (Intermediaries Only) El Yes Li No FO Not Applicable K.

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AC)? Does the client or related party have any financial or other association/ interactions i—i H. L.J Yes ...?, No within high risk countries? I. Corporate Documentation Attached (Legal Entities Only) RI Yes O No El Not Applicable J. Undisclosed Principal Form Complete (Intermediaries Only) O Yes O No n Not Applicable K. I

n, the 0 O O O O O O O O O 2 0 E2) Jeffrey ipstern " r 1 0 0 0 J 0 0 0 0 0 3 O O Hauy Bel ler O O O • 21 O O O O • Brennan O ID O • O O O O • O 5 0 0 Daen rodYke O O O • O 0 O O O Imps://dbforcepb.my.salesforce.com/servlet/servlet.Integration?lid-0IN

(OFAC)? O Yes a No H. Does the client or related party have any financial or other association/ interactions within hit nal • Yes @ No countries' I. Corporate Documentation Attached (Legal Entities Only) 0 Yes O No • Not Applicable J. Undisclosed Principal Form Complete (Intermediaries Only) O Yes O No El Not Appicable K. If

ller O O O O 21 O O O O • 0 O O Jeanne Brennan • O • O O OO O O O Imps://dbforcepb.my.sa

ctioned of (OFAC), H. Does the dent or related party have any financial or other association/ interactions within high risk D yes 2 No ccuntries> I. Corporate Documentation Attached (Legal Entities Only) RI Yes • No O Not Applicable J. Undisclosed Principal Form Complete (Intermediaries Only) 0 Yes 0 No 5 Not Applicable K. If

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C)? U Yes RI No H. Does the dent or related party have any finandal or other association/ interactions within ugh r❑I--I i Yes 2 No countries? I. Corporate Documentation Attached (Legal Entities Only) 2 Yes O No O Not Applicable: ). Undisclosed Prinopal Form Complete (Intermediaries Only) • Yes O No 2 Not Applicable: IC If

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n Assets Control (OFAC)? H. Does the client or related party have any financial or other association/ interactions within high risk countries? I. Corporate Documentation Attached (Legal Entities Only) J. Undisclosed Principal Form Complete (Intermediaries Only) A Yes No Yes A No Yes A No Yes A No A Yes Yes No Not App