Epstein Secrets

nce immediately) Does the client or related party have any finanaal or other assoctation I interactions G within countries or regimes sanctioned by the Office of Foreign Assets Control D yes ['21No (OFAC)? Does the them or related party have any finanaal or other association/ interactions H .Yes No within high risk countries?

ey Tax ID / SSN: Current Employer: Kellerhals Ferguson Kroblin PLLC Position/Title/Rank: Attorney Address of employer: 9100 Port of Sale Mall, Ste 15 St. Thomas Virgin Islands, U.S. 00802 Does the person work as senior executive of a DB-recognized regulated entity In the financial industry? or an ent

Does the client or related party have any financial or other association / interactions within countries Ll I—I Yes No or regimes sanctioned by the Office of Foreign Assets Control (OFAC)? Does the client or related party have any financial or other association/ interactions within high risk i_J I—I Yes g No H. countries? I.

ey Tax ID / SSN: Current Employer: Kellerhals Ferguson Kroblin PLLC Position/Title/Rank: Attorney Address of employer: 9100 Port of Sale Mall, Ste 15 St. Thomas Virgin Islands, U.S. 00802 Does the person work as senior executive of a DB-recognized regulated entity in the financial Industry? or an ent

immediately) G Does the client or related party have any financial or other association / interactions within countries or regimes sanctioned by the Office of Foreign Assets Control (OFAC)? H Does the client or related party have any financial or other association/ interactions within high risk countries? I. Corporate Docume

p: Has client resided outside of his/her country of nationality for 5 years or more? Tax ID / SSN: Position/Title/Rank: 9100 Port of Sale Mall, Ste 15 St. Thomas Virgin Islands, U.S. 00802 Does the person work as senior executive of a DB-recognized regulated entity in the financial industry? or an en