Epstein Secrets

(3) Its Delscalti d a U.S emity. (Goa Out subpart Val if it is not true. N Statement 3 is not true. cross out and complete an apprepliste Rem V&S) The Internal Revenue Service does not require your consent to any provision of this document other than the Certification required to avoid I backup withholding. Date n 5. In

CneoUa• Gotincil Fon or &Ott Conte., as bir Rom . Has snow .7. E. 0d " yet VW a.thrZea, fan b 5034rolinet Doctezred.S.SA phtstn *snot A. Is the NAICS seloaml mgr roil B. Does en Wens:se have a prime ATM maim on see/ C. la the Manna a romvon organization? D. Is the buttress a Mittel eareMitbbe

054. 65 Interest deducted in computing Fll (see instructions) • et 66 Depreciable assets and land entered on your federal return • 66. 67 If the Internal Revenue Service (IRS) has completed an audit of any of your returns within the last five years, list years: 68 If you are a member of an affiliated federal group,

Tax Dept use 0nbl do Number and steel a PO box Dale of Mcorporegan 12-06-04 Coy State weeds Foreign corporalicns: dale began business in NYS NAICS business code number (from federal return) II address above CI,our mmtimpbyeridtailkaaen motet. aldag.or owerelloatinlorrmws Ne Audi Pa Tax Depl u

ble to verify any Wcimation provided to Pain Beach NlillOnSI Bonk & Trust Company on Via Appication on any such ranged document. racketing Wig**, to the Internal Revenue Service, busmen craft reponing and Credit bureau agencies end associations. end we authorise Palm Beach National Bank & Trust Company, Its holding company e

n, Jr. New York, NY 10020 OFFIaR V 1 REFERRING OFFICER Nancy Bruno PHONE LOAN GRADE 3 r AX ID V(S) OBLIGOR NUMBER ItELAten ,m, AORROWERS NAICS CODES :EFJ LAST APPROVAL OWING AS OF 8/1/02 ) 6/21/02 ) r-; +.5% Fixed $25,000 -.<;j8 Annual Fee 5% Fixed JO • ukcl 1153 Vol-D _o ffryX 3