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LAUREL. INC Account Number S.S./TINJEIN: Physical Address: RED HOOK PLAZA QTR B3 Mailing Address: 6133 RED HOOK QTR B3 ST THOMAS VI 00802-0000 ST THOMAS. VI 00802-0000 Beefless Tenpins** (340)7752525 Business Fax a internoswebsite Address: Line of Business: Office Administraeve Se NAGS Code: 5811
lace ot Birth: NY Social Security: Physical Address: semi Masse: Urns Saint James Isiaml 8100 Red Hook OuartEet 83 St. Thomas. VI 00802 St Thomas. V100802 Place of Employment FinanClal Ins EMMY Occupation: F ' Work Phone: WIWI a Relation Account Title: asident ID Tat End Drivel Li
st hereby in tie Gies Informs/bon 0.ornineroal Accounts Under penalties Dcposncr a not wienciang as a ynthhcM nu or it is true, cross out The Internal Revenue backup withhoicfing. Date of newt resell exempt and waft that FIndlank Ms been desIgnated as a depository d t drafter area Sine (KYC) and f
tion Number: Form: SS-4 Member of this notice: CT 575 G sourHun FINANCIAL LLC t SOUTHERN TRUST COMPANY INC SOLE M 9100 PORT OF SALE MALL STE 15 ST THOMAS, VI 00802 For assistance you may call us at: 1-800-829-4933 IF YOU WRITE, ATTACH THE STUB AT THE END OP THIS NOTICE. WE ASSIGNED YOU AN EMPLOYER
l K We beee (nsvuctiom)o o HIM 'number. Street and sec or sues no.) 6100 Red Hook Quarter 83 neessawaneresandaddress City, state. end 2v rode St Thomas, USW 00802 UM account numbs*. here (optbnag P a I Taxpayer Identification Number (fl triter yew TIN k the appropriate box. The TIN provided must m
ued to me), and 2. I ern not subject to backup withholding because: (a) I all exempt from backup withholding, or (b) I nave not been notified by the Internal Revenue Semce pm that I em subplot to backup withholding as a result of a (allure to report all Interest or dividends, or (c) the IRS has notified me that I
Deutsche Asset & Wealth Management Account Agreement Southern Financial LLC Clinics) AN6- 61, 3F0c, Address 6100 Red Hook Quarter 83 St Thomas City 00802 State op Code Account Title (Complete if Efferent from the Client above) Nctfil 01.38oci Account Numbed') IMPORTANT PLEASE SIGN AN
be hued to ma), and 2. I am not subject to backup withholding because: (a) I am *awns( tan backup withholding, a (b) I have not been notified by the Internal Revenue Servos (iRS) that I am subject to backup wIthholdng as a result of a faauro to upon Si Interest or candlinelk or (c tne IRS het notibed me thill I a
d the name of the resident agent of the Corporation is Kellerhals Ferguson LLP, whose mailing address is 9100 Havensight, Port of Sale, Suite 15-16, St Thomas, U.S. Virgin Islands 00802, and whose physical address 9100 Havensight, Port of Sale, Suite 15-16, St. Thomas, U.S. Virgin Islands. ARTICLEJII Wi
s of the Applicant 11. Tax Clearance Certificate. Applicant must provide a Tax Clearance Letter from the Govemment of the Virgin Islands Bureau of Internal Revenue. Chock if Attached, Appendix 37 (X) RTPark Application - Page 10 RTPark-PC-02-1-2012 EFTA00292624 12. Suspicious Financial Transactions Applic
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