er: 575 Ledngton Avenue, 4th Floor Homey NY United States 10022 Does the person work as senior erearive cf a DB-recognized regulated entity in the (Vandal ndustry? or an entity listed on a DB-recognised exchange? (Not applicable fct operating entitles n yes O No '—' Is the lnthl&al a Poetically Expo

ns within counties a rts 2 No or regimes sanctioned by the Office of Foreign Assets Control (OFAC)? II' Does the client or related party have any (Vandal or other association) interactions within Ngh risk O yes 2 No countries? I. Corporate Documentation Attached (Legal Entities Only) @Yes O No O Not

N: Current Employer: Posbonfritle/Rank: Address of employer: Does the person work as senior executive of a DB-recognized regulated entity in the (Vandal ndustry? or an entity listed on a D8-recognised exchange? (Not applicable foe operating entities n yes 2 No I—I Is the indvidual a Pokicalty Expos

oyer: 575 Lexington Ave, 4th Fl Uvingston NY United Slates 10022 Does the person work as senior meative of a 08-recognized regulated entity in the (Vandal ndustry? or an entity listed oha DB-recognised exchange? (Not applicable for operating entities Oft; 2 No Is the Indvicktal a Poetically Exposed P

age neurone any 0Mier purgers gam speoficay droned bottommost Thal epprasal and ell the data Or Named heeetie se prepared fa Me Caws ONLY This Vandal to for the Client. Sol. Know/edge only. No onus um a met aporsitel is auttacoara The apprmsat is ret for asurance papa lentIng paapeera. rue orry o

stant U.S. Attorney ssistant U.S. Attorney 500 So. Australian Avenue, Suite 400 Wes FL 33401-6235 Tel: Fax: •If not applicable. enter 'none.' Vandal m Ntu of 40110 FORM ORD-227 JAN.86 EFTA00223877 U.S. Department of Justice United States Attorney Southern District of Florida 300 S. Austral

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