nationality for 5 years or more' O yes tZ No Profession/Occupation: Attorney Tax 10 / SSN: Current Employer: Kellerhals Ferguson Kroban PLLC Position/Tale/Rank: Address of employer: 9100 Pon of Sale Mall, Ste IS St. Thomas VI United States 00802 Does the person work as senior executive of a 06 -recognized

e of his/her country of nationality for 5 years or more? Yes I No Profession/Occupation: N/A Tax ID / SSN: 706901610 Current Employer: N/A Position/Tale/Rank: N/A Address of employer: N/A Does the person work as senior executive of a 0B-recognized regulated entity in the financial ndustry? or an entit