structtre, es ownership structure and es Top Management. For trusts/foundations, include information about revocatity,setdor and benefklarit,etc.: Sngle member U.C. Jeffrey Epstein Is sole member/owner. The signors on this account are Jeffrey Epstein Harry Beller and Darren Indyke Please indicate how

ast name 1 2 Your social security nwnber Home address (number and street or rural route) 3 0 Single 0 Married . Mamed. but withhold at higher Sngle rate. Note. If married. but legally separated a spouse is a nonresident alien. check the "Single box. City or town. state. and 2IP code 4 If your