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(OFAC)?
H. Does the client or related party have any financial or other association/ interactions D kii No
within high risk countries? Yes
I. Corporate Documentation Attached (Legal Entities Only) R Yes 0 No 0 Not Applicable
J. Undisclosed Principal Form Complete (Intermediaries Only) 0 Yes 0 No RI Not Applicable
K If Lexis/Nexis Search Results, Corporate Documents or Other Supporting Documentation is not in English, please provide an English
summary of the nature/contents of the non-English Documentation:
L. Special Risk Factors
Does the account have a Nexus to High risk Countries? 0Yes 74 No
Is the account structure unusually complex? • yes ON*
Is there any indication the client set up a non operating
company expressly for the purpose of transferring shares to 0 yes JO No
third parties?
Is there any indication this could be a prohibited business
relationship? . Yes 74 NO
Are the bearer shares identified subject to acceptable controls? ❑Yes 0 No
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CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0051781
CONFIDENTIAL SDNY_ GM_00197965
EFTA01362391