# Profoundd archive — Epstein Files # Bates number: EFTA01100198 # Title: 2861 Minornne 2Jr;} tn. Tray" Mu...atAram Soma # Dataset: 9 # Pages: 23 # Images: 23 detected # Tags: epstein, doj, dataset-9, image-described # Source PDF: https://profoundd.com/epstein-docs/EFTA01100198/download # Doc viewer: https://profoundd.com/epstein-docs/EFTA01100198 # # Text below is what Profoundd has extracted from the source PDF. # 'ocr-enriched' tag means OCR was applied to scan-only pages. # Image descriptions are AI-generated factual captions (llava:13b). #---------------------------------------------------------------------- === SUMMARY === raw 2861 Minornne 2Jr;} tn. Tray" Mu...atAram Soma Name of shareholder Information Return by a Shareholder of a Passive Foreign ormnems“ou Investment Company or Qualified Electing Fund fleet mem Information about Form $621 end its separate instruct° II LI , Sknoloco r., 69 THE HAZE TRUST Number, erect, and room or suite ro. (Oa P.O. box, see Instructions.) 6100 RED HOOK QUARTER, B3 City or town, stale, and ZIP Code 0Counter ST THOMAS, VI 00802 Check type ci shareholder ling Parttime LJ la4ividwl === EXTRACTED TEXT === raw 2861 Minornne 2Jr;} tn. Tray" Mu...atAram Soma Name of shareholder Information Return by a Shareholder of a Passive Foreign ormnems“ou Investment Company or Qualified Electing Fund fleet mem Information about Form $621 end its separate instruct° II LI , Sknoloco r., 69 THE HAZE TRUST Number, erect, and room or suite ro. (Oa P.O. box, see Instructions.) 6100 RED HOOK QUARTER, B3 City or town, stale, and ZIP Code 0Counter ST THOMAS, VI 00802 Check type ci shareholder ling Parttime LJ la4ividwl LJ Corporation Li Partnership s Corporation LJ Nongrantm Trust LJ Estate Name of passive foreign Investmew. company (PFIC) a malted testing fund (OEF) Employer idendlicadon member (it my) Wirddymenumberisce Nx. 13-7185414 • annotoner lax year: an* ,.n 2012 et ore tzt bervile0 .nor aging s) HIGHBRIDGE CAPITAL CORPORATION Address (Enter number, street, dyer test, and county.) PO BOK 309, UGLAND HOUSE, GEORGE TOWN GRAND CAYMAN, CAYMAN ISLANDS 98-0538848 Re itleICe ID number (set ketructiors) Tax year of PFIC or OFF: calendar year spryer begirning tang 2012 win and I. Part I.1 Summary of Annual Information Part I is reserved for future use (see instruction). Provide the ha:being information with respect to an stares of the PFIC Held by the shareholder. 1 Description of each cans of snares held by the shareholder. CD Check if shares loIntly owned with spouse. 2 Dale shares acquired duringthe taxable year, it applicable: 3 Number of shares held at the end of the taxable year: 4 Slake of shares held at the ead of the Maple year (check the appropriate box, II agalabteK (a) CD 30-53,000 (I) IL) $50,001.100,000 (a) I= SICO.00I.160,000 (d) O S150,0131.200,000 (e) II more than 5200.000, ist vac 6 Type of PRC and amount of any wa:ess crelributon or gain treated as en excess diseibuten under section 1291, irclusioe under secion 1293, or inclusion Or &Mitten under Section 1296: (a) 0 Section 1291 $ (b) CD Section 1293 (Osalifled Betting Fund) S (e) CI Section 1296 (Mark to Market) S l',Partil I Elections (See instructions.) A LXJ Election To Treat me PFIC as a OEF. I, a shareholder of a SIC. Pal to treat tie PFIC as e OEF. Compaq. Wks 6e through 7c of Part Id B CD Election To Extend Time For Payment of Tax. I, a shareholder of Ai:Sc.elect to extend the time for payment of lax on me undistiOund earnhos and Drafts of me Off until the eir.tion 6 terrnhatel Complete goes 8a through 9c of Pan M to calculate the tax that may be deferred. Note: if any portion of line 6a or one 7a of Part M is Includible under section 951, you maync,4 make this election. Abp, see sections 1294(c) and 1294(0 and tee related reguistions for events that terminate this election. C Recline To Mertmo-learket PFIC Stock. I, a shareholder of a PFIC. elect to mark-to-market the PFIC stook that is marketable witin the meaning of section 1296(e). Complete Pan IV. D Deemed Sole McRae. I, a shareholder on the irst day orb PFIC's lest tax year as a GEE, recto recognize gen on the darned sale of my Interest in the PFIC. Enter gain &foss on Me 751 of Part V. E 0 Canned MvIdend Elution. a shareholder on the lag day of a PFIC's (*situ year as a Cif that Is a confr0ded Imign corporation (C), elect to teat an amount equal 10 my shire of Pte pcst.1986 earnings and moths of the Cr-Cas an excess detibutte Enter this amount on fire 15e of Parr, V. the excess distribution is greater than zero, also complete line 16 al Part V. F 0 Election To Recognize Bain en Deemed Sale of PFIC. I, a shareholder °reformer PFIC or a PFIC to which section 1297(d) apples, elect to west as an excess diStritution the gain recognized on the deemed sale of my interest in the PFIC on the last dry of Its last tax yer as a PFIC under motion 1297(a). Enter gain on one 15f of Pert V. a CD Deemed Dividend Election With Respect to a Section 1297(e) PFIC. I, a sharcholde of a wetter 1297(e) PAC, within the meaning el Regulations semen 1.1297.3(a). elect to mare a teemed dividend eleellon with respect to the Secton 1297(e) PFIC. My holding period in the stock of the Section 1297(i) PRO includes me CFC qualification date, as deemed In Reputations Mellen 1.12,37-3(d). Enter the excess distribution on Me 15e, Pan V. It the excess dIstnbutice is greeter than zero, also compete ono 16, Part V. H Deemed Dividend Election With Respect to a Former PFIC. I, a shareholder or a former PFIC, vahin the meaning of Regutuers section 1.1298-3;a), elect to nuke a deernes dividend action with respect to the former PFIC. My toldkm period in the stock of the former PFIC names me lorrination dale, as defined in Regulations section 1.1298-3(4 Enter the excess distribution an Me 15e, Part V. If the excess arstribrition is greater than zero, also complete tine 16, Pm V. o r•20-13 LRA Far Disclosure, Privacy Act, and Paperwork Redocgoe Act Notice, see separate instructions. Form 8621 (Rev. 12012) 15 EFTA01100198 Form 8621 (Rev. 12.2012) THE HAZE TRUST 13-7185414 P442 KPaftIlli Income From a Qualified Electing Fund (QEF).AIICE: srizre:moes cOniete lines 6a through k II Yee are Making faction B, also complete toes Ba through 9c. (See instructions.) a Enier your pro ram share of to armory earnings of me OEF lea 1 3,015,046. h Enter the portion of line 6a teet is included in imams under setdan 951er that may tie excluded under section 1293(g) . .... 6bI Subsacl Sno 6b from he 6a. Enter this amount on your taxreturn as ordinary income la Enter your mo ins shme of the total net capital gain of the BEE ; 7aI b Enter inb portion of line 7a list Is included in income under section 951 a That may be excluded under section 1293(g) I 7b c Subtract line 7b from Ina 7a. This amount is a net lonetem capital gab. Enter the ammo In Part II of Me Schedule used for your Income tax ratan. (See instructions.) a kW MeS k and 7c ,. Enter the total amount of cash and tut lair market value Of other property distributed a deemed distributed 13 you during the tax yet of the OEF. (See instructions.) c hie the [onionof line 8a netabbacy Inobriet in line & that is atiributabb tones in IN CEP Mat ycu disposedof, pledged.« olnenvlse transferred during the tax year Be 3,015,046. Te 8a d Add Ines Bo and & e Subtract hoe 84 from Me 8a, and enter the «faience (d zero or less, enter amount In bladets) Imprint if Me S. is greater than zero, and no patio of tita 6a or la Is Inoknlible in income under section Pe, you may make Election B with respect to the account on tine 8e. 9a Enter the total lax tor the lax year (See Instructions.) IM I b Enter tne soul tax for the ax year deterraked valour regard tote amount ensred