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CLIENTINFORMATIONSHEETDIRECTIONS: THIS DOCUMENT SHOULD BE COMPLETED IN FULL. IF A LINE ITEM DOES NOTPERTAINTHENINSERTTHETERM:“N/A”(NON-APPLICABLE).CORPORATEINFORMATION(IFAPPLICABLE)FULLNAMEOFCORPORATION:DATEOFINCORPORATION:INCORPORATEDIN(CITY/STATE/COUNTRY):REGISTRATIONNUMBER:BOARDOFDIRECTORS(NAME&TITLE):OFFICERS(NAME&TITLE):SHAREHOLDERS:PERSONALINFORMATIONOFPRINCIPALSIGNATORYFIRSTNAME:MIDDLENAME:LASTNAME:GENDER:DATEOFBIRTH:SOCIALSECURITYNUMBER:COUNTRYOFCITIZENSHIP:LANGUAGES:PASSPORTNUMBER:DATEOFISSUE:DATEOFEXPIRY:ISSUINGAUTHORITY:REGISTEREDADDRESS(FORCORPORATIONONLY)STREETADDRESS:CITY:STATE:COUNTRY:POSTALCODE:

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LOCATIONOFADDRESS:LIVINGORMAILINGADDRESSSTREETADDRESS:CITY:STATE:COUNTRY:POSTALCODE:CONTACTINFORMATIONTELEPHONENUMBER:FAXNUMBER:MOBILENUMBER:EMAILADDRESS:SKYPE:LANGUAGES/TRANSLATORLANGUAGES:DOESTHESIGNATORYSPEAKENGLISH?:IFNO,NAMEOFTRANSLATOR:TELNUMBER: EMAILADDRESS: LEGALADVISORFULLNAME:COMPANY:ADDRESS:CITY:STATE:COUNTRY:POSTALCODE:TELEPHONENUMBER:FAXNUMBER:EMAILADDRESS:

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BANKINFORMATIONBANKNAME(WHEREFUNDSARECURRENTLYONDEPOSIT): STREETADDRESS:CITY:STATE:COUNTRY:POSTALCODE:ACCOUNTNAME:ACCOUNTNUMBER:SORTCODEABANO.:SWIFTCODE:ACCOUNTSIGNATORY(1):ACCOUNTSIGNATORY(2):BANKOFFICER#1NAME:BANKOFFICER#2NAME:TELEPHONENUMBER:FAXNUMBER:CLIENTACCOUNTWHEREPROFITSTOBEPAIDBANKNAME: STREETADDRESS:CITY:STATE:COUNTRY:POSTALCODE:ACCOUNTNAME:ACCOUNTNUMBER:SORTCODEABANO.:SWIFTCODE:BANKOFFICERNAME:TELEPHONENUMBER:FAXNUMBER:

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INVESTMENTFUNDSAVAILABLEFORTHISTRANSACTION:TYPEOFCURRENCY:DETAILEDORIGINOFFUNDS:ARE THESE FUNDS FREE AND CLEAR OF ALL LIENS, ENCUMBRANCES AND THIRD PARTYINTERESTS:I,(NAME),HEREBYSWEARUNDERPENALTYOFPERJURY,THATTHEINFORMATIONPROVIDEDHEREINISACCURATEANDTRUEASOFTHISDATE:JUNE5,2016 FORANDONBEHALFOF(NAMEOFCOMPANY/INDIVIDUAL)SIGNATURE:__________________________________ SEALOFCOMPANY

NAME/TITLE:COMPANY:PASSPORTNUMBER:DATEOFISSUE:DATEOFEXPIRY:COUNTRYOFISSUANCE:

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COPYOFCLIENT’SPASSPORT