The Company hereby confirms and declares that as at the date hereof, the following individual(s) is/are the ultimate beneficial owner(s) of the Company through ownership in the intermediate or ultimate holding companies:

In accordance with the Financial Intelligence Regulations the following documents should be provided for verification:

I hereby declare that the details furnished above are true and correct for the best of my knowledge and belief and I undertake to inform you of any changes therein, immediately. In case any of the above information is found to be false or untrue or misleading or misrepresenting, I am aware that I may be liable for it.