[INSERT APPLICANT LETTERHEAD]

[INSERT APPLICANT ADDRESS, TELEPHONE, EMAIL]

DOCUMENTATION ENCLOSED

*** INDIVIDUAL ENTRY ***

DATE: June 27, 2018

TO: Trade Authority / Program Manager
RE: Participation in Structured Private Financial Opportunity

 AFFIDAVIT REQUESTING INFORMATION

 CLIENT INFORMATION SHEET
 SOURCE OF FUNDS AFFIDAVIT
 LETTER OF NON-SOLICITATION & REQUEST
 AUTHORIZATION TO VERIFY FUNDS
 PASSPORT(S)
 PROOF OF FUNDS

APPLICANT INITIALS ___________ PAGE 1 OF 13

[INSERT APPLICANT LETTERHEAD]
[INSERT APPLICANT ADDRESS, TELEPHONE, EMAIL]

AFFIDAVIT REQUESTING INFORMATION

DATE : June 27, 2018

TO : Trade Authority / Program Manager
RE : Participation in Structured Private Financial Opportunity

INVESTOR TRANSACTION CODE:

Dear Sir,

I, (INSERT NAME), the undersigned, on my own behalf, do hereby affirm that I have requested
specific information about Private Placement Opportunities and or the Participation in
Investment Programs. The confidential information presented, received, and learned is not for the
solicitation of funds, nor is it an offering of any kind, but is for my general knowledge. I confirm
that I have requested the information of my own free will and choice, and further confirm that no
party has solicited me in any way. I hereby agree to keep all information received from you
strictly confidential, private, and proprietary, and that I will not disclose it to any other third
party.

I, (INSERT NAME), further affirm that any funds or assets I decide to place are done so at my
own specific initiative, risk, and authorization with full consideration and without duress. I
further affirm that the information received is intended solely for my PRIVATE &
CONFIDENTIAL USE ONLY. I am a sophisticated investor by all definitions of that
classification known to me; I make my own investment decisions, and have legally acquired
assets available. I, hereby reaffirm, under penalty of perjury that I have requested information
from you and your organization and that you have not solicited me in any manner.

I, (INSERT NAME), understand that the contemplated transaction is strictly one of Private
Placement and is in no way relying upon existing regulations in relation to the United States
Securities Act of 1933 as amended, or related regulations, and does not involve the buy and sell
of securities. I further declare that I am not a licensed securities broker or government employee
and understand that neither are you or your organization. I mutually agree that this Private
Placement Transaction is exempt from the securities act.

I, (INSERT NAME), understand and agree that the ICC NON-DISCLOSURE and NON-
CIRCUMVENTION rules apply to this affidavit and business relationship, and hereby agree to
the current application standards of the International Chamber of Commerce, Paris, France which
rules are made a part hereof by this reference.

I, (INSERT NAME), under penalty of perjury, with full individual responsibility, hereby
irrevocably, confirm that neither myself, nor anyone else associated with my organization, my
corporation, or the individual investor are working for any Agencies of any Government. I

APPLICANT INITIALS ___________ PAGE 2 OF 13

[INSERT APPLICANT LETTERHEAD]
[INSERT APPLICANT ADDRESS, TELEPHONE, EMAIL]

further state under penalty of perjury that I am not involved in any Government entrapment
operation.

I, (INSERT NAME), under penalty of perjury, with full individual responsibility, hereby
irrevocably, confirm that neither myself, nor anyone else associated with my organization or
corporation have been convicted of a felony, either within the United States or anywhere in the
world where that crime would be considered equal to a US felony. To the best of my knowledge I
am not nor are any of my associates considered to be terrorists or on any watch list with the
United States Department of Homeland Security.

I, (INSERT NAME), agree that all email and facsimile transmitted documents shall be treated as
original documents. I further agree that in all cases where plural might apply where singular
tense is used it is so applied.

I, (INSERT NAME), hereby swear under penalty of perjury, that the information provided
herein is accurate and true as of this date: June 27, 2018

For and on behalf of (NAME OF INDIVIDUAL)

Signature :
_________________________
Name / Title :
Passport Number :
Date of Issue :
Date of Expiry :
Country of Issuance :

APPLICANT INITIALS ___________ PAGE 3 OF 13

[INSERT APPLICANT LETTERHEAD]
[INSERT APPLICANT ADDRESS, TELEPHONE, EMAIL]

CLIENT INFORMATION SHEET (P art 1 )

Directions: This document must be completed in full. If a line item does not pertain then insert
the term: “N/A” (non-applicable).

PERSONAL INFORMATION

First Name :
Middle Name :
Last Name :
Gender :
Date of Birth :
Social Security Number :
Country of Citizenship :

Passport Number :
Date of Issue :
Date of Expiry :
Issuing Authority :

Home Street Address :

City :
State :
Country :
Postal Code :

Telephone Number :
Fax Number :
Mobile Number :
Email Address :
Home Street Address :
City :
State :
Country :

LANGUAGES / TRANSLATOR

Languages :
Does the Signatory speak English? :
If No, Name of Translator :
Tel Number :
Email Address :

APPLICANT INITIALS ___________ PAGE 4 OF 13

[INSERT APPLICANT LETTERHEAD]
[INSERT APPLICANT ADDRESS, TELEPHONE, EMAIL]

CLIENT INFORMATION SHEET (P art 2)

LEGAL ADVISOR

Full Name :
Company :
Address :
City :
State :
Country :
Postal Code :
Telephone Number :
Fax Number :
Email Address :

APPLICANT INITIALS ___________ PAGE 5 OF 13

[INSERT APPLICANT LETTERHEAD]
[INSERT APPLICANT ADDRESS, TELEPHONE, EMAIL]

CLIENT INFORMATION SHEET (P art 3 )

BANK INFORMATION
* Please attach copy of account statement from bank

Bank Name (where funds are :

currently on deposit):
Street Address: :
City: :
State: :
Country: :
Postal Code: :

Account Name: :
Account Number: :
Sort Code ABA No.: :
SWIFT Code: :
Account Signatory : :

Bank Officer # 1 Name: :

Bank Officer # 2 Name: :
Bank Officer Email: :
Telephone Number: :
Fax Number: :

CLIENT ACCOUNT WHERE PROFITS TO BE PAID

Bank Name: :
Street Address: :
City: :
State: :
Country: :
Postal Code: :

Account Name: :
Account Number: :
Sort Code ABA No.: :
SWIFT Code: :
Bank Officer Name: :
Telephone Number: :
Fax Number: :

APPLICANT INITIALS ___________ PAGE 6 OF 13

[INSERT APPLICANT LETTERHEAD]
[INSERT APPLICANT ADDRESS, TELEPHONE, EMAIL]

CLIENT INFORMATION SHEET (P art 4 )

Investment :
Funds available for this transaction: :
Type of currency: :
Origin of funds: :
Are these funds free and clear of all liens, :
encumbrances and third party interests:

I, (INSERT NAME), hereby swear under penalty of perjury, that the information provided
herein is accurate and true as of this date: June 27, 2018

For and on behalf of (NAME OF INDIVIDUAL)

Signature :
_________________________
Name / Title :
Passport Number :
Date of Issue :
Date of Expiry :
Country of Issuance :

APPLICANT INITIALS ___________ PAGE 7 OF 13

[INSERT APPLICANT LETTERHEAD]
[INSERT APPLICANT ADDRESS, TELEPHONE, EMAIL]

SOURCE OF FUNDS AFFIDAVIT (Part1)

DATE : June 27, 2018

TO : Trade Authority / Program Manager
RE : Participation in Structured Private Financial Opportunity

INVESTOR TRANSACTION CODE:

Dear Sir,

I, (INSERT NAME), bearing (COUNTRY) Passport No. (NUMBER), duly authorized do

solemnly swear/attest the following statements to be true.

I, (INSERT NAME), declare under penalty of perjury and with full personal and legal
responsibility under the International Court of Law that I legally hold the sum of (SPELL
AMOUNT) United States Dollars ($_____,000,000.00 USD) and it is deposited in Account No
(ACCOUNT NUMBER) at (NAME OF THE BANK), located at (ADDRESS OF BANK).

I further declare these funds are current and valid currency lawfully obtained and constitute
clean, cleared funds of legitimate, non-criminal, commercial origin. There are no liens,
contractual obligations or encumbrances of any kind against these funds.

I have full and complete, legal ownership of, and the unrestricted right and authority to pledge or
otherwise utilize these funds. The funds are ready for transfer or release upon my instruction.

These funds are authentic and verifiable. I am not aware of any matter which could or might
cause the non-validation of these funds and I hereby indemnify the Program Manager and/or
assignees, intermediaries, or other parties involved, against any claims, demands, civil and/or
criminal in nature, and liabilities, damages, or expenses including without limitation any
attorney’s fees which may arise, whether in whole or in part, caused by reason of reliance upon
this sworn declaration.

E-mail, facsimile copies or photocopies of documents or agreements pertaining to this subject are
declared and regarded as valid and equal to the original, provided they are represented by proper
signatories. Originals may be obtained upon request.

APPLICANT INITIALS ___________ PAGE 8 OF 13

[INSERT APPLICANT LETTERHEAD]
[INSERT APPLICANT ADDRESS, TELEPHONE, EMAIL]

SOURCE OF FUNDS AFFIDAVIT (Part1)

I, (INSERT NAME), hereby swear under penalty of perjury, that the information provided
herein is accurate and true as of this date: June 27, 2018

For and on behalf of (NAME OF INDIVIDUAL)

Signature :
_________________________
Name / Title :
Passport Number :
Date of Issue :
Date of Expiry :
Country of Issuance :

APPLICANT INITIALS ___________ PAGE 9 OF 13

[INSERT APPLICANT LETTERHEAD]
[INSERT APPLICANT ADDRESS, TELEPHONE, EMAIL]

LETTER OF NON-SOLICITATION & REQUEST

DATE : June 27, 2018

TO : Trade Authority / Program Manager
RE : Participation in Structured Private Financial Opportunity

INVESTOR TRANSACTION CODE:

Dear Sir,

I, (INSERT NAME), the undersigned, hereby confirm that I have requested of you and your
organization specific confidential information and documentation on behalf of ourselves. I
hereby declare that I am fully aware of the information received from you is in direct response to
my request, and is not in any way considered or intended to be a solicitation of funds of any sort,
or any type of offering, and is intended for our general knowledge only. I hereby affirm under
penalty of perjury that you have not solicited in any way. I understand that the contemplated
transaction is strictly one of private placement, and is in no way relying on or related to the
United States Securities Act of 1933, as amended or related regulations, and does not involve the
sale of securities. That affiant makes this affidavit knowing that the recipients will rely on the
contents hereof, and agrees to indemnify and hold-harmless all recipients and all other parties --
including intermediaries -- against any and all claims resulting from any applicant
misrepresentation of a material fact or any loss of asset value or any act (legal or not) of a bank
or other financial institution, governing authority or agency, the Federal Reserve or an official or
other insider of any such entity. Further, I hereby declare we are not licensed brokers or
government employees, and understand that neither are you or your organization. We mutually
agree that this private placement transaction is exempt from the Securities Act, and not intended
for the general public, and all materials are for private use only.

For and on behalf of (NAME OF INDIVIDUAL)

Signature :
_________________________
Name / Title :
Passport Number :
Date of Issue :
Date of Expiry :
Country of Issuance :

APPLICANT INITIALS ___________ PAGE 10 OF 13

[INSERT APPLICANT LETTERHEAD]
[INSERT APPLICANT ADDRESS, TELEPHONE, EMAIL]

AUTHORIZATION TO VERIFY FUNDS

DATE : June 27, 2018

TO : Trade Authority / Program Manager
RE : Participation in Structured Private Financial Opportunity

INVESTOR TRANSACTION CODE:

Know all men, by these that I, (INSERT NAME), at the address shown above, give you clear
notice that you have my direct permission and full authority to do all matters necessary to
confirm, verify, and authenticate my beneficially owned cash funds and/or application asset(s)
and its associated good standing account status, in an amount of (SPELL AMOUNT) United
States Dollars ($_____,000,000.00 USD) on a bank to bank basis. The below stated beneficially
owned account is of good, clean, and cleared cash funds obtained via legal means, and is
currently available at the bank coordinates below:

CASH AMOUNT : ($_____,000,000.00 USD)

BANK NAME : (NAME OF THE BANK),
BANK ADDRESS : (ADDRESS OF BANK)
ACCOUNT NAME : (ACCOUNT NAME)
ACCOUNT NUMBER : (ACCOUNT NUMBER)
ACCOUNT SIGNATORY : (ACCOUNT SIGNATORY)
BANK OFFICER & TITLE : (BANK OFFICER / TITLE)
BANK OFFICER EMAIL : (BANK OFFICER EMAIL)
COPY OF THIS AUTHORIZATION WILL BE LODGED AND PRESENTED TO MY
BANK OFFICER.

In witness hereof I, (INSERT NAME), hereby swear under penalty of perjury, that the
information provided herein is accurate and true as of this date: June 27, 2018

For and on behalf of (NAME OF INDIVIDUAL)

Signature :
_________________________
Name / Title :
Passport Number :
Date of Issue :
Date of Expiry :
Country of Issuance :

C.C.: (INSERT NAME OF BANK AND BANK OFFICER)

APPLICANT INITIALS ___________ PAGE 11 OF 13

[INSERT APPLICANT LETTERHEAD]
[INSERT APPLICANT ADDRESS, TELEPHONE, EMAIL]

PASSPORT

PROVIDE COLOR COPY ENLARGED (140%) TO THIS SIZE (8½ X 11 INCHES). PICTURE
MUST BE CLEAR AND NOT DARK. ENLARGE & LIGHTEN (USING PHOTO SETTING).
COLOR SCAN THE PASSPORT INTO YOUR COMPUTER AT A HIGH RESOLUTION IN
THE JPEG FORMAT AND INSERT.

APPLICANT INITIALS ___________ PAGE 12 OF 13

[INSERT APPLICANT LETTERHEAD]
[INSERT APPLICANT ADDRESS, TELEPHONE, EMAIL]

CURRENT BANK STATEMENT OR BCL

CURRENT BANK STATEMENT OR BCL, RECENT FIVE (5) DAYS TEAR SHEET IS THE
REQUESTED ACCEPTABLE PROOF OF FUNDS OR BCL, BANK LETTERS SIGNED BY
BANK OFFICER(S), CERTIFICATE OF ACCOUNT OR CONFIRMATION OF FUNDS MAY
BE INCLUDED AS SUPPLEMENTAL BANKING. KINDLY INCLUDE UN‐SANITIZED
CURRENT BANK STATEMENT OR TEAR SHEET WITH YOUR SUBMISSION.
TRANSMIT HIGH-QUALITY, COLOR SCANS OF REAL DOCUMENTS. THANK YOU.

APPLICANT INITIALS ___________ PAGE 13 OF 13