Company Formation Form

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1 Company Formation Form WILLOW TRUST LIMITED registered No ; WILLOW TRUSTEES LIMITED registered No Licensed by the Guernsey Financial Services Commission under The Regulation of Fiduciaries, Administration Businesses and Company Director, etc. (Bailiwick of Guernsey) Law, 2000.

2 Company Formation Form Purpose of company Please supply a detailed explanation of the proposed main purpose of the company. This must include main objects (e.g. property holding in..., to hold an investment portfolio consisting of...), expected future activity and information concerning the sources of funds to be used in the initial funding and ongoing operation of the company. For existing companies being transferred to us, please provide this information from a historical perspective. Geographical area of activities of company Please supply first, second and third preference. If acquiring a pre-formed company, then please state the name held for you. First Second Third held Beneficial owners Please list below the full names and percentage of ownership of each beneficial owner. Please use a separate sheet if necessary. A Client Due Diligence Verification Questionnaire must be completed for each beneficial owner (and additional documentation supplied as specified). Where a company is to be a beneficial owner, it is necessary to divulge the ultimate individual beneficial owner(s) of that company and provide a Client Due Diligence Verification Questionnaire for each of them (and additional documentation supplied as specified thereon). In these circumstances please provide a full structure diagram. Type of company required! Guernsey! British Virgin Islands IBC! English! Other jurisdiction (please specify)

3 Capital structure Issued capital Nominal value of each share Currency Shareholders We can provide nominee shareholders if requested. If we are not providing nominees, then please give the details of the shareholder(s) as specified below.! Portfolio valuation and net asset statement! Investment schedule! Trial balance! Loan schedule (amount, interest and repayments) Frequency of reporting! Quarterly! Half-yearly! Annually! Please provide nominee shareholders or The initial shareholder(s) will be To whom should we send the accounting information? Full name Number of shares Directors and Secretary Corporate Directors and Secretary (where required by law) will be provided by Willow. Bookkeeping It is necessary for us to maintain accounting records and produce annual financial statements for all Companies. Guernsey companies are also required to be audited unless they are eligible for exemption from audit please contact us for more details. We can undertake all bookkeeping functions for a company, liaising with auditors if required. Audit status! Audited! Unaudited If audited, please provide the following details of the auditor Full name Please supply the following information: Financial year end First accounting period end Book currency Contact name Reporting Required If additional reporting is required, please indicate below:! Profit and loss account and balance sheet! Bank account movements

4 Banking Banker s name Declaration I/We declare and confirm that: 1. The above particulars are true and correct to the best of my/our knowledge and belief. 2. The intended beneficial owner(s) is/are not acting as nominee, trustee or representative of any third party. Type and currency of account(s) Signed in BLOCK Anticipated annual turnover Dated Future communication Please indicate day-to-day lines of communication so that we can efficiently administer the company. Contact name Signed in BLOCK Dated Mobile number Fax number Where this form is not signed by the Client please provide the following details: Introducer Organisation Fees Our current fee scale appears below and are subject to annual review and may be increased from time to time as noted in our Standard Terms and Conditions. Prior to arranging for the incorporation of any company it is our standard practice to complete all our Due Diligence procedures and to request sufficient funds to settle our initial fee invoice that will cover the set up fee (including any statutory fee etc.) and our first years annual fee. Fax number

5 COMPANY FEES: 2015 Formation Fee We are able to form companies in most jurisdictions worldwide and our charges for incorporating and annual management are as follows:- Formation 1,525 These charges include taking instructions, legal expenses, provision of corporate documentation, seal & records and the minimum stamp duty or registration fee. In cases where variations to the standard Memorandum and Articles of Association or standard authorized share capital are requested additional fees may be payable. Charges for other jurisdictions are available on request. Basic Annual Maintenance Fee Basic Annual Maintenance Fee 1,875 The basic annual maintenance fee includes the provision of Directors 1, Company Secretary, Treasurer &/or President (depending on jurisdiction), Nominee Shareholders, and registered office. It covers the cost of holding the annual AGM & considering the accounts (but not the preparation thereof), the preparation of annual return, and the annual compliance review. It does NOT include the annual payment of any tax exemption fee, filing fee, registered office and registered agent s fees that will be charged at cost. It is payable annually in advance, each January (on a pro-rata basis in the year of incorporation) and is nonrefundable. Administration Charges Any administrative services that we provide for the company are recorded and are invoiced quarterly in arrears. These services would include, for example, the opening and operation of a bank account, keeping accounts for the company, the purchase and sale of assets, the preparation of invoices and so forth. Such activities are invoiced on the basis of the amount of time taken plus the costs of any disbursements. Details of our hourly charges are available on request. We may agree to fixed-fee billing, if preferred, subject to negotiation. Termination Fee A termination fee is chargeable on cessation of corporate administration or transfer to another corporate service provider and will be calculated on a time spent basis plus any disbursements incurred. This fee is subject to a minimum sum equivalent to the Basic Annual Maintenance Fee as 1 In some jurisdictions a locally resident director &/or secretary may be required by law which will incur additional fees.

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