INSTRUCTIONS UNITED KINGDOM CDOT JURISDICTION ADDENDUM SELF- CERTIFICATION FOR ENTITIES

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1 INSTRUCTIONS UNITED KINGDOM CDOT JURISDICTION ADDENDUM SELF- CERTIFICATION FOR ENTITIES United Kingdm Crwn Dependencies & Overseas Territries (UK CDOT) Overview T cmply with the United Kingdm (UK) and its related Crwn Dependencies and Overseas Territries ( CD/OTs ) rules gverning infrmatin reprting n certain financial accunts (including investments in funds), Wells Farg is required t btain a Self-Certificatin frm frm yu. The purpse f this frm is t enable Wells Farg t identify Jersey, Guernsey, Gibraltar and Isle f Man residents and t cllect ther pertinent infrmatin necessary t determine whether financial accunt reprting is required under UK CDOT. Therefre, please nte that Wells Farg may be bligated t share this infrmatin with the relevant tax authrities. Yu are required t state the residency fr tax purpses f the Accunt Hlder. The Accunt Hlder is the entity entitled t the incme and/r assets assciated with a financial accunt. Definitins t assist yu in identifying the UK CDOT classificatin f the Accunt Hlder and in cmpleting this frm can be fund belw. If the Accunt Hlder is classified as a Passive Nn-Financial Entity and has Cntrlling Persns, yu will als be required t prvide infrmatin n the natural persns wh exercise cntrl ver the Entity ( the Cntrlling Persn(s) ) by prviding Annex I - Cntrlling Persn Tax Residency Self-Certificatin cmpleted and signed by each Cntrlling Persn. Please cmplete and return the Self-Certificatin frm as directed as well as any Annexes applicable t avid being subject t ptential jurisdictinal penalties. Instructins fr Cmpletin Yu must cmplete this frm if yu are an Entity and are claiming that yu are the beneficial wner f any incme paid t yu in cnnectin with the accunt(s)/investment(s) fr which the Self-Certificatin is being prvided r are therwise cnsidered a financial accunt. Please nte: Wells Farg may be bligated t share this and ther infrmatin with relevant tax authrities. D nt use this frm if the Accunt Hlder is an individual. Instead yu shuld cmplete and prvide the Self-Certificatin fr Individuals frm. If any f the infrmatin belw abut the tax residency f the Accunt Hlder changes, yu are required t prvide Wells Farg with a new updated Self-Certificatin frm within 30 days f such change in circumstances. The persn cmpleting the frm n the Accunt Hlder s behalf shuld indicate the capacity in which the persn signed in the signature sectin. Fr jint r multiple Accunt Hlders, please cmplete a separate frm fr each Accunt Hlder. Where the Accunt Hlder is a Passive Nn-Financial Entity, then yu are als required t prvide infrmatin n the natural persn(s) wh exercise cntrl ver the entity ( the Cntrlling Persn(s) ) by having each Cntrlling Persn cmplete and sign Annex I - Cntrlling Persn Tax Residency Self- Certificatin. If yu have any questins abut hw t cmplete this frm r abut hw t determine yur tax residency status yu shuld cntact yur tax advisr r jurisdictinal tax authrity. Page 1 f 5

2 Sectin I Specified Persn Line 1. If yur Entity is tax resident in Jersey, Guernsey, Isle f Man r Gibraltar then it must indicate whether it shuld be treated as a Specified Persn in that jurisdictin. Specified Persn is defined as an Entity wh is resident in Jersey, Guernsey, Gibraltar r Isle f Man fr tax purpses, and includes an Entity wh is resident in ne r mre f the abve jurisdictins under the respective dmestic law f each, and is NOT: (a) a crpratin the stck f which is regularly traded n ne r mre established securities markets; (b) a crpratin that is a member f the same affiliated grup, as defined in Sectin 1471(e)(2) f the U.S. Internal Revenue Cde, as a crpratin described in (a) abve; (c) a Depsitry Institutin; (d) a brker r dealer in securities, cmmdities, r derivative financial instruments that is registered as such under lcal law; r (e) an exempt beneficial wner (as defined in the Line 4 instructins belw). Line 2. If N, please enter the cde applicable indicated abve (a, b, c, d, e) n the frm. Sectin II- UK CDOT Classificatin Please prvide yur UK CDOT classificatin under Intergvernmental Agreements entered int between the UK and the CD/OTs by checking the crrespnding bx(es). Line 3(a-m). Financial Institutin. If the Entity is a Financial Institutin, check the bx Financial Institutin. Line a. Please specify GIIN. If the entity is a Registered Deemed Cmplaint Financial Institutin (including a Mdel 2 Reprting Freign Financial Institutin, a Participating Freign Financial Institutin, r a Spnsred Financial Institutin with a Glbal Intermediary Identificatin Number GIIN) prvide the Entity s GIIN. In general, the term Financial Institutin includes any entity that meets the definitin f: Depsitry Institutin : An entity that accepts depsits in the rdinary curse f a banking r similar business. Custdial Institutin : An entity which hlds financial assets fr the accunt f thers as a substantial prtin f its business. Investment Entity : An entity which cnducts as a business trading in certain financial instruments n behalf f a custmer r an entity which is investing, administering r managing funds r mney n behalf f ther persns. This wuld als include an institutin which is primarily investing, reinvesting r trading in financial assets and is managed by anther Financial Institutin. Specified Insurance Cmpany : An entity that issues, r is bligated t make payments with respect t, any cash value insurance cntract, annuity cntract r ther financial accunt r the hlding cmpany f such an insurance cmpany. Hlding Cmpany r Treasury Centre f a Financial Grup : An entity that is part f a financial grup and acts as a hlding cmpany r treasury centre. The term Registered Deemed Cmpliant Financial Institutin means a Nn-Reprting Financial Institutin t which a Glbal Intermediary Identificatin Number has been prperly allcated. Line b. US Financial Institutin. If the entity is a US Financial Institutin, please check this bx. The term US Financial Institutin means a Financial Institutin which is resident in the US. Line c. Financial Institutin that has nt yet btained a GIIN but intends t d s if required. If the entity is a Financial Institutin that has nt yet btained a GIIN number but intends t d s if required, please check this bx. Line d. Nn-Reprting Financial Institutin. If the entity is a Nn-Reprting Financial Institutin, please check this bx and select what type f Nn-Reprting Financial Institutin crrespnds t the entity in lines d. k. The term Nn-Reprting Financial Institutin means any Financial Institutin r ther Entity that is described as a Nn-Reprting Financial Institutin under UK CDOT and includes: Spnsred Financial Institutins, Trustee- Page 2 f 5

3 Dcumented Trusts, Cllective Investment Vehicles, Lcal Credit Unins, Qualified Credit Card Issuers, Financial Institutins with nly lw value accunts, Investment advisrs r Investment managers. Line e. Spnsred Financial Institutin (including a Spnsred Clsely Held Investment Vehicle) with GIIN. If the entity is a Spnsred Investment Entity r a Spnsred Clsely Held Investment Vehicle, please prvide Name and GIIN number f the Spnsring Entity that has agreed t perfrm due diligence n behalf f yur entity. If the entity has btained a GIIN, please prvide the entity s GIIN number as well under Line 3a abve. Nte that this field is nt required t be prvided until January 1, Line f. Trustee-Dcumented Trust. If the entity is a Trustee Dcumented Trust, please check this bx and prvide the Trustee s name and GIIN. Line g. Cllective Investment Vehicle. If the entity is a Cllective Investment Vehicle, please check this bx. The term Qualified Cllective Investment Vehicle applies t Investment Entities that are wned slely thrugh Participating Freign Financial Institutins r directly by large institutinal investrs (e.g. pensin funds). Line h. Registered Deemed Cmpliant Financial Institutin. If the entity is a Registered Deemed Cmpliant Financial Institutin, please check this bx and prvide the entity s GIIN. The term Registered Deemed Cmpliant Financial Institutin means a Nn-Reprting Financial Institutin t which a Glbal Intermediary Identificatin Number has been prperly allcated. Line i. Qualified Credit Card Issuer. If yur entity is a Qualified Credit Card Issuer, please check this bx. The term Qualified Credit Card Issuer means an entity that: Is a Financial Institutin slely because it is an issuer f credit cards that accepts depsits nly when the custmer makes a payment in excess f the utstanding balance n the card due and des nt immediately return the verpayment t the custmer; and Implements plicies and prcedures (by the later f 30 June 2014 r the date it registers as a Deemed Cmpliant Financial Institutin) either t prevent a custmer depsit in excess f $50,000 r t ensure that any custmer depsit in excess f $50,000 is refunded t the custmer within 60 days. Line j. Financial Institutin with nly lw value accunts. If the entity is a Financial Institutin with nly lw value accunts please check this bx. The term Financial Institutin with nly lw value accunts means a Financial Institutin that: is nt an Investment Entity, has Financial Accunts belw $50,000, and has less than $50 millin in assets n its balance sheet at the end f its mst recent accunting year, and has less than $50 millin in assets n its cnslidated r cmbined balance sheet where it is in a grup with related entities Line k. Investment advisr r Investment manager. If the entity is an investment advisr r investment manager that slely renders investment advice r manages prtflis fr, and acts n behalf f, a custmer fr the purpses f investing, managing, r administering funds depsited in the name f the custmer with a Financial Institutin ther than a Nnparticipating Financial Institutin and des nt therwise undertake investment services r maintain financial accunts, please check this bx. Line l. Other Type f Nn-Reprting Financial Institutin (please specify). If the entity is anther type f Nn-Reprting Financial Institutin nt included in lines d. t k., please specify the type f Nn-Reprting Financial Institutin. Line m. Fr an FFI that must btain a GIIN but has nt dne s, prvide the reasn the GIIN has nt been btained. If the FFI must btain a GIIN but has nt yet dne s, please prvide a brief explanatin f the reasn why in this field. Page 3 f 5

4 Line 4 (a d). Exempt Beneficial Owner. Please check the applicable exempt beneficial wner classificatin fr yur entity. The term Exempt Beneficial Owner includes any entity that meets the definitin f: Gvernmental Organizatin: A freign gvernment, any plitical subdivisin f a freign gvernment r any whlly wned agency r instrumentality f any ne r mre f the freging. Central Bank: An institutin that is by law r gvernment sanctin the principal authrity, ther than the gvernment f the jurisdictin itself, issuing instruments intended t circulate as currency. Exempt Retirement Funds: A fund that meets certain regulatry criteria and is perated principally t administer r prvide pensin r retirement benefits. Internatinal Organizatin: Any internatinal rganizatin r whlly wned agency r instrumentality theref. The rganizatins listed belw are Nn-Reprting Financial Institutins and will be treated as Exempt Beneficial Owners. Any UK ffice f: The Internatinal Mnetary Fund The Wrld Bank The Internatinal Bank fr Recnstructin and Develpment The Internatinal Finance Crpratin The Internatinal Finance Crpratin Order, 1955 (SI 1955 N.1954) The Internatinal Develpment Assciatin The Asian Develpment Bank The African Develpment Bank The Eurpean Cmmunity The Eurpean Cal and Steel Cmmunity The Eurpean Atmic Energy Cmmunity The Eurpean Investment Bank The Eurpean Bank fr Recnstructin and Develpment The OECD Supprt Fund The Inter-American Develpment Bank Entity whlly wned by an Exempt Beneficial Owner: Any entity whlly wned by an entity that fits any f the definitins f this sectin. Line 5. Active Nn-Financial Freign Entity. If yur entity is an Active NFFE, please check this bx. An Active Nn-Financial Freign Entity is a Nn-Financial Entity that meets any f the fllwing criteria: a) Less than 50 percent f the NFFE s grss incme fr the preceding calendar year r ther apprpriate reprting perid is passive incme and less than 50 percent f the assets held by the NFFE during the preceding calendar year r ther apprpriate reprting perid are assets that prduce r are held fr the prductin f passive incme; b) The stck f the NFFE is regularly traded n an established securities market r the NFFE is a Related Entity f an Entity the stck f which is regularly traded n an established securities market; c) The NFFE is a gvernment, a plitical subdivisin f such gvernment (which, fr the avidance f dubt, includes a state, prvince, cunty, r municipality), r a public bdy perfrming a functin f such gvernment r a plitical subdivisin theref, r an Entity whlly wned by ne r mre f the freging; d) Substantially all f the activities f the NFFE cnsist f hlding (in whle r in part) the utstanding stck f, r prviding financing and services t, ne r mre subsidiaries that engage in trades r businesses ther than the business f a Financial Institutin, except that an entity shall nt qualify fr NFFE classificatin if the entity functins (r hlds itself ut) as an investment fund, such as a private equity fund, venture capital fund, leveraged buyut fund, r any investment vehicle whse purpse is t acquire r fund cmpanies and then hld interests in thse cmpanies as capital assets fr investment purpses; e) The NFFE is nt yet perating a business and has n prir perating histry, but is investing capital int assets with the intent t perate a business ther than that f a Financial Institutin, prvided that the NFFE shall nt qualify fr this exceptin after the date that is 24 mnths after the date f the initial rganizatin f the NFFE; Page 4 f 5

5 f) The NFFE was nt a Financial Institutin in the past five years, and is in the prcess f liquidating its assets r is rerganizing with the intent t cntinue r recmmence peratins in a business ther than that f a Financial Institutin; r g) The NFFE primarily engages in financing and hedging transactins with, r fr, Related Entities that are nt Financial Institutins, and des nt prvide financing r hedging services t any Entity that is nt a Related Entity, prvided that the grup f any such Related Entities is primarily engaged in a business ther than that f a Financial Institutin. Line 6. Passive Nn-Financial Entity. If the entity is a Passive NFE, please check this bx. A Passive Nn-Financial Entity is any NFFE that is nt an Active NFFE as defined abve, it is bradly any entity that is nt a Financial Institutin and is nt an Active Nn-Financial Entity r an Exempt Beneficial Owner. Nte: If the Entity is a Passive Nn-Financial Entity, yu als will be required t prvide infrmatin n the natural persns wh exercise cntrl ver the Entity ( the Cntrlling Persn(s) ) by cmpleting an Annex I - Cntrlling Persn tax residency Self-Certificatin frm fr each Cntrlling Persn. If there are n natural persn(s) wh exercise cntrl f the Entity then the Cntrlling Persn will be the natural persn(s) wh hld the psitin f senir managing fficial. The term Cntrlling Persns refers t the natural persns wh exercise cntrl ver an Entity. In the case f a trust, such term means the settlr, the trustees, the prtectr (if any), the beneficiaries r class f beneficiaries, and any ther natural persn exercising ultimate effective cntrl ver the trust. In the case f a legal arrangement ther than a trust, such term means persns in equivalent r similar psitins. The term Cntrlling Persns shall be interpreted in a manner cnsistent with the Recmmendatins f the Financial Actin Task Frce. Sectin III - Declaratin and Signature Prvide the signature f the individual authrized t sign n behalf f the entity, print the name f the individual and the capacity in which the individual is signing, and date the frm. If signing the frm under a pwer f attrney, please attach a certified cpy f the pwer f attrney. Page 5 f 5

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