Securities ona Exchange Commission SEC Memorandum Circular No, 17_ Series of 2018 TO + ALL SEC REGISTERED DOMESTIC CORPORATIONS SUBJECT _: REVISION OF THE GENERAL INFORMATION SHEET (GIS) TO INCLUDE BENEFICIAL OWNERSHIP INFORMATION Pursuant to its mandate to assist in the implementation of the Anti-Money Laundering Act (AMLA), as amended, and to ensure timely access to adequate, accurate and current information on the beneficial ownership and control of SEC registered corporations and prevent their misuse for money laundering and terrorist financing purposes, the Securities and Exchange Commission (“SEC", “Commission") hereby issues this Memorandum Circular. SECTION 1. Coverage. - This Memorandum Circular shall apply to all SEC registered domestic corporations, both stock and non-stock. SECTION 2. Definition of Terms. - 2.1. “Beneficial Owner” refers to any natural person who: (2) Ultimately owns or controls the corporation; or (2) Has ultimate effe e control over the corporation. 2.2, “Ultimate Effective Control” refers to any situation in which ownership/control is exercised through actual or a chain of ownership or by means other than direct control. This may be achieved through, but not limited to, any of the following situations: a) direct or indirect ownership of at least 25% of any category of voting shares or capital of a legal person, arrangement, understanding, relationship or otherwise has or shares voting power, which includes the Power to vote, or to direct the voting of, such security; and/or investment returns or power, which includes the power to dispose of, or to direct, the disposition of ‘such security; Provided, that a person shall be deemed to have an indirect beneficial ownership interest in any security which is: (held by’members of his/her immediate family sharing the same household; (ii) _ held by a partnership in which he/she is a general partner; Gil) held by a corporation of which he/she is the controlling shareholder; or Published: Menila Standard, Novenber 28, 2018(iv) subject to any contract, arrangement or understanding which gives him/her voting power or investment power with respect to such securities: Provided, however, that a person shall not be deemed to be a beneficial owner of securities held by him/her for the benefit of third parties or in customer or fiduciary accounts in the ordinary course of business, so long as such shares were acquired by such person without the purpose or effect of changing or influencing control of the issuer. b) the ability to elect a majority of the board of directors, or any similar body, ofa legal person or arrangement; or ©) anysituation in which: (@__aperson has the ability in fact to exert a dominant influence over the management or policies of a legal person or arrangement; or (i) a majority of the members of the board of directors of a such legal Person or arrangement, or any equivalent body, are accustomed or under an obligation, whether formal or informal, to act in accordance with a given person’s directions, instructions or wishes in conducting the affairs of the legal person or arrangement. 2.3. "GIS" refers to the General Information Sheet. SECTION 3. Disclosure of Beneficial Ownership. - To ensure timely access to adequate, accurate and current information on the beneficial ownership and control of SEC registered corporations, all SEC registered corporations are required to disclose their beneficial owners as defined herein. Accordingly, the GIS is hereby revised to include such information. ‘The following information on the beneficial owner shall be provided, to wit: @ Complete name which shall include the surname, given name, middle name and name extension (ie, Jr, St. II}; b. Specific residential address; c. Nationalit 4. Tax identification number; and €. Percentage of ownership, if applicable. This requirement on the disclosure of beneficial ownership shall be initially complied with beginning 01 January 2019. SECTION 4. Determination of Beneficial Ownership. - Where a corporation is owned through multiple layers, any intermediate layers of the company’s ownership structure should be fully identified. Such information shall be declared in the GIS and illustrated in an ownership chart to be attached thereto clearly showing the intermediate layers with their respective ownership amounts.SECTION S. | Updating of Beneficial Ownership Information. - The SEC shall be timely apprised of all relevant changes in the submitted beneficial ownership information contained in the Gls as they arise. An updated GIS shall be submitted to the SEC within seven (7) days after such change occurred or became effective. SECTION 6. Validating Information. - The Commission shall validate the beneficial ownership information provided in the GIS through an on-site inspection of the books and records of the corporations and/or through other means available. SECTION 7. Effectivity. - This national newspaper of general Pasay City, Philippines, 27 November 2018, FOR THE COMMISSION: EI AQUINO Chairperson‘GENERAL INFORMATION SHEET (G15) FOR THE YEAR STOCK CORPORATION ‘GENERAL INSTRUCTIONS: FOR USER CORPORATION: THIS GIS SHOULD BE SUBMITTED WITHIN THIRTY (30) CALENDAR DAYS FROM THE DATE OF THE ANNUAL] STOCKHOLDERS’ MEETING. DO NOT LEAVE ANY ITEM BLANK. WRITE “KA” IF THE INFORMATION REQUIRED 1S NOT APPLICABLE TO Til CORPORATION OR "NONE" F THE INFORMATION 1S NON-ENISTENT.IFTHE ANNUAL STOCKHOLDERS’ MEETING IS HELD ON A DATE OTHER THAN} ‘THAT STATED IN THE BY-LAWS, THE GIs SHALL BE SUBMITED WITHIN THIRTY (20) CALENDAR DAYS PROM THE ACTUAL DATE OF THE ANNUA] STOCKHOLDERS" MEETING. 2 IPNO MEETING I HELD, THE CORPORATION SHALL SUBMIT THE GIS NOT LATER THAN JANUARY 0 OF THE FOLLOWING YEAR. HOWEVER SHOULD] {AN ANNUAL STOCKHOLDERS MEETING BEHELD THEREAFTER, ANEW GS SHALL BE SUBMITTED FLED, ‘Tl GIS SHALL BE ACCOMPLISHED IN ENGLISH ANO CERTIFIED AND SWORN TO BY THE CORPORATE SECRETARY OF THE CORPORATION, ‘THE SBC SHOULD BE TIMELY APPRISED OF RELEVANT CHANGES IN THE SUBMITTED INFORMATION AS THEY ARISE. FOR CHANGES RESULTING FROM ACTIONS THAT AROSE BETWEEN THE ANNUAL MEETINGS, THE CORPORATION SHALL SUBMIT ONLY THE AFFECTED PAGE OF THE cis THAN RELATES TO THE NEW INFORMATION TOGETHER WITH A COVER LETTER SIGNED BY THE CORPORATE SECRETARY OF THE CORPORATION. THE PAGE ‘OF THE Gis AND COVER LETTER SHALL BE SUBMITTED WITHIN SEVEN (7) DAYS AFTER SUCH CHANGE OCCURRED OR BECAME EFFECTIVE SUBMT FOUR (4) COPIES OF THE GIS TO THE CENTRAL RECEIVING SECTION, GROUND FLOOR, SEC BLDG. EDSA, MANDALLONG CITY AL COPIES SHALL UNIFORMLY BE ON At OR LETTER-SIZED PAPER WITH A STANDARD COVER PAGE THE PAGES OF ALL COPIES SHALL USE ONLY ONE SIDE] ‘CORPORATIONS SUBMITTING A COPY OF THEIR IS ONLINE OR VIA INTERNET SHALL SUBMIT ONE (2) HARD COPY OF THE GIS, TOGETHER WITH (CERTIFICATION UNDER OATH BY ITs CORPORATE SECRETARY THAT THE COPY SUBMITTED ONLINE CONTAINS THE EXACT DATA INTHE WARD COPY. (ONLY THE cis ACCOMPLISHED IN ACCORDANCE WITH THESE INSTRUCTIONS SHALL BE CONSIDERED AS HAVING BEEN FILED. 7. TS IS MAY BE USED AS EVIDENCE AGAINST THE CORPORATION AND ITS RESPONSIBLE DIRECTORS OFFICERS FOR ANY VIOLATION OF ExisTING| {AWS RULES AND REGULATIONS fa [DATE REGISTERED: BUSINESS TRADE NAME, [sec REGISTRATION NONTER STE OF ARAUAL MEETING PER LAWS aeRO fen ‘DATE OF ANNUAL MEETING ear RE COMPLETE BUSINESS ADDRESS a TAN OF EXTERNAL AUDITOR & FS STONING PARTRER ETAT TT 6 INDUSTRY CCASSFCRTION ——CEOCRAPHICAT- CODE: —] OEE OTOL ETT srook20%) PuesGENERAL INFORMATION SHEET ‘STOCK CORPORATION PLEASE PRINT LEGIBLY_ ‘7 Is the Corporation a covered person under the Anti Money Laundering Act —~ ve, No (AMLA), as amended? (Rep. Acts. 9160/9164/10167/10365) Please check the appropriate box: 4] _ Jewelry dealers in precious metals, who, as a C1 & Oshore Banking Units ‘business trade in precious metals Cc Quast-Banks C1 a trust Entities Gl e. Non-Stock Savings and Loan Associations Gi & Pawnshops lg Foreign Exchage Dealers yb. Money Changers i i Remittance Agents ) 5, Bectronie Money Issuers Gi ke Financial institutions which Under Special Laws are subjectto Bangko Sentra ng Pilipinas’ (BSP) supervision and/or regulation, Including their subsidiaries and afflates Jewelry dealers in precious stones, who, as @ 7 business, trade in precious stone Company service providers which, as a business, provide any of the following services to third parti Ta Insurance Companies CO b. Insurance Agents CO insurance Brokers ¢ Professional Reinsurers CO e Reinsurance Brokers 1 6 Holding Companies 1 & Hoang Company Systems 5 b Premneed Companies Cl & Mutual Benefit Association 1 allother Persons and entities supervised and/or regulated by the Insurance Commission (10) “a acting as_a formation agent of juridical persons acting as (or arranging for another person to act a: director or corporate secretary of a company, a partner ofa partnership, ora similar position in relation to other juridical persons Te providing a registered office, business address or ‘ccommodation, correspondence or administrative adress fora company, a partnership or any other legal person or arrangement, Ta Securities Dealers Ob. Securities Brokers Ci c Securities Salesman a acting as (or arranging for another person to actas nominee shareholder for another person 7. Persons who provide any of the following services: CO a. Investment Houses Oe Investment Agents and Consultants OD trading advisors 1 & Other enios managing Securities or rendering similar services 1. Mutual Funds or Open-nd Investment Companies \. lose-end investment Compantes 5, common Trust Funds or ssuers and ater similar entides ie Transfer Companles and other sila eles 1 1 other enties administering or otherse dealing in currency, commodities or financial derivatives based tere on Cm nites administering of otherwise dealing in valuable objects (1 2. Entities administering or otherwise dealing in cash Substitutes and| other similar monetary instrument or propery supervised ‘nd/or regulated by the Secures and Exchange Commission (SEC) Has tne Corporation compiled with We requirements on Customer Due DIigemee (€DD) oF Know Your Customer (KY), record-keeping, and submission of reports under the AMLA, as amended, since the las ‘managing of client money, securities or other asset C1 b. management of bank, savings or securities account C. « organization of contributions for the creation, ‘operation or management of companies C1 a creation, operation or management of juridical persons or arrangements, and buying and selling business entities None ofthe above, Describe nature of business: CYes @No §is.stock(v.2018) +AGENERAL INFORMATION SHEET ‘STOCK CORPORATION = PLEASE PRINT LEGIBL’ [CORPORATE NAME: “CAPITAL STRUCTURE [AUTHORIZED CAPITAL STOCK + | Numpen or "AMOUNT (PHP) ‘TYPE OF SHARES: eae PAR/STATED VALUE. ie ecenarse x Pos faeora vee TOTAL ‘TOTAL >| [SUBSCRIDED CAPITAL =a NUMBER OF | xumperor |sHaresiv tHe] par/stareD wor Fitipino | stock. | TYPEOFSHARES ee | samen ee AMOUNT (PhP) pee HOLDERS pesorm Ae co bora Tor 7] NUMBER OF ronticn | noor uorcareay | sroce | rrreorsuanes+ | NuMmunor |suanss ous] ranysrar Amour ene) nor simonauiry) | wowDens amcor [Percentage of Foreign Equity: TOTAL [Foray Tort | "TOTAL SUBSCRIBED P| [PAID-UP CAPITAL Noor riirino | sroce | ryeeorsuanes> | *UMMEROP | pauysrarso VALUE Amour (ene) ee FORETEN | WEF nocareay | root | rvorsuanes+ | MUMBEROF | puaysrarepvauuE amour enn) | ay ith NATIONALITY) | HOLDERS aes Tora Tora | TOTAL PAIDUP_P NOTE: USE ADDITIONAL SHEET IF NECESSARY. Common, Preferred or other classification {= Other than Directors, Ofcers, Shareholders owning 10¥ af outstanding saree 18 STOCK (v2018) Page 2GENERAL INFORMATION SHEET ‘STOCK CORPORATION eeceeccneneeeeeennennneennenenes PLEASE PRINT LEGIBLY — [CORPORATE NAME: DIRECTORS / OFFICERS NAME AND NATIONALITY wer | BoarD | sex | STOCK | opricer EXEC. COMM. HOLDER r z 70 Tr 7% 74 5 [sTRucTION: FOR SEX COLUMN, PUT “F* FOR FEMALE, FOR MALE. FOR BOARD COLUMN, PUT"C” FOR CHAIRMAN, "MT FOR MEMBER, FOR INDEPENDENT DIRECTOR: FOR INC COLUMN, PUT" IF AN INCORPORATOR, "Nf HOT FOR STOCKHOLDER COLUMN, PUT“Y" IFA STOCKHOLDER, "IF NOT. FOR OFFICER COLUMN, INDICATE PARTICULAR POSITION IF AN OFFICER, FROM VP UP INCLUDING THE POSITION OF THE TREASURER, ‘SECRETARY, COMPLIANCE OFFICER ANDIOR ASSOCIATED PERSON. FOR EXECUTIVE COMMITTEE, INDICATE "CF MEMBER OF THE COMPENSATION COMMITTEE: A" FOR AUDIT COMBMTTEE; "N" FOR NOMINATION ANO ELECTION COMMITTEE. ADOVTIONALLY WRITE “C" AFTER SLASH IF CHAIRMAN AND "ut IF MEMBER Gis STOCK (v2018) PageGENERAL INFORMATION SHEET ‘STOCK CORPORATION ‘CORPORATE NAME: ‘TOTAL ASSETS BASED ON LATEST AUDITED FINANCIAL STATEMENTS: ‘STOCKHOLDER'S INFORMATION PLEASE PRINT LEGIBLY == ‘SHARES SUBSCRIBED NAME AND NATIONALITY vee | Numner AMOUNT (Phe) OF OWNER. SHIP AMOUNT PAID (Phe) ToTAT} TOTAL| Tora] ToTAL| TOTAL TOTAL ToTAl} "TOTAL AMOUNT OF SUBSCRIBED CAPITAL 0.00%] ‘TOTAL AMOUNT OF PAID-UP CAPITAL 0.00 INSTRUCTION: SPECIFY THE TOP 20 STOCKHOLDERS AND INDICATE THE REST AS OTHERS Totes For PD Nonmnce included ln helt, please Indicate further the beneficial owners owning more than 5% of any class of te companys voting TarTIGe Aach separate sheet. necessary. «is srock (v.2016) PagesGENERAL INFORMATION SHEET ‘STOCK CORPORATION ‘= PLEASE PRINT LEGIBLY =: ‘ORPORATE NAME: (OTAL NUMER OF STOCKHOLDERS [ores wiv ieeonmensianstc (OTAL ASSETS BASED ON LATEST AUDITED FS ‘STOCKHOLDER'S INFORMATION ‘SHARES SUBSCRIBED ‘AMOUNT PAID NAME AND NATIONALITY %OF ree | numer AONT | OWNER: cer) a ‘SIP TOTAL i TOTAL TOTAL T TOTAL z TOTAL TOTAL z TOTAL ‘TOTAL AMOUNT OF SUBSCRIBED CAPITAL 0.00% 0.00 ‘TOTAL AMOUNT OF PAID-UP CAPITAL INSTRUCTION: SPECIFY THE TOP 20 STOCKHOLDERS AND INDICATE THE REST AS OTHERS ie: For FOTE Nominee included in che lst, please indicate further the beneficial owners owning more than 39% of any class ofthe Companys voting ‘urities,Atach separate sheet, necessary. ‘is stock (v.2018)GENERAL INFORMATION SHEET ‘STOCK CORPORATION [conronaTe NAME: ‘STOCKHOLDERS INFORBTION NAME AND NATIONALITY a aout | oor reer ae co) ‘sr TOTAL ToTAL| TOTAL] Tora TE GHRERS Gaal he waar oT Fag sectbelder) Tora] TOTAL ANOUNT OF SUBSCRIBED CAPITAL 0.00% = "TOTALAMOUNT OF PAID-UP CAPITAL ie INSTRUCTION, SPECIFY THE TOP 20 STOCKHOLDERS AND INDICATE THE REST AS OTHERS [Rie Por OTE Rema cd ne poase nate rer he Beil wer owing ma han Tf any a companys Vtg TTB TA [new feces a sroeK 2030)(GENERAL INFORMATION SHEET ‘STOCK CORPORATION ‘PLEASE PRINT LEGIBLY INAME OF CORPORATION: [CORPORATE SUBSCRINERS (ANY. ‘SHOCRIOLDEN'S INFORMATION ‘SHARES SUBSCRIBED Name ANDNaTIONALITY — | —— ‘ROMER ‘AMOUNT ene) OF AMOUNT PAID (Par) TOTAL, TOTAL, TOTAL TOTAL TOTAL TOTAL TOTAL, [TOTAL AMOUNT OF SUBSCRIBED CAPITAL. [TOTAL AMOUNT OF PAID-UP CAPITAL 0.00% 0.00 INSTRUCTION: SPECIFY THE TOP 20 STOCKHOLDERS AND INDICATE THE REST AS OTHERS (sock (vo Attach separate STOCK (v.2019) [Notes Please indicate further che benefictal owners owning a Teast more than 5% of any class of the company outstanding caplaT Page 61GENERAL INFORMATION SHEET. ‘STOCK CORPORATION [NAME OF CORPORATION: NAME / RESIDENTIAL ADDRESS (OPTIONAL) POSITION/TITLE NATIONALITY 70 7 NOTE: USE ADDITIONAL SHEET IF NECESSARY lnote: Please indicate further the beneficial owners owning atleast more than 5% of any class of the company's outstanding capital stock (voting and non-voting). Attach separate sheet. if necessary. STOCK (v.2018) Page 62GENERAL INFORMATION SHEET ‘STOCK CORPORATION = PLEASE PRINT LEGIBLY CORPORATE NAME: {i INVESTMENT OF CORPORATE “AMOUNT (PRP) DATE OF BOARD RESOLUTION FUNDS IN ANOTHER CORPORATION A STOCKS ‘12 BONDS/COMMERCIAL PAPER (Issued by Private Corporations) LOANS/ CREDITS/ ADVANCES is 14 GOVERNMENT TREASURY BILLS TS OTHERS INVESTMENT OF CORPORATE FUNDS IN ACTIVITIES UNDER TITS DATE OF BOARD DATE OF ‘SECONDARY PURPOSES (PLEASE SPECIFY: RESOLUTION STOCKHOLDERS RATIFICATION. % ASTO THE TOTAL NO. OF SHARES ISSUED NO. OF SHARES [4 UNRESTRICTED /UNAPPROPRIATED RETAINED EARNINGS AS OF END OF LAST FISCAL YEAR [5. DIVIDENDS DECLARED DURING THE IMMEDIATELY PRECEDING YEAR ‘TYPE OF DIVIDEND AMOUNT (PhP) DATE DECLARED 5. CASH 52 _ STOCK 5.3 PROPERTY Tora | P [6. ADDITIONAL SHARES ISSUED DURING THE PERIOD: DATE NO. OF SHARES “AMOUNT [SECONDARY LICENSE/REGISTRATION WITH SEC AND OTHER GOV'T AGENCY, INAME OF AGENCY: SEC. BSP Te [TYPE OF JLIceNse/REGN. [DATE ISSUED: DATESTARTED JOPERATIONS ‘TOTAL ANNUAL COMPENSATION OF DIRECTORS DURING THE PRECEDING FISCAL YEAR (in PhP) ‘TOTALNO. OF RANK & FILE EMPLOYEES ‘TOTAL MANPOWER ‘TOTALNO. OF OFFICERS COMPLEMENT SSS TON EET ENE > Gis. STOCK (v.2018) Page?BENEFICIAL OWNERSHIP DECLARATION ‘A. Natural person who ultimately owns or controls the corporation: COMPLETE NAME (Surname, Given Name, Middle | SPECIFICRESIDENTIAL | NATIONALITY % OF TAK ‘Name, Name Extension ADDRESS: OWNERSHIP | IDENTIFICATION [le Je Ses It)) NO. B. Natural person who exercises ultimate effective control" over the corporation: COMPLETE NAME (Surname, Given Name, Middle | SPECIFICRESIDENTIAL | NATIONALITY % OF TAX Name, Name Extension ‘ADDRESS OWNERSHIP | IDENTIFICATION (le, Jes Se I)) No. ‘CORPORATE STOCKHOLDERS: ULTIMATE BENEFICIAL OWNER® COMPLETE NAME CORPORATE NAME | (Surname, Given Name, SPECIFIC % OF TAX AND Middle Name, Name | RESIDENTIAL | NATIONALITY | OWNERSHIP | IDENTIFICATION BUSINESS/TRADE Extension ‘ADDRESS, No. NAME [es Jr, Sr tI) OTHER STOCKHOLDER: ‘A. PARTNERSHIPS ULTIMATE BENEFICIAL OWNER® COMPLETE NAME PARTNERSHIP NAME | (Surname, Given Name, SPECIFIC % OF Tax Middle Name, Name || RESIDENTIAL | NATIONALITY | OWNERSHIP | IDENTIFICATION Extension ‘ADDRESS, NO. ie. Jr. Sr Ml) B_TRUSTS ULTIMATE BENEFICIAL OWNER® ‘COMPLETE NAME (Gurname, Given Name, SPECIFIC NATIONALITY % OF TAX NAME, Middle Name, Name | RESIDENTIAL OWNERSHIP. | IDENTIFICATION Extension ‘ADDRESS, No. fle. Jr, Sr I) * Refer to the definition of ultimate effective control under Section 2.2. of SEC Memorandum Circular No. 17, series of 2018. 2 Indicate the intermediate layers of the company’s ownership structure, any, ina separate sheet and attach an ownership chart clearly showing the intermediate layers with their respective ownership amounts ® Refer to the definition of beneficial owner under Sections 2.1 and 2.2. of SEC Memorandum Circular No. 17, series of 2018, ‘Refers tothe natural person who ultimately owns or controls the partnership or who exercises ultimate effective control over the partnership. 5 Identity of the persons who control the trust and make the investment decisions; trust beneficiaries and the trustee; and individuals who furnish funds into the trust. PagesBENEFICIAL OWNERSHIP DECLARATION ‘A. Natural person who ultimately owns or controls the corporation: COMPLETE NAME (Surname, Given Name, Middle | SPECIFICRESIDENTIAL | NATIONALITY % OF TAX ‘Name, Name Extension ADDRESS OWNERSHIP | IDENTIFICATION NO. B. Natural person who exercises ultimate effective control! over the corporation: COMPLETE NAME (Surname, Given Name, Middle | SPECIFICRESIDENTIAL | NATIONALITY % OF TAX Name, Name Extension ‘ADDRESS ‘OWNERSHIP | IDENTIFICATION fe, Ir, Se, IN]) No. CORPORATE STOCKHOLDERS? ULTIMATE BENEFICIAL OWNER® COMPLETE NAME CORPORATE NAME | (Surname, Given Name, SPECIFIC % OF TAX AND ‘Middle Name, Name | RESIDENTIAL | NaTionaLITY | OWNERSHIP | IDENTIFICATION BUSINESS/TRADE Extension ADDRESS, No. NAME fle. Jr, Sr IN) (OTHER STOCKHOLDERS: ‘A PARTNERSHIPS ULTIMATE BENEFICIAL OWNER® COMPLETE NAME PARTNERSHIP NAME | (Surname, Given Name, SPECIFIC % OF TAX Middle Name, Name | RESIDENTIAL | NATIONALITY | OWNERSHIP | IDENTIFICATION Extension ‘ADDRESS No. [ie. Jr. Se.) B_ TRUSTS ULTIMATE BENEFICIAL OWNER® COMPLETE NAME (Surname, Given Name, SPECIFIC NATIONALITY %6 OF TAK NAME ‘Middle Name, Name’ | RESIDENTIAL. OWNERSHIP | IDENTIFICATION Extension ‘ADDRESS, No. [e, Jr Se, HM) 4 Refer to the definition of ultimate effective control under Section 2.2. of SEC Memorandum Circular No. 17, series of 2018. * Indicate the intermediate layers of the company’s ownership structure, ifany, in a separate sheet and attach an ownership ‘hart clearly showing the intermediate layers with their respective ownership amounts. + Refer to the definition of beneficial owner under Sections 2.1 and 2.2. of SEC Memorandum Circular No. 17, series of 2018, ‘Refers to the natural person who ultimately owns or controls the partnership or who exercises ultimate effective control over the partnership. 5 Identity of the persons who control the trust and make the investment decisions; trust beneficiaries and the trustee; and individuals who furnish funds into the trust. PagesCorporate Secretary of —__ declare under penalty of perjury that all matters set forth in this GIS have been duly verified by me and to the best of my knowledge and belief are true and correct. By indicating herein the personal information of the incorporators, stockholders, directors, officers, beneficial owners, external auditor, notary public and their agents, I attest that the aforementioned persons authorize the SEC to: (1) collect, process and store their personal information through the GIS forms and related documents, for the period allowed under the applicable laws and regulations; and (2) share with and make available the GIS to interested Parties in order to pursue lawful purposes and legitimate interests, and comply with legal mandate. also attest that the company and the aforementioned persons authorized the undersigned to file this GIS with SEC, and the information provided herein are true, accurate, timely and complete. | further attest that they are aware of their rights under the Data Privacy Act, including the right to be informed, to access, to object, to erasure or blocking, to damages, to file a complaint, to rectify and to data portability, and understand that there are procedures, conditions and exceptions to be complied with in order to exercise or invoke such rights. likewise understand that the failure of the corporation to file this GIS for five (5) consecutive years shall be construed as non-operation of the corporation and a ground for the revocation of the corporations’ certificate of incorporation in this eventuality, the corporation hereby waives its right to hearing for the said revocation. Done this day of. 20___in (Signature over printed name) SUBSCRIBED AND SWORN TO before me in on by affiant who personally appeared before me and exhibited to me his/her competent evidence of identity consisting of, issued at on ; NOTARY PUBLICGENERAL INFORMATION SHEET STOCK CORPORATION [CORPORATE NAM LIST OF STOCKHOLDERS DIRECTORS AND OFFICERS ‘TAX IDENTIFICATION NO. (TIN) INFORMATION NAME AND CURRENT RESIDENTIAL ADDRESS NATIONALITY T [nsraucrioN FOR POSITION COLUMN, PUT THE FOLLOWING IP APPLICABLE: “cfor Chatman "6° for Member," for Independent Director and/or Indleatethe Particular Postion, Ofer (eg, resident, Treurr, Corporat Secretary ete) and/or "Stor tackalder, NOTE: USE ADDITIONAL SHEET IF NECESSARY