Process of claiming the unclaimed deposit / activating inoperative

J.P Morgan Chase Bank, N.A., India Branches

Process of claiming the unclaimed deposit / activating

inoperative account

April 2024

Process of claiming the unclaimed deposit / activating the inoperative account

In order to reactivate an inoperative account, customer will have to provide fresh Know Your

Customer (KYC) documents and start transacting in their account. along with the relevant documents

as listed below. This is an indicative list of documents and is subject to change as per the applicable

regulations issued from time to time. Please reach out to your relationship manager or client service

representative if you have questions.

• Annexure 1 – List of Documents for KYC

• Annexure 2 – Self-Certification Form CRS – E

• Annexure 3 – Form W-8BEN-E

• Annexure 4 - Know Your Customer (KYC) Application Form (Legal Entity/ Other than Individuals)

• Annexure 5 - Know Your Customer (KYC) Application Form (Related Persons)

• Annexure 6 – LEI Instructions

KYC Documents

Requirements

Documents for Know Your Customer (KYC)

No.

Document

Ownership Structure

- Please provide a certified full ownership chart with %, up to the ultimate parent company entity, and including any/ all

shareholders / Ultimate Beneficial Owner(s) (UBOs) of 10% or more.

(Where no natural person is identified above, then the person holding Senior managing official in the entity becomes the

BO. Example : Senior Official such as C-suite individuals.

Additionally then we would require PAN / Adhaar / Financial Status like estimated Networth document of Senior managing

official / UBO will be required)

List of Directors - Please confirm if we can utilize from MCA ?

List of Senior Managers - Please provide a list of Senior Managers

Note - Senior manager is the natural person(s) who exercises executive control over the daily or regular affairs of the legal

entity customer through a senior management position, such as (but not limited to) a chief executive officer (CEO), chief

financial officer (CFO), managing or executive director, or president etc., or equivalent depending on the client's entity

hierarchy.

PAN Card

- Please certify the document following below guidelines

Certificate of Incorporation

- Please certify the document following below guidelines

Memorandum and Articles of Association

- Please certify the document following below guidelines

Board Resolution

- Please provide a BR Certified by Company Secretary or 2 Directors or Signatories

Signatories KYC Document

For Indian nationals: PAN + Any 1 of Adhaar/Passport/Driving License + Latest Photo + Specimen Signatures

For Foreign Nationals:

1) Passport (containing address) / Driving License (containing address) or Passport/Driving License + Utility Bill not older

than 2 months (notarized by public notary)

2) Kindly confirm over email that these signatories do not have any PAN nor taxable income in India requiring such

person to obtain a PAN and/or have not entered into transactions covered in Rule 114B in India.

Note - We will leverage the KYC documents available in the J.P. Morgan repository if the signatories are already onboarded

for any of your group entities.

CRS & W8BENE Forms

CKYC forms- Required for both entity and Individuals (all Authorized signatories & UBO)

Request you to please provide response to below queries as these can be closed via email confirmation:

- Registered address – Kindly confirm if the registered address on MCA is valid to be considred in our records

- Physical Address: Please confirm over email that the registered address and physical address are the same. In case if the

physical address is different, we will require the evidence for the same. (e.g. GST certificate/utility bill within 2 months)

- Mailing Address - Please confirm if there is any other mailing address apart from Registered / Physical Address

Certification Guidelines*

Company documents need to be certified by “Any whole time Director OR Company Secretary OR individuals authorized by Board

Resolution” and should include the following-

I. A sentence such as “I certify this is a true copy of the original / Certified True Copy” or language to that effect

b. Signature of the certifier

c. Full name of certifier

d. Job role / Professional title

e. Date of certification

Individuals KYC documents to be OSV'd by JPMC Employee . If foreign Nationals then we can accept Notarized documents or

OSV'd by JPMC Employee of that location.

Annexure - Self-Certification Form CRS - E

Entity Tax Residency

Self-Certification Form

CRS - E

December 2016

Please read these instructions before completing the form.

Regulations based on the Organisation for Economic Cooperation and Development

("OECD") Common Reporting Standard (“CRS”) require Financial Institutions ("FIs") to collect

and report certain information about an account holder’s tax residency. If the account holder’s

tax residence is located outside the country where the FI maintaining the account is located,

we may be legally obliged to pass on the information in this form and other financial

information with respect to your financial accounts to the tax authorities in the country where

the FI is located and they may exchange this information with tax authorities of another

jurisdiction or jurisdictions pursuant to intergovernmental agreements to exchange financial

account information.

How to complete this form

Who should complete this form?

Please complete this form where you need to self-certify on behalf of an entity account holder.

•

If you are an individual account holder or sole trader or sole proprietor do not complete this form. Instead

please complete an “Individual tax residency self-certification form”.

•

For joint or multiple account holders please complete a separate form for each account holder.

If the Account Holder is a U.S. tax resident under U.S. law, you should indicate that you are a U.S. tax resident on this

form and you also need to complete and provide an IRS W-9 form. For more information on tax residence, please

consult your tax adviser or the information at the following link: OECD automatic exchange of information portal.

Where the Account Holder is a Passive Non Financial Entity ("NFE"), or an Investment Entity located in a Non-

Participating Jurisdiction managed by another Financial Institution: Please provide information on the natural person(s)

who exercise control over the Account Holder (individuals referred to as “Controlling Person(s)”) by completing a

“Controlling Person tax residency self-certification form” for each Controlling Person. This information should be

provided by all Investment Entities located in a Non-Participating Jurisdiction managed by another FI.

You should indicate the capacity in which you have signed in Part 4 (e.g., as custodian or nominee of an account on behalf

of the account holder, or under a signatory authority or power of attorney).

1 http://www.oecd.org/tax/automatic-exchange/

Understanding the Terminology

You can find summaries of defined terms such as an "Account Holder", entity classifications such as

“Financial Institution” and “International Organisation” and other terms, in the Appendix.

For additional information on overcoming common form rejection reasons please refer to the following link

https://www.jpmorgan.com/directdoc/assist-completion-CRS-self-certification.pdf

Validity of form and No Tax Advice notice

This form is intended to request information consistent with local law requirements.

This form will remain valid unless there is a change in circumstances relating to information, such as

the Account Holder’s tax status or other mandatory field information that makes the form incorrect or

incomplete. In that case you must notify us and provide an updated self-certification.

As a financial institution, we are not allowed to give tax advice. Your tax adviser may be able to

assist you in answering specific questions on this form. Your domestic tax authority can provide

guidance regarding how to determine your tax status.

More information on the rules

You can find out more information, including a list of jurisdictions that have signed agreements to automatically

exchange information, along with details about the information being requested, on the OECD automatic exchange

of information portal at http://www.oecd.org/tax/automatic-exchange/.

Mandatory fields are marked with *

Entity tax residency self-certification form (CRS – E)

Please complete parts 1-3 by typing the details into the form or using BLOCK CAPITALS if completing by hand. Mandatory fields

are marked with *.

Part 1 - Identification of the Account Holder

A: Legal Name of Entity/Branch*

B: Country of incorporation or organisation*

C: Current Residence Address*

Line1 House/Apt/Suite, Name, Number, Street

Line 2 Town/City/, Province/County/State

Country

Postal Code/Zip Code

D: Mailing Address (please only complete if different from your current residence address above)

Line1 House/Apt/Suite, Name, Number, Street

Line 2 Town/City/, Province/County/State

Country

Postal Code/Zip Code

❑

Part 2* - Entity Type

Please classify the Account Holder by selecting one of the following. Further information on definitions can be found in the

Appendix.

Entity Type*

Financial Institution - Investment Entity

(i.)

An Investment Entity located in a Non-Participating Jurisdiction and managed by another Financial Institution

(ii.)

Other Investment Entity

Financial Institution – Depository Institution, Custodial Institution or Specified Insurance Company

Active NFE – a corporation the stock of which is regularly traded on an established securities market or a corporation

which is a related entity of such a corporation

Active NFE – a Government Entity or Central Bank

Active NFE – an International Organisation

Active NFE – other than C–E

Passive NFE

Please provide additional required information depending on your entity type above.

Additional Entity Information

Entity Type Information needed

A or B

If you have selected A or B above, please provide, if held, the Account Holder’s Global Intermediary Identification

Number (“GIIN”) obtained for FATCA purposes.

If you have selected C, please provide the name of the established securities market on which the corporation is

regularly traded:

If you are a Related Entity of a regularly traded corporation, please provide the name of that regularly traded

corporation: The Entity classified as C is a Related Entity of .

A (i.) or G

Controlling Persons of Passive

NFEs

Please indicate the name of

any Controlling Person(s) of

the Account Holder*

Please complete a “Controlling Person tax residency self-certification form” for each Controlling Person.*

Note: Please see definition of Controlling Person in Appendix. If there are no natural person(s) who exercise control

of the Entity then the Controlling Person will be the natural person(s) who hold the position of senior managing official.

Part 3* - Country of Residence for Tax Purposes and related Taxpayer Identification Number or

functional equivalent* (“TIN”) (see Appendix)

Please complete the following table indicating:

(i)

where the Account Holder is tax resident, and

(ii)

the Account Holder’s TIN for each country indicated.

Please note:

•

If the Account Holder is not tax resident in any jurisdiction (e.g., because it is fiscally transparent), please indicate

that on line 1 and provide its place of effective management or country in which its principal office is located.

•

If the Account Holder is tax resident in more than three countries please use a separate sheet.

•

If a TIN is unavailable please provide the appropriate reason A, B or C where appropriate:

Reason A:

The country/jurisdiction where the Account Holder is resident does not issue TINs to its residents

Reason B:

The Account Holder is otherwise unable to obtain a TIN or equivalent number.

Please explain why you are unable to obtain a TIN in the table below if you have selected this reason.

Reason C:

No TIN is required.

Please only select this reason if the domestic law of the relevant jurisdiction does not require the collection of the TIN issued by

such country/jurisdiction

Country/Jurisdiction of tax residence

TIN

If no TIN available enter Reason A,B or C

Please explain in the following boxes why you are unable to obtain a TIN if you selected Reason B above.

Part 4*

Declaration and Signature

The Account Holder understands that the information supplied by it is covered by the full provisions of the terms and conditions

governing the Account Holder’s relationship with the Financial Institution setting out how the Financial Institution may use and

share the information supplied by the Account Holder.

The Account Holder acknowledges that the Financial Institution may disclose and transfer to the Financial Institution’s parent

companies, and its and their respective branches, subsidiaries, affiliates, representative offices, or third party service providers

located anywhere in the world (in or outside the country or jurisdiction in which the Account Holder resides, in which their

relationship with the Financial Institution is maintained, in which the account or transaction is booked, in which information is

collected and/or retained or in which the transaction is conducted) the information contained in this form and other information

regarding the Account Holder, any Controlling Person and any Reportable Account(s) when considered necessary by the

Financial Institution for its business purposes or in connection with, to comply with, or to facilitate compliance with, any law,

regulation, court order or requirement (including under any code, guideline, standard, policy, circular or notice) of a

governmental, regulatory, supervisory, law enforcement, prosecuting, tax or similar authority or industry body in any jurisdiction

existing currently or in the future, or for the purposes of ongoing cooperation with such governmental, regulatory and/or

statutory authority, or to comply with any agreement or arrangement with such authority or between such authorities in any

jurisdiction existing currently or in the future. The Account Holder consents to and instructs and authorizes the Financial

Institution to make such disclosures and transfers and expressly waive any protection or right under data protection,

confidentiality, or any other applicable law, to the extent necessary for such disclosures and transfers.

The Account Holder acknowledges that the information contained in this form and information regarding the Account Holder may

be reported to the tax authorities of the country/jurisdiction in which this account(s) is/are maintained and exchanged with tax

authorities of another country/jurisdiction or countries/jurisdictions in which the Account Holder may be tax resident pursuant to

intergovernmental agreements to exchange financial account information.

I certify that I am authorised to sign for the Account Holder in respect of all the account(s) to which this form relates.

The Account Holder declares that all statements made in this declaration are, to the best of its knowledge and belief,

correct and complete.

The Account Holder undertakes to advise the Financial Institution, within 90 days of any change in circumstances which affects

the tax residency status of the Account Holder identified in Part 1 of this form or causes the information contained herein to

become incorrect or incomplete (including any changes to the information on controlling persons identified in Part 2 question 2a),

and to provide the Financial Institution that maintains the account with a suitably updated self-certification and Declaration within

90 days of such change in circumstances.

Signature:*

Print name:*

Date:* (dd/mm/yyyy)

Capacity*

Please indicate the capacity in which you are signing the form (for example ‘Authorised Officer’).

If signing under a power of attorney please also attach a certified copy of the power of attorney.

Appendix – Summary Descriptions of Select Defined Terms

Note: These are selected summaries of defined terms provided to assist you with the completion of this form. Further details can

be found within the OECD “Common Reporting Standard for Automatic Exchange of Financial Account Information” (the “CRS”),

the associated “Commentary” to the CRS, and domestic guidance. Relevant information can be found at the OECD automatic

exchange of information portal at http://www.oecd.org/tax/automatic-exchange/.

If you have any questions then please contact your tax adviser or domestic tax authority.

Account Holder

The “Account Holder” is the person listed or identified as the holder of a Financial Account by the

Financial Institution that maintains the account. This is regardless of whether such person is a flow-

through Entity. Thus, for example, if a trust or an estate is listed as the holder or owner of a Financial

Account, the trust or estate is the Account Holder, rather than the trustee or the trust’s owners or

beneficiaries. Similarly, if a partnership is listed as the holder or owner of a Financial Account, the

partnership is the Account Holder, rather than the partners in the partnership. A person, other than a

Financial Institution, holding a Financial Account for the benefit or account of another person as agent,

custodian, nominee, signatory, investment advisor, or intermediary, is not treated as holding the

account, and such other person is treated as holding the account.

Active NFE

An Active NFE if it meets any of the criteria listed below. In summary, those criteria refer to:

•

active NFEs by reason of income and assets;

•

publicly traded NFEs;

•

Governmental Entities, International Organisations, Central Banks, or their wholly

owned Entities;

•

holding NFEs that are members of a non-financial group;

•

start-up NFEs;

•

NFEs that are liquidating or emerging from bankruptcy;

•

treasury centres that are members of a non-financial group; or

•

non-profit NFEs.

An entity will be classified as an Active NFE if it meets any of the following criteria:

less than 50% of the NFE’s gross income for the preceding calendar year or other

appropriate reporting period is passive income and less than 50% of the assets held by

the NFE during the preceding calendar year or other appropriate reporting period are

assets that produce or are held for the production of passive income;

the stock of the NFE is regularly traded on an established securities market or the NFE

is a Related Entity of an Entity the stock of which is regularly traded on an established

securities market;

the NFE is a Governmental Entity, an International Organisation, a Central Bank, or an

Entity wholly owned by one or more of the foregoing;

substantially all of the activities of the NFE consist of holding (in whole or in part) the

outstanding stock of, or providing financing and services to, one or more subsidiaries

that engage in trades or businesses other than the business of a Financial Institution,

except that an Entity does not qualify for this status if the Entity functions (or holds itself

out) as an investment fund, such as a private equity fund, venture capital fund,

leveraged buyout fund, or any investment vehicle whose purpose is to acquire or fund

companies and then hold interests in those companies as capital assets for investment

purposes;

the NFE is not yet operating a business and has no prior operating history (a "start-up

NFE”) but is investing capital into assets with the intent to operate a business other than that of a

Financial Institution, provided that the NFE does not qualify for this exception after the date that is

24 months after the date of the initial organisation of the NFE;

the NFE was not a Financial Institution in the past five years, and is in the process of

liquidating its assets or is reorganising with the intent to continue or recommence

operations in a business other than that of a Financial Institution;

the NFE primarily engages in financing and hedging transactions with, or for, Related

Entities that are not Financial Institutions, and does not provide financing or hedging

services to any Entity that is not a Related Entity, provided that the group of any such

Related Entities is primarily engaged in a business other than that of a Financial

Institution; or

the NFE meets all of the following requirements (a “non-profit NFE”)

it is established and operated in its jurisdiction of residence exclusively for

religious, charitable, scientific, artistic, cultural, athletic, or educational purposes; or

it is established and operated in its jurisdiction of residence and it is a professional

organisation, business league, chamber of commerce, labour organisation,

agricultural or horticultural organisation, civic league or an organisation operated

exclusively for the promotion of social welfare;

ii)

it is exempt from income tax in its jurisdiction of residence;

iii)

it has no shareholders or members who have a proprietary or beneficial interest in

its income or assets;

iv)

the applicable laws of the NFE’s jurisdiction of residence or the NFE’s formation

documents do not permit any income or assets of the NFE to be distributed to, or

applied for the benefit of, a private person or non-charitable Entity other than

pursuant to the conduct of the NFE’s charitable activities, or as payment of

reasonable compensation for services rendered, or as payment representing the

fair market value of property which the NFE has purchased; and

the applicable laws of the NFE’s jurisdiction of residence or the NFE’s formation

documents require that, upon the NFE’s liquidation or dissolution, all of its assets

be distributed to a Governmental Entity or other non-profit organisation, or escheat

to the government of the NFE’s jurisdiction of residence or any political subdivision.

Note: Certain entities (such as U.S. Territory NFFEs) may qualify for Active NFFE status under

FATCA but not Active NFE status under the CRS.

Control

"Control" over an Entity is generally exercised by the natural person(s) who ultimately has a

controlling ownership interest (typically on the basis of a certain percentage (e.g. 10%)) in the

Entity. Where no natural person(s) exercises control through ownership interests, the Controlling

Person(s) of the Entity will be the natural person(s) who exercises control of the Entity through

other means. Where no natural person or persons are identified as exercising control of the Entity

through ownership interests, the Controlling Person of the Entity is deemed to be the natural person

who holds the position of senior managing official.

Controlling Person(s)

“Controlling Person(s)” are the natural person(s) who exercise control over an entity. Where that

entity is treated as a Passive Non-Financial Entity (“Passive NFE”) then a Financial Institution is

required to determine whether or not these Controlling Persons are Reportable Persons. This

definition corresponds to the term “beneficial owner” described in Recommendation 10 and the

Interpretative Note on Recommendation 10 of the Financial Action Task Force

Recommendations (as adopted in February 2012).

In the case of a trust, the Controlling Person(s) are the settlor(s), the trustee(s), the protector(s) (if

any), the beneficiary(ies) or class(es) of beneficiaries, or any other natural person(s) exercising

ultimate effective control over the trust (including through a chain of control or ownership). Under

the CRS the settlor(s), the trustee(s), the protector(s) (if any), and the beneficiary(ies) or

class(es) of beneficiaries, are always treated as Controlling Persons of a trust, regardless of

whether or not any of them exercises control over the activities of the trust.

Where the settlor(s) of a trust is an Entity then the CRS requires Financial Institutions to also

identify the Controlling Persons of the settlor(s) and when required report them as Controlling

Persons of the trust. In the case of a legal arrangement other than a trust, “Controlling Person(s)”

means persons in equivalent or similar positions.

Custodial Institution

The term “Custodial Institution” means any Entity that holds, as a substantial portion of its

business, Financial Assets for the account of others. This is where the Entity’s gross income

attributable to the holding of Financial Assets and related financial services equals or exceeds

20% of the Entity’s gross income during the shorter of: (i) the three-year period that ends on 31

December (or the final day of a non-calendar year accounting period) prior to the year in which

the determination is being made; or (ii) the period during which the Entity has been in existence.

Depository Institution

The term “Depository Institution” means any Entity that accepts deposits in the ordinary course of

a banking or similar business.

FATCA

FATCA stands for the US provisions commonly known as the Foreign Account Tax Compliance

Act, which were enacted into US law as part of the Hiring Incentives to Restore Employment

(HIRE) Act on March 18, 2010. FATCA creates a new information reporting and withholding

regime for payments made to certain non-US financial institutions and other non-US entities.

Entity

The term “Entity” means a legal person or a legal arrangement, such as a corporation,

organisation, partnership, trust or foundation. This term covers any person other than an

individual (i.e. a natural person).

Financial Account

A Financial Account is an account maintained by a Financial Institution and includes: Depository

Accounts; Custodial Accounts; Equity and debt interest in certain Investment Entities; Cash Value

Insurance Contracts; and Annuity Contracts.

Financial Institution

The term “Financial Institution” means a “Custodial Institution”, a “Depository Institution”, an

“Investment Entity”, or a “Specified Insurance Company”. Please see the relevant domestic

guidance and the CRS for further classification definitions that apply to Financial Institutions.

International Organisation

International Organisation” includes any intergovernmental organisation (including a

supranational organisation), or wholly owned agency or instrumentality of such an organisation,

that:

•

primarily comprises governments; and

•

has in effect a headquarters or substantially similar agreement with a jurisdiction; and

•

the income of which is not for the benefit of private persons.

Arrangements substantially similar to headquarters arrangements include, for example,

arrangements that entitle the organisation’s offices or establishments in the jurisdiction (e.g. a

subdivision, or a local or regional office) to privileges and immunities.

Investment Entity

The term “Investment Entity” includes two types of Entities:

an Entity that primarily conducts as a business one or more of the following

activities or operations for or on behalf of a customer:

• Trading in money market instruments (cheques, bills, certificates of deposit,

derivatives, etc.); foreign exchange; exchange, interest rate and index

instruments; transferable securities; or commodity futures trading;

• Individual and collective portfolio management; or

• Otherwise investing, administering, or managing Financial Assets or money on

behalf of other persons. Such activities or operations do not include rendering

non-binding investment advice to a customer.

ii)

The second type of “Investment Entity” (“Investment Entity managed by another

Financial Institution”) is any Entity the gross income of which is primarily

attributable to investing, reinvesting, or trading in Financial Assets where the Entity

is managed by another Entity that is a Depository Institution, a Custodial Institution,

a Specified Insurance Company, or the first type of Investment Entity.

Investment Entity located

in a Non-Participating

Jurisdiction and managed

by another Financial

Institution

The term “Investment Entity located in a Non-Participating Jurisdiction and managed by another

Financial Institution” means any Entity the gross income of which is primarily attributable to

investing, reinvesting, or trading in Financial Assets if the Entity is (i) managed by a Financial

Institution and (ii) not a Participating Jurisdiction Financial Institution.

Investment Entity

managed by another

Financial Institution

An Entity is “managed by” another Entity if the managing Entity performs, either directly or

through another service provider on behalf of the managed Entity, any of the activities or

operations described in clause (i) above in the definition of "Investment Entity".

An Entity only manages another Entity if it has discretionary authority to manage the other

Entity’s assets (either in whole or part). Where an Entity is managed by a mix of Financial

Institutions, NFEs or individuals, the Entity is considered to be managed by another Entity that is

a Depository Institution, a Custodial Institution, a Specified Insurance Company, or the first type

of Investment Entity, if any of the managing Entities is such another Entity.

NFE

An “NFE” is any Entity that is not a Financial Institution.

Non-Reporting Financial

Institution

A Non-Reporting Financial Institution” means any Financial Institution that is:

•

a Governmental Entity, International Organisation or Central Bank, other than with

respect to a payment that is derived from an obligation held in connection with a

commercial financial activity of a type engaged in by a Specified Insurance Company,

Custodial Institution, or Depository Institution;

•

a Broad Participation Retirement Fund; a Narrow Participation Retirement Fund; a

Pension Fund of a Governmental Entity, International Organisation or Central Bank; or

a Qualified Credit Card Issuer;

•

an Exempt Collective Investment Vehicle;

•

a Trustee-Documented Trust: a trust where the trustee of the trust is a Reporting

Financial Institution and reports all information required to be reported with respect to

all Reportable Accounts of the trust; or

•

any other defined in a country's domestic law as a Non-Reporting Financial Institution.

Participating Jurisdiction

A “Participating Jurisdiction” means a jurisdiction with which an agreement is in place pursuant

to which it will provide the information required on the automatic exchange of financial account

information set out in the Common Reporting Standard and that is identified in a published list.

Participating Jurisdiction

Financial Institution

The term “Participating Jurisdiction Financial Institution" means:

(i)

any Financial Institution that is tax resident in a Participating Jurisdiction, but excludes any

branch of that Financial Institution that is located outside of that jurisdiction, and

(ii)

any branch of a Financial Institution that is not tax resident in a Participating Jurisdiction, if

that branch is located in such Participating Jurisdiction.

Passive NFE

Under the CRS a “Passive NFE” means any NFE that is not an Active NFE. An Investment Entity

located in a Non-Participating Jurisdiction and managed by another Financial Institution is also

treated as a Passive NFE for purposes of the CRS.

Related Entity

An Entity is a “Related Entity” of another Entity if either Entity controls the other Entity, or the two

Entities are under common control. For this purpose control includes direct or indirect ownership

of more than 50% of the vote and value in an Entity.

Reportable Account

The term “Reportable Account” means an account held by one or more Reportable Persons or by

a Passive NFE with one or more Controlling Persons that is a Reportable Person.

Reportable Jurisdiction

A "Reportable Jurisdiction" is a jurisdiction with which an obligation to provide financial account

information is in place and that is identified in a published list.

Reportable Jurisdiction

Person

A "Reportable Jurisdiction Person" is an Entity that is tax resident in a Reportable Jurisdiction(s)

under the tax laws of such jurisdiction(s) - by reference to local laws in the country where the

Entity is established, incorporated or managed. An Entity such as a partnership, limited liability

partnership or similar legal arrangement that has no residence for tax purposes shall be treated

as resident in the jurisdiction in which its place of effective management is situated. As such if an

Entity certifies that it has no residence for tax purposes it should complete the form stating the

address of its principal office.

Dual resident Entities may rely on the tiebreaker rules contained in tax conventions (if applicable)

to determine their residence for tax purposes.

Reportable Person

A “Reportable Person” is defined as a “Reportable Jurisdiction Person”, other than:

•

a corporation the stock of which is regularly traded on one or more established

securities markets;

•

any corporation that is a Related Entity of a corporation described above;

•

a Governmental Entity;

•

an International Organisation;

•

a Central Bank; or

•

a Financial Institution (except for an Investment Entity described in Sub Paragraph A(6)

b) of the CRS that is not are Participating Jurisdiction Financial Institution. Instead, such

Investment Entities are treated as Passive NFEs.)

Resident for tax purposes

Each jurisdiction has its own rules for defining tax residence, and jurisdictions have provided

information on how to determine whether an entity is tax resident in the jurisdiction on the

following website: http://www.oecd.org/tax/automatic-exchange/.

Generally, an Entity will be resident for tax purposes in a jurisdiction if, under the laws of that

jurisdiction (including tax conventions), it pays or should be paying tax therein by reason of its

domicile, residence, place of management or incorporation, or any other criterion of a similar

nature, and not only from sources in that jurisdiction. Dual resident Entities may rely on the

tiebreaker rules contained in tax conventions (if applicable) to solve cases of double residence

for determining their residence for tax purposes. An Entity such as a partnership, limited liability

partnership or similar legal arrangement that has no residence for tax purposes shall be treated as

resident in the jurisdiction in which its place of effective management is situated. For additional

information on tax residence, please talk to your tax adviser or see the OECD automatic

exchange of information portal at http://www.oecd.org/tax/automatic-exchange/.

Specified Insurance

Company

The term “Specified Insurance Company” means any Entity that is an insurance company (or the

holding company of an insurance company) that issues, or is obligated to make payments with

respect to, a Cash Value Insurance Contract or an Annuity Contract.

TIN (including “functional

equivalent”)

The term “TIN” means Taxpayer Identification Number or a functional equivalent in the absence of

a TIN. A TIN is a unique combination of letters or numbers assigned by a jurisdiction to an

individual or an Entity and used to identify the individual or Entity for the purposes of

administering the tax laws of such jurisdiction. Further details of acceptable TINs can be found at

the OECD automatic exchange of information portal at http://www.oecd.org/tax/automatic-

exchange/. Some jurisdictions do not issue a TIN. However, these jurisdictions often utilise some

other high integrity number with an equivalent level of identification (a “functional equivalent”).

Examples of that type of number include, for Entities, a Business/company

registration code/number.

Annexure Form W-8BEN0E

Form

W-8BEN-E

(Rev. October 2021)

Department of the Treasury

Internal Revenue Service

Do NOT use this form for:

Certificate of Status of Beneficial Owner for

United States Tax Withholding and Reporting (Entities)

▶

For

use

entities.

Individuals

must

use

Form

W-8BEN.

▶

Section

references

are

the

Internal

Revenue

Code.

▶

Go to www.irs.gov/FormW8BENE for instructions and the latest information.

▶

Give this form to the withholding agent or payer. Do not send to the IRS.

OMB No. 1545-1621

Instead use Form:

•

U.S. entity or U.S. citizen or resident ...........................................................................................................................................................................W-9

•

A foreign individual . . . . . . . . . . . . . . . . . . . . . . . . . . . . W-8BEN (Individual) or Form 8233

•

A foreign individual or entity claiming that income is effectively connected with the conduct of trade or business within the United States

(unless claiming treaty benefits) ............................................................................................................................................................................. W-8ECI

•

A foreign partnership, a foreign simple trust, or a foreign grantor trust (unless claiming treaty benefits) (see instructions for exceptions) . . W-8IMY

•

A foreign government, international organization, foreign central bank of issue, foreign tax-exempt organization, foreign private foundation, or

government of a U.S. possession claiming that income is effectively connected U.S. income or that is claiming the applicability of section(s) 115(2),

501(c), 892, 895, or 1443(b) (unless claiming treaty benefits) (see instructions for other exceptions) ...................................................

W-8ECI or W-8EXP

•

Any person acting as an intermediary (including a qualified intermediary acting as a qualified derivatives dealer) ............................................... W-8IMY

Part I

Identification of Beneficial Owner

1 Name of organization that is the beneficial owner

2 Country of incorporation or organization

Name of disregarded entity receiving the payment (if applicable, see instructions)

Chapter 3 Status (entity type) (Must check one box only):

Simple trust Tax-exempt organization

Central Bank of Issue Private foundation

Grantor trust Disregarded entity

Corporation

Complex trust

Estate

International organization

Partnership

Foreign Government - Controlled Entity

Foreign Government - Integral Part

you

entered

disregarded

entity,

partnership,

simple

trust,

grantor

trust

above,

the

entity

hybrid

making

treaty

claim?

“Yes,”

complete

Part

III.

Yes

Chapter 4 Status (FATCA status) (See instructions for details and complete the certification below for the entity's applicable status.)

Nonparticipating FFI (including an FFI related to a Reporting IGA

FFI other than a deemed-compliant FFI, participating FFI, or

exempt beneficial owner).

Participating FFI.

Reporting Model 1 FFI.

Reporting Model 2 FFI.

Registered deemed-compliant FFI (other than a reporting Model 1

FFI, sponsored FFI, or nonreporting IGA FFI covered in Part XII).

See instructions.

Sponsored FFI

Name of sponsoring entity:

Check whichever box applies.

I certify that the entity identified in Part I:

•

Is an investment entity;

•

Is not a QI, WP (except to the extent permitted in the withholding foreign partnership agreement), or WT; and

•

Has agreed with the entity identified above (that is not a nonparticipating FFI) to act as the sponsoring entity for this entity.

I certify that the entity identified in Part I:

•

Is a controlled foreign corporation as defined in section 957(a);

•

Is not a QI, WP, or WT;

•

Is wholly owned, directly or indirectly, by the U.S. financial institution identified above that agrees to act as the sponsoring entity for this entity; and

•

Shares a common electronic account system with the sponsoring entity (identified above) that enables the sponsoring entity to identify all account

holders and payees of the entity and to access all account and customer information maintained by the entity including, but not limited to, customer

identification information, customer documentation, account balance, and all payments made to account holders or payees.

Form W-8BEN-E (Rev. 10-2021)

Part VI

Part VII

I certify that the FFI identified in Part I:

•

Operates and is licensed solely as a bank or credit union (or similar cooperative credit organization operated without profit) in its country of

incorporation or organization;

•

Engages primarily in the business of receiving deposits from and making loans to, with respect to a bank, retail customers unrelated to such

bank and, with respect to a credit union or similar cooperative credit organization, members, provided that no member has a greater than 5%

interest in such credit union or cooperative credit organization;

•

Does not solicit account holders outside its country of organization;

•

Has no fixed place of business outside such country (for this purpose, a fixed place of business does not include a location that is not

advertised to the public and from which the FFI performs solely administrative support functions);

•

Has no more than $175 million in assets on its balance sheet and, if it is a member of an expanded affiliated group, the group has no more

than $500 million in total assets on its consolidated or combined balance sheets; and

•

Does not have any member of its expanded affiliated group that is a foreign financial institution, other than a foreign financial institution that

is incorporated or organized in the same country as the FFI identified in Part I and that meets the requirements set forth in this part.

Certified Deemed-Compliant FFI with Only Low-Value Accounts

I certify that the FFI identified in Part I:

•

Is not engaged primarily in the business of investing, reinvesting, or trading in securities, partnership interests, commodities, notional

principal contracts, insurance or annuity contracts, or any interest (including a futures or forward contract or option) in such security,

partnership interest, commodity, notional principal contract, insurance contract or annuity contract;

•

No financial account maintained by the FFI or any member of its expanded affiliated group, if any, has a balance or value in excess of

$50,000 (as determined after applying applicable account aggregation rules); and

•

Neither the FFI nor the entire expanded affiliated group, if any, of the FFI, have more than $50 million in assets on its consolidated or

combined balance sheet as of the end of its most recent accounting year.

Certified Deemed-Compliant Sponsored, Closely Held Investment Vehicle

Name of sponsoring entity:

I certify that the entity identified in Part I:

•

Is an FFI solely because it is an investment entity described in Regulations section 1.1471-5(e)(4);

•

Is not a QI, WP, or WT;

•

Will have all of its due diligence, withholding, and reporting responsibilities (determined as if the FFI were a participating FFI) fulfilled by the

sponsoring entity identified on line 20; and

•

20 or fewer individuals own all of the debt and equity interests in the entity (disregarding debt interests owned by U.S. financial institutions,

participating FFIs, registered deemed-compliant FFIs, and certified deemed-compliant FFIs and equity interests owned by an entity if that

entity owns 100% of the equity interests in the FFI and is itself a sponsored FFI).

Part VIII Certified Deemed-Compliant Limited Life Debt Investment Entity

I certify that the entity identified in Part I:

•

Was in existence as of January 17, 2013;

•

Issued all classes of its debt or equity interests to investors on or before January 17, 2013, pursuant to a trust indenture or similar agreement; and

•

Is certified deemed-compliant because it satisfies the requirements to be treated as a limited life debt investment entity (such as the

restrictions with respect to its assets and other requirements under Regulations section 1.1471-5(f)(2)(iv)).

Part IX Certain Investment Entities that Do Not Maintain Financial Accounts

I certify that the entity identified in Part I:

•

Is a financial institution solely because it is an investment entity described in Regulations section 1.1471-5(e)(4)(i)(A), and

•

Does not maintain financial accounts.

Part X Owner-Documented FFI

Note: This status only applies if the U.S. financial institution, participating FFI, or reporting Model 1 FFI to which this form is given has agreed that it will

treat the FFI as an owner-documented FFI (see instructions for eligibility requirements). In addition, the FFI must make the certifications below.

24a (All owner-documented FFIs check here) I certify that the FFI identified in Part I:

•

Does not act as an intermediary;

•

Does not accept deposits in the ordinary course of a banking or similar business;

•

Does not hold, as a substantial portion of its business, financial assets for the account of others;

•

Is not an insurance company (or the holding company of an insurance company) that issues or is obligated to make payments with respect to

a financial account;

•

Is not owned by or in an expanded affiliated group with an entity that accepts deposits in the ordinary course of a banking or similar

business, holds, as a substantial portion of its business, financial assets for the account of others, or is an insurance company (or the holding

company of an insurance company) that issues or is obligated to make payments with respect to a financial account;

•

Does not maintain a financial account for any nonparticipating FFI; and

•

Does not have any specified U.S. persons that own an equity interest or debt interest (other than a debt interest that is not a financial

account or that has a balance or value not exceeding $50,000) in the FFI other than those identified on the FFI owner reporting statement.

Form W-8BEN-E (Rev. 10-2021)

Part XI

Check box 24b or 24c, whichever applies.

b I certify that the FFI identified in Part I:

•

Has provided, or will provide, an FFI owner reporting statement that contains:

(i)

The name, address, TIN (if any), chapter 4 status, and type of documentation provided (if required) of every individual and specified

U.S. person that owns a direct or indirect equity interest in the owner-documented FFI (looking through all entities other than specified

U.S. persons);

(ii)

The name, address, TIN (if any), and chapter 4 status of every individual and specified U.S. person that owns a debt interest in the

owner-documented FFI (including any indirect debt interest, which includes debt interests in any entity that directly or indirectly owns

the payee or any direct or indirect equity interest in a debt holder of the payee) that constitutes a financial account in excess of

$50,000 (disregarding all such debt interests owned by participating FFIs, registered deemed-compliant FFIs, certified deemed-

compliant FFIs, excepted NFFEs, exempt beneficial owners, or U.S. persons other than specified U.S. persons); and

(iii)

Any additional information the withholding agent requests in order to fulfill its obligations with respect to the entity.

•

Has provided, or will provide, valid documentation meeting the requirements of Regulations section 1.1471-3(d)(6)(iii) for each person

identified in the FFI owner reporting statement.

c I certify that the FFI identified in Part I has provided, or will provide, an auditor's letter, signed within 4 years of the date of payment,

from an independent accounting firm or legal representative with a location in the United States stating that the firm or representative has

reviewed the FFI’s documentation with respect to all of its owners and debt holders identified in Regulations section 1.1471-3(d)(6)(iv)(A)(2),

and that the FFI meets all the requirements to be an owner-documented FFI. The FFI identified in Part I has also provided, or will provide, an

FFI owner reporting statement of its owners that are specified U.S. persons and Form(s) W-9, with applicable waivers.

Check box 24d if applicable (optional, see instructions).

I certify that the entity identified on line 1 is a trust that does not have any contingent beneficiaries or designated classes with unidentified

beneficiaries.

Restricted Distributor

25a (All restricted distributors check here) I certify that the entity identified in Part I:

•

Operates as a distributor with respect to debt or equity interests of the restricted fund with respect to which this form is furnished;

•

Provides investment services to at least 30 customers unrelated to each other and less than half of its customers are related to each other;

•

Is required to perform AML due diligence procedures under the anti-money laundering laws of its country of organization (which is an FATF-

compliant jurisdiction);

•

Operates solely in its country of incorporation or organization, has no fixed place of business outside of that country, and has the same

country of incorporation or organization as all members of its affiliated group, if any;

•

Does not solicit customers outside its country of incorporation or organization;

•

Has no more than $175 million in total assets under management and no more than $7 million in gross revenue on its income statement for

the most recent accounting year;

•

Is not a member of an expanded affiliated group that has more than $500 million in total assets under management or more than $20 million

in gross revenue for its most recent accounting year on a combined or consolidated income statement; and

•

Does not distribute any debt or securities of the restricted fund to specified U.S. persons, passive NFFEs with one or more substantial U.S.

owners, or nonparticipating FFIs.

Check box 25b or 25c, whichever applies.

I further certify that with respect to all sales of debt or equity interests in the restricted fund with respect to which this form is furnished that are made

after December 31, 2011, the entity identified in Part I:

Has been bound by a distribution agreement that contained a general prohibition on the sale of debt or securities to U.S. entities and U.S.

resident individuals and is currently bound by a distribution agreement that contains a prohibition of the sale of debt or securities to any

specified U.S. person, passive NFFE with one or more substantial U.S. owners, or nonparticipating FFI.

c Is currently bound by a distribution agreement that contains a prohibition on the sale of debt or securities to any specified U.S. person, passive

NFFE with one or more substantial U.S. owners, or nonparticipating FFI and, for all sales made prior to the time that such a restriction was

included in its distribution agreement, has reviewed all accounts related to such sales in accordance with the procedures identified in

Regulations section 1.1471-4(c) applicable to preexisting accounts and has redeemed or retired any, or caused the restricted fund to transfer

the securities to a distributor that is a participating FFI or reporting Model 1 FFI securities which were sold to specified U.S. persons, passive

NFFEs with one or more substantial U.S. owners, or nonparticipating FFIs.

Form W-8BEN-E (Rev. 10-2021)

Part XII

Nonreporting IGA FFI

I certify that the entity identified in Part I:

•

Meets the requirements to be considered a nonreporting financial institution pursuant to an applicable IGA between the United States and

. The applicable IGA is a

Model 1 IGA or a Model 2 IGA; and

is treated as a under the provisions of the applicable IGA or Treasury regulations

(if applicable, see instructions);

•

If you are a trustee documented trust or a sponsored entity, provide the name of the trustee or sponsor

The trustee is:

U.S.

Foreign

Part XIII Foreign Government, Government of a U.S. Possession, or Foreign Central Bank of Issue

I certify that the entity identified in Part I is the beneficial owner of the payment, and is not engaged in commercial financial activities of a

type engaged in by an insurance company, custodial institution, or depository institution with respect to the payments, accounts, or

obligations for which this form is submitted (except as permitted in Regulations section 1.1471-6(h)(2)).

Part XIV International Organization

Check box 28a or 28b, whichever applies.

28a I certify that the entity identified in Part I is an international organization described in section 7701(a)(18).

b I certify that the entity identified in Part I:

•

Is comprised primarily of foreign governments;

•

Is recognized as an intergovernmental or supranational organization under a foreign law similar to the International Organizations Immunities

Act or that has in effect a headquarters agreement with a foreign government;

•

The benefit of the entity’s income does not inure to any private person; and

•

Is the beneficial owner of the payment and is not engaged in commercial financial activities of a type engaged in by an insurance company,

custodial institution, or depository institution with respect to the payments, accounts, or obligations for which this form is submitted (except as

permitted in Regulations section 1.1471-6(h)(2)).

Part XV Exempt Retirement Plans

Check box 29a, b, c, d, e, or f, whichever applies.

29a I certify that the entity identified in Part I:

•

Is established in a country with which the United States has an income tax treaty in force (see Part III if claiming treaty benefits);

•

Is operated principally to administer or provide pension or retirement benefits; and

•

Is entitled to treaty benefits on income that the fund derives from U.S. sources (or would be entitled to benefits if it derived any such income)

as a resident of the other country which satisfies any applicable limitation on benefits requirement.

b I certify that the entity identified in Part I:

•

Is organized for the provision of retirement, disability, or death benefits (or any combination thereof) to beneficiaries that are former

employees of one or more employers in consideration for services rendered;

•

No single beneficiary has a right to more than 5% of the FFI’s assets;

•

Is subject to government regulation and provides annual information reporting about its beneficiaries to the relevant tax authorities in the

country in which the fund is established or operated; and

(i)

Is generally exempt from tax on investment income under the laws of the country in which it is established or operates due to its status as

a retirement or pension plan;

(ii)

Receives at least 50% of its total contributions from sponsoring employers (disregarding transfers of assets from other plans described in

this part, retirement and pension accounts described in an applicable Model 1 or Model 2 IGA, other retirement funds described in an

applicable Model 1 or Model 2 IGA, or accounts described in Regulations section 1.1471-5(b)(2)(i)(A));

(iii)

Either does not permit or penalizes distributions or withdrawals made before the occurrence of specified events related to retirement,

disability, or death (except rollover distributions to accounts described in Regulations section 1.1471-5(b)(2)(i)(A) (referring to retirement

and pension accounts), to retirement and pension accounts described in an applicable Model 1 or Model 2 IGA, or to other retirement

funds described in this part or in an applicable Model 1 or Model 2 IGA); or

(iv)

Limits contributions by employees to the fund by reference to earned income of the employee or may not exceed $50,000 annually.

c I certify that the entity identified in Part I:

•

Is organized for the provision of retirement, disability, or death benefits (or any combination thereof) to beneficiaries that are former employees

of one or more employers in consideration for services rendered;

•

Has fewer than 50 participants;

•

Is sponsored by one or more employers each of which is not an investment entity or passive NFFE;

•

Employee and employer contributions to the fund (disregarding transfers of assets from other plans described in this part, retirement and pension

accounts described in an applicable Model 1 or Model 2 IGA, or accounts described in Regulations section 1.1471-5(b)(2)(i)(A)) are limited by

reference to earned income and compensation of the employee, respectively;

•

Participants

that

are

not

residents

the

country

which

the

fund

established

operated

are

not

entitled

than

20%

the

fund’s

assets;

and

•

Is subject to government regulation and provides annual information reporting about its beneficiaries to the relevant tax authorities in the country

in which the fund is established or operates.

Form W-8BEN-E (Rev. 10-2021)

Part XV

Exempt Retirement Plans (continued)

b I certify that the entity identified in Part I is formed pursuant to a pension plan that would meet the requirements of section 401(a), other

than the requirement that the plan be funded by a trust created or organized in the United States.

c I certify that the entity identified in Part I is established exclusively to earn income for the benefit of one or more retirement funds

described in this part or in an applicable Model 1 or Model 2 IGA, or accounts described in Regulations section 1.1471-5(b)(2)(i)(A) (referring to

retirement and pension accounts), or retirement and pension accounts described in an applicable Model 1 or Model 2 IGA.

d I certify that the entity identified in Part I:

•

Is established and sponsored by a foreign government, international organization, central bank of issue, or government of a U.S. possession

(each as defined in Regulations section 1.1471-6) or an exempt beneficial owner described in an applicable Model 1 or Model 2 IGA to provide

retirement, disability, or death benefits to beneficiaries or participants that are current or former employees of the sponsor (or persons designated

by such employees); or

•

Is established and sponsored by a foreign government, international organization, central bank of issue, or government of a U.S. possession

(each as defined in Regulations section 1.1471-6) or an exempt beneficial owner described in an applicable Model 1 or Model 2 IGA to provide

retirement, disability, or death benefits to beneficiaries or participants that are not current or former employees of such sponsor, but are in

consideration of personal services performed for the sponsor.

Part XVI Entity Wholly Owned by Exempt Beneficial Owners

I certify that the entity identified in Part I:

•

Is an FFI solely because it is an investment entity;

•

Each direct holder of an equity interest in the investment entity is an exempt beneficial owner described in Regulations section 1.1471-6 or in an

applicable Model 1 or Model 2 IGA;

•

Each direct holder of a debt interest in the investment entity is either a depository institution (with respect to a loan made to such entity) or an

exempt beneficial owner described in Regulations section 1.1471-6 or an applicable Model 1 or Model 2 IGA.

•

Has provided an owner reporting statement that contains the name, address, TIN (if any), chapter 4 status, and a description of the type of

documentation provided to the withholding agent for every person that owns a debt interest constituting a financial account or direct equity interest

in the entity; and

•

Has provided documentation establishing that every owner of the entity is an entity described in Regulations section 1.1471-6(b), (c), (d), (e),

(f) and/or (g) without regard to whether such owners are beneficial owners.

Part XVII Territory Financial Institution

I certify that the entity identified in Part I is a financial institution (other than an investment entity) that is incorporated or organized under

the laws of a possession of the United States.

Part XVIII Excepted Nonfinancial Group Entity

I certify that the entity identified in Part I:

•

Is a holding company, treasury center, or captive finance company and substantially all of the entity’s activities are functions described in

Regulations section 1.1471-5(e)(5)(i)(C) through (E);

•

Is a member of a nonfinancial group described in Regulations section 1.1471-5(e)(5)(i)(B);

•

Is not a depository or custodial institution (other than for members of the entity’s expanded affiliated group); and

•

Does not function (or hold itself out) as an investment fund, such as a private equity fund, venture capital fund, leveraged buyout fund, or any

investment vehicle with an investment strategy to acquire or fund companies and then hold interests in those companies as capital assets for

investment purposes.

Part XIX Excepted Nonfinancial Start-Up Company

I certify that the entity identified in Part I:

•

Was formed on (or, in the case of a new line of business, the date of board resolution approving the new line of business)

(date must be less than 24 months prior to date of payment);

•

Is not yet operating a business and has no prior operating history or is investing capital in assets with the intent to operate a new line of

business other than that of a financial institution or passive NFFE;

•

Is investing capital into assets with the intent to operate a business other than that of a financial institution; and

•

Does not function (or hold itself out) as an investment fund, such as a private equity fund, venture capital fund, leveraged buyout fund, or any

investment vehicle whose purpose is to acquire or fund companies and then hold interests in those companies as capital assets for investment purposes.

Part XX Excepted Nonfinancial Entity in Liquidation or Bankruptcy

I certify that the entity identified in Part I:

•

Filed a plan of liquidation, filed a plan of reorganization, or filed for bankruptcy on

;

•

During the past 5 years has not been engaged in business as a financial institution or acted as a passive NFFE;

•

Is either liquidating or emerging from a reorganization or bankruptcy with the intent to continue or recommence operations as a nonfinancial

entity; and

•

Has, or will provide, documentary evidence such as a bankruptcy filing or other public documentation that supports its claim if it remains in

bankruptcy or liquidation for more than 3 years.

Form W-8BEN-E (Rev. 10-2021)

Part XXI 501(c) Organization

I certify that the entity identified in Part I is a 501(c) organization that:

•

Has been issued a determination letter from the IRS that is currently in effect concluding that the payee is a section 501(c) organization that is

dated ; or

•

Has provided a copy of an opinion from U.S. counsel certifying that the payee is a section 501(c) organization (without regard to whether the

payee is a foreign private foundation).

Part XXII Nonprofit Organization

I certify that the entity identified in Part I is a nonprofit organization that meets the following requirements.

•

The

entity

established

and

maintained

its

country

residence

exclusively

for

religious,

charitable,

scientific,

artistic,

cultural

educational

purposes;

•

The entity is exempt from income tax in its country of residence;

•

The entity has no shareholders or members who have a proprietary or beneficial interest in its income or assets;

•

Neither the applicable laws of the entity’s country of residence nor the entity’s formation documents permit any income or assets of the entity to

be distributed to, or applied for the benefit of, a private person or noncharitable entity other than pursuant to the conduct of the entity’s charitable

activities or as payment of reasonable compensation for services rendered or payment representing the fair market value of property which the

entity has purchased; and

•

The applicable laws of the entity’s country of residence or the entity’s formation documents require that, upon the entity’s liquidation or dissolution,

all of its assets be distributed to an entity that is a foreign government, an integral part of a foreign government, a controlled entity of a foreign

government, or another organization that is described in this part or escheats to the government of the entity’s country of residence or

any political subdivision thereof.

Part XXIII Publicly Traded NFFE or NFFE Affiliate of a Publicly Traded Corporation

Check box 37a or 37b, whichever applies.

37a I certify that:

•

The entity identified in Part I is a foreign corporation that is not a financial institution; and

•

The stock of such corporation is regularly traded on one or more established securities markets, including

(name one securities exchange upon which the stock is regularly traded).

b I certify that:

•

The entity identified in Part I is a foreign corporation that is not a financial institution;

•

The entity identified in Part I is a member of the same expanded affiliated group as an entity the stock of which is regularly traded on an

established securities market;

•

The name of the entity, the stock of which is regularly traded on an established securities market, is

; and

•

The name of the securities market on which the stock is regularly traded is

Part XXIV Excepted Territory NFFE

I certify that:

•

The entity identified in Part I is an entity that is organized in a possession of the United States;

•

The entity identified in Part I:

(i)

Does not accept deposits in the ordinary course of a banking or similar business;

(ii)

Does not hold, as a substantial portion of its business, financial assets for the account of others; or

(iii)

Is not an insurance company (or the holding company of an insurance company) that issues or is obligated to make payments with

respect to a financial account; and

•

All of the owners of the entity identified in Part I are bona fide residents of the possession in which the NFFE is organized or incorporated.

Part XXV

Active NFFE

I certify that:

•

The entity identified in Part I is a foreign entity that is not a financial institution;

•

Less than 50% of such entity’s gross income for the preceding calendar year is passive income; and

•

Less than 50% of the assets held by such entity are assets that produce or are held for the production of passive income (calculated as a

weighted average of the percentage of passive assets measured quarterly) (see instructions for the definition of passive income).

Part XXVI

Passive NFFE

40a I certify that the entity identified in Part I is a foreign entity that is not a financial institution (other than an investment entity organized in a

possession of the United States) and is not certifying its status as a publicly traded NFFE (or affiliate), excepted territory NFFE, active

NFFE, direct reporting NFFE, or sponsored direct reporting NFFE.

Check box 40b or 40c, whichever applies.

b I further certify that the entity identified in Part I has no substantial U.S. owners (or, if applicable, no controlling U.S. persons); or

c I further certify that the entity identified in Part I has provided the name, address, and TIN of each substantial U.S. owner (or, if applicable,

controlling U.S. person) of the NFFE in Part XXIX.

Form W-8BEN-E (Rev. 10-2021)

Part XXVII

Excepted Inter-Affiliate FFI

41 I certify that the entity identified in Part I:

•

member

expanded

affiliated

group;

•

Does not maintain financial accounts (other than accounts maintained for members of its expanded affiliated group);

•

Does not make withholdable payments to any person other than to members of its expanded affiliated group;

•

Does not hold an account (other than depository accounts in the country in which the entity is operating to pay for expenses) with or receive

payments from any withholding agent other than a member of its expanded affiliated group; and

•

Has not agreed to report under Regulations section 1.1471-4(d)(2)(ii)(C) or otherwise act as an agent for chapter 4 purposes on behalf of any financial

institution, including a member of its expanded affiliated group.

Part XXVIII

Sponsored Direct Reporting NFFE (see instructions for when this is permitted)

Part XXIX Substantial U.S. Owners of Passive NFFE

As required by Part XXVI, provide the name, address, and TIN of each substantial U.S. owner of the NFFE. Please see the instructions for a definition of

substantial U.S. owner. If providing the form to an FFI treated as a reporting Model 1 FFI or reporting Model 2 FFI, an NFFE may also use this part for

reporting its controlling U.S. persons under an applicable IGA.

Name

Address

TIN

Part XXX

Certification

Under penalties of perjury, I declare that I have examined the information on this form and to the best of my knowledge and belief it is true, correct, and complete. I further certify

under penalties of perjury that:

•

The entity identified on line 1 of this form is the beneficial owner of all the income or proceeds to which this form relates, is using this form to certify its status for

chapter 4 purposes, or is submitting this form for purposes of section 6050W or 6050Y;

•

The entity identified on line 1 of this form is not a U.S. person;

•

This form relates to: (a) income not effectively connected with the conduct of a trade or business in the United States, (b) income effectively connected with the

conduct of a trade or business in the United States but is not subject to tax under an income tax treaty, (c) the partner’s share of a partnership’s effectively connected

taxable income, or (d) the partner’s amount realized from the transfer of a partnership interest subject to withholding under section 1446(f); and

•

For broker transactions or barter exchanges, the beneficial owner is an exempt foreign person as defined in the instructions.

Furthermore, I authorize this form to be provided to any withholding agent that has control, receipt, or custody of the income of which the entity on line 1 is the beneficial owner

or any withholding agent that can disburse or make payments of the income of which the entity on line 1 is the beneficial owner.

I agree that I will submit a new form within 30 days if any certification on this form becomes incorrect.

I certify that I have the capacity to sign for the entity identified on line 1 of this form.

Sign Here

Signature of individual authorized to sign for beneficial owner Print Name Date (MM-DD-YYYY)

Form W-8BEN-E (Rev. 10-2021)

Name of sponsoring entity:

I certify that the entity identified in Part I is a direct reporting NFFE that is sponsored by the entity identified on line 42.

▲

Annexure - Know Your Customer (KYC) Application Form (Legal Entity/ Other than Individuals)

‘CENTRAL KYC REGISTERY | Know Your Customer (KYC) Application Form | Other than Individuals

Important Instructions:

A) Fields marked with * are mandatory fields

B) Tick wherever applicable

C) Please fill the date in DD-MM-YYYY format

D) Please fill the form in English and in BLOCK letters

E) KYC Number of applicant is mandatory for update

application

For Office Use Only

Application Type* New ☐ Update ☐

(to be filled by financial institution)

KYC Number Click or tap here to enter text. (Mandatory for KYC Update Request)

1. ENTITY DETAILS (Please refer to instruction A at the end)

Name*

Click or tap here to enter text.

Entity Constitution Type*

Click or tap here to enter text. ( Please refer instruction B at the end)

Date of incorporation /

Formation*

Click or tap to

enter a date.

Date of commencement of business:

Click or tap to enter a

date.

Place of Incorporation /

Formation*

Click or tap here to enter

text.

Country of

Incorporation /

Formation*

Click or tap here

to enter text.

TIN or Equivalent

Issuing Country

Click or tap here to

enter text.

PAN*

Click or tap here to enter

text.

☐Form 60 furnished

TIN / GST Registration Number Click or tap here to enter text.

2. PROOF OF IDENTITY (Pol)* (Please refer instruction B at the end)

☐Officially valid document(s) in respect of person authorized to transact

☐Certificate of incorporation / Formation Click or tap here to enter text.

☐Registration Certificate Click or tap here to enter text.

☐Memorandum and Articles of Association

☐Partnership Deed

☐Trust Deed

☐Resolution of Board / Managing Committee

☐Power of attorney granted to its manager, officers or employees to transact on its behalf

☐Activity Proof – 1 (For Sole Proprietorship

Only)

☐Activity Proof – 2 (For Sole Proprietorship)

3. ADDRESS* (Please see instruction C at the end)

3.1 Registered Office Address / Place of Business*

Proof of Address*

☐Certificate of

incorporation/Formation

☐Registration Certificate

☐Other Document MCA

EXTRACT

Line 1*

Line 2

Line 3

Click or tap here to enter

text.

City/Town/Village*

Click or tap here to enter text.

District*

Click or tap here to enter

text.

Pin/Post Code*

Click or tap here to

enter text.

State / U.T Code*

Click or tap here to

enter text.

ISO 3166 Country Code*

Click or tap here to enter text.

3.2 Local Address in India (if different from above)*

Central KYC Registry

Know Your Customer (KYC) Application Form

Legal Entity/ Other than Individuals

F) List of State / U.T code as per India Motor Vehicle Act, 1988 is available at

the end

G) List of two character ISO 3166 country codes is available at the end

H) Please read section wise detailed guidelines / instructions at the end

I) For particular section update, please tick in the box available before the

section number and strike off the sections not required to be updated

Line 1*

Click or tap here to enter text.

Line 2

Click or tap here to enter text.

Line 3

Click or tap here to enter

text.

City / Town / Village*

Click or tap here to enter text.

District*

Click or tap here to enter

text.

Pin/Post Code*

Click or tap here to

enter text.

State/ U.T Code*

Click or tap here to

enter text.

ISO 3166 Country Code*

Click or tap here to enter text.

4 CONTACT DETAILS (All communications will be sent on provided mobile no./Email ID* may be used) (Please refer to instruction D at the end)

Tel. (Off)

FAX

Click or tap here to enter text.

Mobile

Click or tap here to enter

text.

Email ID

Click or tap here to enter text.

Mobile

Click or tap here to enter

text.

Email ID

Click or tap here to enter text.

5. NUMBER OF RELATED PERSONS 1 (Please refer instruction E at the end)

6. REMARKS (if any)

7. APPLICATION DECLARATION (Please refer instruction G at the end)

I hereby declare that the details furnished above are true and correct to 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 held liable for it.

I/we hereby consent to receiving information from Central KYC Registry through

SMS/Email on the above registered number/email address

Date: 08/08/2022

Place: Mumbai

Signature / Thumb Impression of Authorized Person(s)

8. ATTESTATION/FOR OFFICE USE ONLY

Documents

Received

☐Certified Copies

☐Equivalent e-document

KYC VERIFICATION CARRIED OUT BY

INSTITUTION DETAILS

Identity Verification ☐

Done

Date: 03/11/2021

Name

Click or tap here to enter text.

Emp. Name

Click or tap here to enter

text.

Code

Click or tap here to enter text.

Emp. Code

Click or tap here to enter

text.

[Institution Stamp]

Emp. Designation

Click or tap here to enter

text.

Emp. Branch

Click or tap here to enter

text.

[Employee Signature]

CENTRAL KYC REGISTRY| Instructions/ Check list Guidelines for filling Legal Entity/ Other than Individuals KYC Application Form

A. Clarification / Guidelines for filling Entity Details section

1. Entity Constitution Type

A – Sole Proprietorship

H – Trust

O – Artificial Juridical Person

B – Partnership Firm

I – Liquidator

P – International Organization or Agency/

Foreign Embassy or Consular Office etc.

C – HUF

J – limited Liability Partnership

Q – Not Categorized

D – Private Limited Company

K – Artificial Liability Partnership

R – Others

E – Public Limited Company

L – Public Sector Banks

S – Foreign Portfolio Investors

F – Society

M – Central/State Government Department

or Agency

G – Association of Persons (AOP) / Body of

Individuals (BOI)

N – Section 8 Companies (Companies Act,

2013)

2. In case of companies and partnership, PAN of the entity is mandatory. In case of other entities, FORM 60 may be obtained if PAN is

not available

B. Clarification / Guidelines for filling “Proof of Identity [Pol]” section

1. Activity Proof – 1 and Activity Proof – 2 are applicable for accounts in case of proprietorship firms. Please refer to relevant instructions

issued by the Reserve Bank of India in this regard.

2. Please refer to the relevant instructions issued by the regulator regarding applicable documents for the legal entity.

3. Certified copy of document or equivalent e-document or OVD obtained through Digital KYC process to be submitted.

4. “Equivalent e-document” means an electronic equivalent of a document, issued by the issuing authority of such document with its valid

digital signature including documents issued to the digital locker account of the client as per rule 9 of the Information Technology

(Preservation and Retention of Information by Intermediaries Proving Digital Locker Facilities) Rules, 2016.

5. “Digital KYC process” has to be carried out as stipulated in the PML Rules, 2005

6. KYC requirements for Foreign Portfolio Investors (FPIs) will be specified by the concerned regulator from time to time.

C. Clarification / Guidelines for filling “Proof of Identity[Pol]’ section

1. State / U.T Code and Pin / Post Code will not be mandatory for Overseas addresses

2. Certified copy of document or equivalent e-document to be submitted

D. Clarification / Guidelines for filling “Contact Details” section

1. Please mention two-digit country code and 10 digit mobile number (e.g. for India mobile number mention 91-9999999999).

2. Do not add “0” in the beginning of Mobile number.

E. Clarification / Guidelines for filling “Related Person Details” section

1. Personal Details

• The name should match the name as mentioned in the Proof of Identity submitted failing which the application is liable to be

rejected

2. Proof of Address [PoA]

• PoA to be submitted only if the submitted Pol does not have an address as per Pol is invalid or not in force

• State / U.T Code and Pin / Post Code will not be mandatory for Overseas addresses

• In case of deemed PoA such as utility bill, the document need not be uploaded on CKYCR

• REs may use the Self Declaration check box where Aadhaar authentication has been carried out successfully for a client and

client wants to provide a current address, different from the address as per the identity information available in the Central

Identities Data Repository

3. If KYC number of Related Person is available, no other details except “Person Type” and “Name of the Related Person” are required.

4. Regulated Entity (RE) shall redact (first 8 digits) of the Aadhaar number from Aadhaar related data and documents such as proof of

possession of Aadhaar, while uploading on CKYCR

F. Provision for capturing signature of multiple authorized person sis to be made by the RE.

List of two digit state / U.T codes as per India Motor Vehicle Act, 1988

State / U.T

Code

State / U.T

Code

State / U.T

Code

Andaman & Nicobar

Himachal Pradesh

Pondicherry

Andhra Pradesh

Jammu & Kashmir

Punjab

Arunachal Pradesh

Jharkhand

Rajasthan

Assam

Karnataka

Sikkim

Bihar

Kerala

Tamil Nadu

Chandigarh

Lakshadweep

Telangana

Chattisgarh

Madhya Pradesh

Tripura

Dadra and Nagar Haveli

Maharashtra

Uttar Pradesh

Daman & Diu

Manipur

Uttarakhand

Delhi

Meghalaya

West Bengal

Goa

Mizoram

Other

Gujarat

Nagaland

Haryana

Orissa

List of ISO 3166 two-digit Country Code

Annexure - Know Your Customer (KYC) Application Form (Related person

Annexure A1

Important Instructions

A) Fields marked with * are mandatory fields

B) Tick wherever applicable

C) Please fill the form in English and in BLOCK letters

D) Please fill the date in DD-MM-YYYY format

E) For particular section update, please tick in the box section

number and strike off the sections not required to be updated

F) Please read section wise detailed guidelines / instructions at the end

G) List of State / U.T code as per Indian Motor Vehicle Act, 1988 is available

at the end

H) List of two character ISO 3166 country codes is available at the end

I) KYC number of applicant is mandatory for update application

For Office Use Only

Application Type* New ☐ Update ☐ Deleted ☐

(to be filled by financial institution)

KYC Number Click or tap here to enter text. (Mandatory for KYC Update Request)

1. DETAILS OF RELATED PERSON* (Pease refer to instruction E at the end)

☒ Addition of Related Person

☐ Deletion of Related

Person

☐Update Related

Person Details

KYC Number of Related Person (if available)* Click or tap

here to enter text.

Related Person Type*

☐ Director

☐ Promoter

☐ Karta

☐ Trustee

☐ Partner

☐ Proprietor

☐ Beneficiary

☐ Authorised Signatory

☐ Beneficial Owner

☐ Court Appointment Official

☐ Power of Attorney Holder

☐ Other (Please specify)

DIN (Director Identification Number)

Click or tap here to enter text. (Mandatory if Related Person Type is Director)

Name*

Prefix

Click or tap here to enter text.

First Name

Click or tap here to enter text.

Middle Name

Click or tap here to enter text.

Last Name

Click or tap here to enter text.

If KYC number and name are provided, below details are optional

Maiden Name

Click or tap here to enter text.

Father / Spouse Name*

Click or tap here to enter text.

Mother Name

Click or tap here to enter text.

Date of Birth*

Click or tap to enter a date.

Nationality*

Click or tap here to enter text.

Gender*

☐M - Male

☐F -Female

☐T - Transgender

PAN*

Click or tap here to enter text.

☐Form 60 furnished

2. PROOF OF IDENTITY AND ADDRESS*

Certified copy of OVD or equivalent e-document of OVD or OVD obtained through

digital KYC process needs to be submitted (anyone of the following OVDs)

☐PHOTO*

A – Passport Number Click or tap here to enter text.

[Insert Photo]

B – Voter ID Card Click or tap here to enter text.

C – Driving License Click or tap here to enter text.

D – NREGA Job Card Click or tap here to enter text.

E – National Population Register Letter Click or tap here to enter text.

F – Proof of Possession of Aadhaar (Last 4 digits) Click or tap here to enter text.

☐E -KYC Authentication (Last 4 digits) Click or tap here to enter text.

III

☐Offline verification of Aadhaar (Last 4 digits) Click or tap here to enter text.

Address

Central KYC Registry

Know Your Customer (KYC) Application Form

Related Person

Line 1*

Line 2

Line 3

Click or tap here to enter text.

City/Town/Village*

Click or tap here to enter text.

District*

Click or tap here to enter text.

Pin/Post Code*

State/U.T Code*

ISO 3166 Country Code*

Click or tap here to enter text.

3. CURRENT ADDRESS DETAILS (Please refer instruction E at the end)

☒Same as above mentioned address (in such cases address details as below need not be provided)

Certified copy of OVD or equivalent e-document of OVD or OVD obtained through digital KYC process needs to be submitted (anyone of the

following OVDs)

A – Passport Number

Click or tap here to enter text.

B – Voter ID Card

Click or tap here to enter text.

C – Driving License

Click or tap here to enter text.

D – NREGA Job Card

Click or tap here to enter text.

E – National Population Register Letter

Click or tap here to enter text.

F – Proof of Possession of Aadhaar (Last 4 Digits)

Click or tap here to enter text.

☐E-KYC Authentication (Last 4 Digits)

Click or tap here to enter text.

III

☐Offline verification of Aadhaar (Last 4 Digits)

Click or tap here to enter text.

☐Deemed Proof Address – Document Type code

Click or tap here to enter text.

☐Self-Declaration

Line 1*

Click or tap here to enter text.

Line 2

Click or tap here to enter text.

Line 3

Click or tap here to enter

text.

City/Town/Village*

Click or tap here to enter text.

District*

Click or tap here to enter

text.

Pin/Post Code*

Click or tap here to enter

text.

State / U.T Code*

Click or tap here to

enter text.

ISO 3166 Country Code*

Click or tap here to enter text.

4 CONTACT DETAILS (All communications will be sent on provided mobile no./Email ID) (Please refer to instruction D at the end)

Tel. (Off)

Click or tap here to enter text.

Tel. (Res)

Click or tap here to enter text.

Mobile

Click or tap here to enter text.

Email ID [email protected]

5. REMARKS (If any)

6. APPLICATION DECLARATION

I hereby declare that the details furnished above are true and correct to 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 held liable for it.

I/we hereby consent to receiving information from Central KYC Registry through

SMS/Email on the above registered number/email address

Date: Click or tap to enter a date. Place: Click or tap here to enter

text.

Signature / Thumb Impression, Name and Designation of

Authorized Person

7. ATTESTATION/FOR OFFICE USE ONLY

Documents

Received

☐Certified Copies

☐E-KYC data received from UIDAI

☐Data received from Offline verification

☐Digital KYC Process

☐Equivalent e-document

KYC VERIFICATION CARRIED OUT BY

INSTITUTION DETAILS

Identity Verification ☐Done

Date: Click or tap to

enter a date.

Name

Click or tap here to enter text.

Emp. Name

Click or tap here to enter text.

Code

Click or tap here to enter text.

Emp. Code

Click or tap here to enter text.

[Institution Stamp]

Emp. Designation

Click or tap here to enter text.

Emp. Branch

Click or tap here to enter text.

[Employee Signature]

Annexure – LEI Information

Legal Entity Identifiers: Frequently Asked Questions

What is an LEI?

•

An LEI is a unique 20-character alphanumeric code that is assigned to each legal entity globally.

•

The LEI system is overseen by the Global LEI Foundation (GLEIF), a not-for-profit organization established in

Switzerland in June 2014. A wealth of information about the GLEIF and the LEI system can be found at

www.gleif.org. The site also includes the full database of all LEIs issued.

Who needs an LEI?

•

The vast majority of entities participating in the financial markets, whether cash, derivatives or financing

markets, will need an LEI in order to comply with applicable laws and regulations.

•

If your organization has multiple legal entities, each will require its own LEI.

What are we asking you to obtain an LEI?

•

The requirements to obtain an LEI began with G20 ministers who mandated the global reporting of all swap

transactions in 2010. There are now over 50 rules or regulations globally that mandate or request the LEI

under a broad spectrum of financial transactions. By way of example:

Many rules require that parties be identified via LEI in transaction reporting.

EU Regulations such as European Market Infrastructure Regulation (EMIR), Securities Financing

Transactions Regulation (SFTR) and Markets in Financial Instruments Regulation (MiFIR) broaden the

types of transactions that are subject to LEI reporting to include securities financing transactions and

cash securities, among others.

Importantly, under Markets in Financial Instruments Directive (MiFIDII), certain services cannot be

provided to clients that can, but did not, obtain an LEI.

New rules are being proposed, such as the SEC’s Investment Company Reporting Modernization

rule, further broadening the scope of the requirement to identifying entities via LEI.

The list of regulations requiring an LEI is available at www.gleif.org.

•

Additionally, LEIs are used for execution of certain processes such as completing the International Swaps and

Derivatives Association (ISDA) protocols for certain types of trading activity. J.P. Morgan also plans to request

LEIs as part of the Credit Support Annex (CSA) re-documentation process in relation to regulatory margin

requirements for uncleared derivatives transactions.

What are the benefits of an LEI?

•

Standardization of information is critical for all financial market participants in both the public and private

sector.

•

The regulatory landscape has shifted and the demand for industry supervisors to have appropriate, usable data

is clear. A standard legal entity identifier will allow regulators to conduct a more accurate analysis of global

systemic risk across markets, products and regions, and identification of concentrations and emerging systemic

risks.

•

Use of the LEI also allows parties to comply with applicable laws and regulations.

How does my company request an LEI?

•

Companies contact their preferred business partner from the list of LEI issuing organizations – also referred to

as Local Operating Units (LOUs). There are 29 LOUs, around the world. Links to the LOUs are available at

www.gleif.org.

•

An LEI is usually issued within 24 to 48 hours of application. Initial registration costs are approximately

$150-200. Annual renewal at approximately half the initial registration cost is required.

•

The LEI registration process requires the following information:

Entity Name and Legal Form

•

Official Entity Name

•

Legal Formation Country

•

Legal Form

Business Registry

•

Country of Business Registry

•

Official Business Registry

•

Official Business Registry Reference

Headquarters Address

•

Address of Headquarters

Legal Formation Address

•

Address of Legal Formation

If you have any questions, please contact your onboarding or sales contact.