CORPORATE LETTERHEAD

CLIENT INFORMATION

Corporate Information:Full Name of Corporation: Date of Incorporation:Incorporated in City/State/Country: Registration Number:Board of Directors (Name, Title):

Officers (Name, Title):

Shareholders:

Parent Corporate Information:Full Name of Corporation: Date of Incorporation:Incorporated in City/State/Country: Registration Number:Board of Directors (Name, Title):

Officers (Name, Title):

Shareholders & Percentage of Ownership:Shareholder Address:

Location of Registered Address:Full Name of Corporation:Street Address:

City: Country:

Mailing Address:

Contact Information:

Legal Advisor/Authorized Representative:Full Name:Company:Address:City:State:Country:Postal Code:

1DAS ________

CORPORATE LETTERHEADTelephone Number:

Fax Number:Email Address:

Bank Information:Bank Name (where funds on deposit): Street Address:City:Country:Account Name:Account Number:SWIFT Code: Account Signatory (1): Bank Officer # 1 Name:Telephone Number:Email Address:

Personal Information of the Transactional Signatory Authorized by Corporation:First Name:Middle Name:Last Name:Gender:Date of Birth:Country of Citizenship:Languages:

Passport Information:Passport Number:Date of Issue:Date of Expiry:Issuing Authority:See copy attached hereto.

Location of Address: Home Legal Residence Full Name of Officer:Street Address:City:Country:Postal Code:

Declarations:I, ___________________, understand that the contemplated transaction is strictly one of Private Placement and is in no way relying upon existing regulations in relation to the United States Securities Act of 1933 as amended, or related regulations, and does not involve the buy and sell of securities. I further declare that I am not a licensed

2DAS ________

CORPORATE LETTERHEADsecurities broker or government employee and understand that neither are you or your organization. I mutually agree that this Private Placement Transaction is exempt from the securities act.

I, _____________, understand and agree that the ICC NON-DISCLOSURE and NON-CIRCUMVENTION rules apply to this affidavit and business relationship, and hereby agree to the current application standards of the International Chamber of Commerce, Paris, France which rules are made a part hereof by this reference. All parties have an obligation to respect professional secrecy and to take all appropriate precautions to protect the confidentiality of the information each holds in respect of the others’ activities. This legal obligation shall remain in full force and effect at all times.

I, ______________, under penalty of perjury, with full corporate and individual responsibility, hereby irrevocably confirm that neither myself, nor anyone else associated with _______________________, are working for any Agencies of any Government. I further state under penalty of perjury that I am not involved in any Government entrapment operation.

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

I, ______________, confirm that the funds utilized to purchase the Au Bullion referenced herein have been earned in the course of normal commercial business and are of commercial origin and legally generated and the funds and assets involved, are not in breach of the “Money Laundering Regulation/Accord of 1993,” howsoever interpreted and defined, whether within the host state of the transaction or internationally. I further declare that there are no liens, commercial obligations or encumbrances of any kind afflicting said funds and that there are no other currently valid or pending commitments, other than for the issuance of the referenced Bank Guarantee.

I, _______________, hereby declare that I am fully aware that the information presented by you is not in any way considered or intended to be solicitation of funds of any sort, or any type of offering, but is intended for general knowledge and educational purposes only. I affirm that I have requested information from you and your associates of my own choice and free will, and further that you have not solicited me in any way.

I, _____________, for and on behalf of ____________________, agree that all email and facsimile transmitted documents shall be treated as original documents. I further agree that in all cases where plural might apply where singular tense is used it is so applied.

I, hereby swear under penalty of perjury, that the information provided herein is accurate and true as of

February____, 2015.

For and on behalf of ______________________.

______________________________NAMETITLE

3DAS ________