Tax Declaration

I understand that the information supplied by me is covered by the full provisions of the terms and conditions governing the account holder's relationship with Chintai Network Services Pte Ltd ("Chintai"), setting out how Chintai may use and share the information supplied by me.

I acknowledge that the information contained in this form and information regarding the account holder and any reportable account(s) may be provided to the tax authorities of the jurisdiction in which this/these account(s) is/are maintained and exchanged with tax authorities of another jurisdiction or 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 in respect to all the account(s) to which this form relates.

I declare that all statements made in this declaration are, to the best of my knowledge and belief, correct and complete.

I undertake to advise Chintai within 30 days of any change in circumstances which affects the tax residency status of the individual identified in this form or causes the information contained herein to become incorrect, and to provide Chintai with a suitably updated Self-Certification Form within 90 days of such change in circumstances.