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Collateral Manager

    Company Employee Details

    MONITORING OF STOCK

    DOCUMENTATION (please attach)

    Additional Remarks / Comments / Information

    DECLARATION

    By signing this document, I am hereby certifying and declaring that all of the information provided above is true, accurate, complete and not misleading by error, omission or otherwise. I confirm that I am a duly authorised representative of the Company and I have the authority to sign on behalf of the Company. We undertake to promptly inform Kimura Capital LLP, as permitted by law, of any civil or criminal penalties imposed on the Company that relate to a failing of our AML/CTF responsibilities and obligations. Additionally, we undertake to promptly inform Kimura Capital LLP upon the identification of any blocked persons, individuals or entities, or any beneficial owners relating to any business placed with Kimura. Finally, we undertake to inform Kimura of any other material changes to the information provided within this document. We expressly recognise the right of Kimura to terminate any business or contractual relationship maintained with the Company in view of a Sanction breach or failure to provide information or documentation that may be required by regulatory or legal obligation.