S.L. 233.3 Art. 12Holders to retain documentary evidence. me/us on or after (b) held abroad and Registration form under the of 2001 and Legal money laundering would result due to Tax Act; registration of the registration agent agent any further exercise of its the relevant fee in Euro on 1;

Holders of a registration certificate who convert their registered eligible assets into other assets shall, after registration, retain the documentary evidence regarding such conversions. of the owner; 2. that the registered assets were (a) held outside Malta and owned by 1 January 2000 and repatriated to Malta prior to 1 September, 2001 and/or owned by me/us on l September, 2001; 3. that these assets are being registered only once under this Investment Scheme and that these assets have not already been registered in any Investment Registration Scheme established by virtue of Legal Notice 315 Notice 59 of 2002; 4. that the registered assets do not represent proceeds from a crime of in terms of the Prevention of Money Laundering Act, or from a crime that an infringement of any law other than the Exchange Control Act or the Income 5. that the documentary evidence being hereby submitted to the appointed agent in support of the registered assets is troe and original; 6. that I/we accept full responsibility for the accuracy and authenticity information and of the documentary evidence submitted to the appointed under the Scheme; 7. that I/we will make available to the appointed registration information, statements or documents that it may require for the proper functions in terms of the Investment Registration Scheme; 8. that the declaration is being made in good faith; 9. that in return for my/our making this declaration and obtaining exemptions arising from law upon registration, I/we hereby pay the registration the market value of the eligible assets as per Column E Row 15 in Section