Bentleys Level13 Ph?hps For. Tcwer 205 Queen Sheet Auckland 1010 DUE DILIGENCE QUESTIONNAIRE Trusts Disclaimer: Please note that if you instruct us to constitute a New Zealand trust, our agreement to constitute such a structure is not to be construed in any way as being tax advice. We will provide tax advice if required, but this will be the subject of a speci?c engagement once we have received your written instruction, which will include your explanation of all relevant factors and the result that you would like to obtain. This will involve the completion of our initial tax planning questionnaire (?Tax Planning Questionnaire"), and following this we can provide you with an estimate of the likely time required. Our fee for the Tax Planning Questionnaire as at 1 April 2014 is USD 900.00 (plus GST and disbursements if relevant). PART A TRUST QUESTIONNAIRE AND DUE DILIGENCE SHEET Information requested in this document is aimed at assisting us in the drafting of trust documentation and ful?lling our due diligence obligations. Such information will be held in the strictest confidence and shall not be disclosed to unauthorised third parties, except as required by law. Please complete fully the information requested below. We require customer due diligence to be completed and returned for each of the following: 1. The Settlor; 2. Any person other than the Settlor who transfers funds or assets to the Trust; 3. The Customer with whom you establish the business relationship, if the Settlor is not the customer; 4. Each Bene?cial Owner (as de?ned in Schedule 1) of the Trust, the Settlor, the Customer and any other person transferring funds or assets to the Trust; and 5. Each person acting on behalf of the Settlor. the Customer or any other person transferring funds or assets to the Trust. Please note that all information must be provided before you establish a business relationship with. or conduct an occasional transaction for, the relevant customer. Please note that you must check each person's details against your customer records to ensure that no other person has presented the same identity information or documents. 1. Settlor?s personal information Please complete fully the personal information requested below Settlor's Full Name: Maria Teresa Cubria Cavazos Home Address: TAM Mexico. Phone (Home): (Of?ce): +55 5515 9709 Facsimile: E-mail address: Nationality: Mexican Domicile (include information if Resident but non-Domiciled): Mexican Fiscal Residence: Mexico Date Place of birth: 3 February 1934 Mexico Passport No: - Occupation: Retired Marital status: Sinqle Married Separated Divorced (please mark as appropriate) Children: YES Is the Settlor a Politically Exposed Person (as de?ned in Schedule /r Other persons (if any) acting on behalf of the Settlor (please complete a due diligence questionnaire for each): Please provide a brief description of the source of funds or wealth of the Settlor: Gift from Dauqhter Ma Teresa Garcia Cubria. A copy of the Deed of Gift and Enolish translation is a?ached. (Please enclose: a) a photocopy of the identification pages of the Settlor's passport that has been certi?ed as a true copy of the original by a Trusted Referee (as de?ned in Schedule 1), such certi?cation to have been carried out within the preceding three months; and b) a photocopy of a utilities bill that is no more than three months old, con?rming the Settlor?s address and that has been certi?ed as a true copy of the original by a Trusted Referee; and c) evidence of the enquiries you have carried out in order to satisfy yourself whether either the Settlor. or any person acting on his or her behalf. is a Politically Exposed Person; and d) copies of information con?rming the source of funds or wealth of the Settlor and evidence of the enquiries you have carried out to verify this information. Note that where the Settlor is a Politically Exposed Person. an enhanced standard of enquiries should be carried out. 2. Name ofintended Trust HUIRACOCHA TRUST 3. Names of Trustees Please list the names of all intended trustees of the Trust. If any of the trustees is not your usual trustee company, in respect of whom we already hold all relevant due diligence information, please complete and return a due diligence questionnaire for each such trustee using the template provided at Schedule 2. ORION TRUST (NEW ZEALAND) LIMITED 4. Objective(s) for which Trust/Settlement is to be established: Please tick as appropriate Estate planning generally Bentleys Tax planning/mitigation Asset protection Con?dentiality and privacy Preservation of family assets Family succession planning Other: 5. Type of Trust: Fixed Interest Discretionary Trust Revocable Trust lrrevocable Trust Charitable Trust 6. Type of trust document: Declaration of Trust Deed of Settlement Settlement (Please provide a certified copy if trust document has already been prepared) 7. Principal Beneficiary/Beneficiaries: Full Name: Ma Teresa Garcia Cubria (Principal Bene?ciary) Addressrm DOB. 17 Feb. 1959 Relationship to Settlor: Daughter Passport No- Flsca' Residence: Mexico. Full Name: Juan Armando Hinoiosa Cantu (Secondary Beneficiary) Address: _Mexico City. Mexico. DOB. 03 Januag 1956 Relationship to Settlor: Son-in-Iaw Passport No? Fiscal Residence:? Mexico City, Mexico. Full Name: Leqitimate children of 15? and 2nd beneficiaries (Third Beneficiares) Address: DOB. Relationship to Settlor: Passport No. Fiscal Residence: Bentleys FuHName: Address: DOB. Relationship to Settlor: Passport No. Fiscal Residence: Full Name: Address: DOB. Relationship to Settlor: Passport No. Fiscal Residence: Full Name: Address: 0.0.8. Relationship to Settlor: Passport No. Fiscal Residence: Full Name: Address: DOB. Relationship to Settlor: Passport No: Fiscal Residence: (If the Trust is not a discretionary trust or charitable trust and has 10 bene?ciaries or less. please enclose a photocopy of the identification pages of each bene?ciary's passport that has been certified as a true copy of the original by a Trusted Referee (as defined in Schedute 1). such certification to have been carried out within the preceding three months) Are there any particular circumstances relating to beneficiaries (physical or meptah in?rmity}? YES Not /_Ar6\any of bene?ciaries Beneficial Owners of the Trust (as de?ned in Schedule Cesmo YES. please complete and return a due diligence questionnaire for each such bene?ciary using the template provided at Schedule 2. 8. Protector Do you wish to have a Protector: YES NO If YES, whom do wish us to appoint as Protector? Full Name: Home Address: . Bentleys Phone (Home): (Of?ce): Facsimile: E?mail address: Nationality: Domicile (include information if Resident but non-Domiciled): Fiscal Residence: Date Place of Birth: Passport No: Occupation: Will the Protector be acting in a professional capacity (if this is the case a charging provision should be included)? YES NO Is the Protector a Bene?cial Owner of the Trust (as defined in Schedule YES NO Is the Protector a Politically Exposed Person (as defined in Schedule YES i NO If the Protector is a Potitically Exposed Person and a Beneficial Owner, please provide a brief description of the source of funds or wealth of the Protester: (Please enclose: a) a photocopy of the identification pages of the Protector's passport that has been certi?ed as a true copy of the original by a Trusted Referee (as defined in Schedule 1), such certi?cation to have been carried out within the preceding three months; and b) a photocopy of a utilities bill that is no more than three months old) confirming the Protector?s address and that has been certified as a true copy of the original by a Trusted Referee; and c) evidence of the enquiries you have carried out in order to satisfy yourself whether either the Protector, or any person acting on his or her behalf. is a Politically Exposed Person; and d) (if applicable) copies of information con?rming the source of funds or wealth of the Protectorc Note that where the Protector is a Politically Exposed Person, an enhanced standard of enquiries should be carried out.) 9. Beneficial Owners Please list each Beneficial Owner (as de?ned in Schedule 1) of the Trust and complete a due diligence questionnaire for each Beneficial Owner who is not the Settlor or Protector using the template provided at Schedule 2: Maria Teresa Cubria Cavazos and Ma Teresa Garcia Cubria I, -.- Bentleys 10. Accounts Do you wish the accounts of the Trust to be prepared by us? YES Do you wish the accounts of the Trust to be audited? YES In any case, please indicate the year end of the Trust: I (Note: 31 March is the usual year end in New Zealand. If another date is selected please provide justi?cation for the need to select another date e.g. to tie in with the balance date in the settlor?s home jurisdiction} 11. Trust Property Please list full details of all assets to be settled and the source of such assets. If the assets are presently held by a banking institution please give the details of such institution. If any assets or funds are transferred to the Trust by any party other than the Settlor, please complete a clue diligence questionnaire for each such person (each, a ??Transferor?), each Bene?cial Owner of a Transferor and any other person acting on behalf of a Transferor using the template provided at Schedule 2. We may seek further documentary confirmation of the source of the initial and subsequent funds and assets. We reserve the right to request such documentation from you. The Huiracocha Trust will hold 99.99% ownership in a UK LLP named HUIRACOCHA INVESTMENTS LLP. The underlying company will have portfolio accounts with banks such as JP Morgan, UBS, Deutsche Bank. (Please enclose copies of information con?rming the source of funds or assets of the trust, if this has not been already provided to us) 12. Date of Termination of Trust (maximum period under New Zealand law is 80 years) 80 years 13. Annual Income of the Trust Please specify the anticipated annual income of the Trust and the countries of origin of the Income. None Bentleys If: PART DECLARATION Please complete and sign the following declaration in respect of each party for whom you have completed and returned a due diligence questionnaire in relation to the Trust (each, 3 ?Relevant Party") I, Valentin Ure?a, Lawyer of MF LEGAL SERVICES, DO HEREBY CERTIFY 1. In addition to all other information provided in this document, the Relevant Party has confirmed the following to me, which to the best of my knowledge is true and correct: Helshe is not insolvent at the date hereof; Heishe understand that above means that: Helshe is able to pay hisiher debts as they fall due; (ii) Hisiher assets exceed hislher liabilities (including contingent liabilities); That upon transferring any assets to the Trustees of the Trust, the value of the Relevant Party's remaining assets will exceed hislher liabilities defined in (ii) above. to) Hefshe understands that once the Trust is created, legal ownership of the Trust property transfers from the Relevant Party to the Trusteets) and that retention of control by himlher over the Trust assets and control of the Trustee is likely to render the Trust a "sham" in law. All information provided in the relevant due diligence questionnaire is true and correct and heishe authorises Bentleys Chartered Accountants Limited to take up such references as they may deem ?t to establish hisfher bona ?des. Hefshe is not aware of any action cause or litigation of whatever nature threatening or outstanding, contingent or pending against himfher or affecting any of hisfher assets and hetshe does not have actual notice of any such claim or of the facts or circumstances which may render himlher liable to any such claim. it) Hefshe has no intention of using the Trust to evade (nor has the Trust been established with a view to evading) any tax obligation of whatever nature and heishe hereby undertakes that all income and capital gains and all such other details of whatever nature as are required by relevant legislation shall be declared by himfher as required under the laws of hisiherjurisdiction. The Settlor has sought professional tax advice in hisiher jurisdiction of domicilefresidence and in each jurisdiction in which any assets are located with regard to the establishment of the Trust and the Setllor understands that Bentleys Chartered Accountants Limited takes no responsibility for any tax consequences of the Trust, nor for any disclosures required to be made to governmental authorities. None of the assets or income to be transferred, either initially or subsequently to the Trustees of the Trust relates to or is in any manner derived from armaments, unlawful drugs or other unlawful controlled substances, money laundering of whatsoever nature, terrorist acts, or any other activity which the Relevant Party knows to be unlawful in hisiher country of citizenship, residence or domicile or in any other part of the world. None of hisiher net worth, income or activities relates in any manner to or is derived from armaments, unlawful drugs or other unlawful controlled substances, money laundering of whatsoever nature, terrorist acts or any other activity which hefshe 3. (-1 Irma Bentleys knows to be unlawful in hisiher country of citizenship, residence or domicile or in any other part of the world. Heishe further understands that, if hefshe made any untruthful, false or misleading statement regarding any of the representations made herein, the Trusthettlement may be voidable at the instance of or upon application by any creditor to a competent Court of Law and the assets held thereunder may be liable to claim by any such creditor andior liable to confiscation by a competent Authority. Hefshe does not intend to hinder, delay or defraud any creditors, or to engage in any unlawful conduct in relation to creditors and does not intend to engage other entities in order to facilitate or otherwise engage in such activity. Hefshe is not a resident for taxation purposes in the United States of America, France, Australia or New Zealand. I have carried out due diligence checks on himfher and can confirm that there is no information in my possession to suggest that hefshe is not a fit and proper person and particularly to my knowledge:- Heishe has never been refused malpractice insurance, liability insurance or indemnity insurance. Neither heishe or any corporation of which heishe has ever been an Officer, Director, or a ten per cent or more shareholder, within the last ten years has ever been bankrupt. or been obliged to compound with creditors and there is no such action currently outstanding. Hisiher tax returns have been filed to date and is not currently being audited by state federal tax authorities or the tax authorities in any other jurisdiction. There are no actions filed or threatened to be ?led against himiher from any source. No company of which hefshe has ever been an Officer. Director, or a ten per cent or more shareholder, has ever been convicted of any crime (other than minor traf?c violations), indicted, or been the subject of any investigation or been interviewed in connection with any investigation by any government law enforcement agency or regulatory body. Except as otherwise disclosed in the relevant due diligence questionnaire, hefshe is not a Politically Exposed Person. (9) None of the following Relevant Parties are a US person Person") for the purposes of the Foreign Account Tax Compliance Act 1. Maria Teresa Cubria Cavazos ii. Juan Armando Hinoiosa Ma Teresa Garcia Cubria iv. Maria Teresa Hinoiosa Garcia v. Maria Fernanda Hinoiosa Garcia The following Relevant Parties are each a US Person for the purposes of FATCA and undertake to ensure full compliance with any FATCA requirements as are or which may be required from time to time: Bentleys 4. If either the Settlor or a Bene?ciary or another Relevant Party in the future becomes fiscally resident in the United States of America, France or Australia, we undertake to notify you immediately upon becoming aware and to make the appropriate arrangements in respect of all obligations to the relevant authorities in that jurisdiction. if either the Settlor or a Beneficiary or another Relevant Party in the future becomes fiscally resident in New Zealand, we undertake to notify you immediately upon becoming aware. 5. ?We acknowledge that: 1. No tax advice is being provided by Bentleys Chartered Accountants in this questionnaire and as part of the constitution of this structure and if any such tax advice is required. that this will be the subject of a separate engagement. 2. If the trustee of the Trust makes its decisions or is controlled in a country other than New Zealand, you do not have any responsibility in respect of any consequences that may arise as a result of other jurisdictions? treatment of the Trust andlr or the trustee. 3. In all cases New Zealand sourced income will be subject to full New Zealand income tax in New Zealand. This can include offshore investment income if the investments are partly undertaken or managed or controlled in New Zealand or contracts are entered into in New Zealand. 4. You are not assuming any FATCA work whatsoever. We accept responsibility to advise you immediately of any FATCA obligations which may include any change in any Relevant Party?s FATCA status or if there are any changes in their US connections. 5. In addition to all due diligence documents provided to you. we confirm that we have carried out the necessary checks by the use of all US indicia as required by FATCA and will undertake the ongoing checks as required by FATCA to determine whether any Relevant Party is a US Person and, if a US Person is identified. we will undertake the necessary compliance with the New Zealand and.r or American authorities as may be required, which may include, inter alia, the appointment of a withholding agent. I FURTHER UNDERTAKE to notify you of any future information that may come to light suggesting himi'her to be otherwise than a ?t and proper person with whom to do business. . i4 I Signature: WDC x/jf22ad1 Name: (Please print] Edison Teano Date: 21 September 2015 1D Bentleys Schedule 1: Definitions ?Bene?cial Owner" means an individual who: a) has effective control of a customer or person on whose behalf a transaction is conducted; or b) owns 25 per cent or more of the customer or person on whose behalf a transaction is conducted. Note that: a} in respect of a trust, the Beneficial Owners may include the trustees and any other individual who has effective control over the trust, specific trust property. or with the power to amend the trust?s deeds, or remove pr appoint trustees. This might include a protector or special trustee (if there are any), or one or more bene?ciaries of the trust; b) in respect of a company, the Beneficial Owners may include shareholders, senior management such as the CEO, and any other person with effective control, such as some directors; and c) in respect of a partnership or limited partnership, the Bene?cial Owners may include general and limited partners. ?Politically Exposed Person? means: a) an individual who holds, or has held at any time in the preceding 12 months, in any overseas country the prominent public function of: i. Head of State or head of a country or government; or ii. government minister or equivalent senior politician; or Supreme Court Judge or equivalent senior Judge; or iv. governor of a central bank or any other position that has comparable influence to the Governor of the Reserve Bank of New Zealand; or v. senior foreign representative, ambassador, or high commissioner; or vi. high-ranking member of the armed forces; or vii. board chair. chief executive, or chief ?nancial officer of, or any other position that has comparable influence in, any State enterprise; and b) an immediate family member of a person referred to in paragraph including: i. a spouse: or ii. a partner, being a person who is considered by the relevant national law as equivalent to a spouse; or a child and a child?s spouse or partner; or iv. a parent; and c) having regard to information that is public or readily available,? i. any individual who is known to have joint bene?cial ownership of a legal entity or legal arrangement, or any other close relationship, with a person referred to in paragraph or ii. any individual who has sole beneficial ownership of a legal entity or legal arrangement that is known to exist for the benefit of a person described in paragraph "Trusted Referee" means: a) a director of MF Legal Services; or b) a notary public; or c) an Ambassador, High Commissioner, Commissioner, Minister, Counsellor, Charge d'Affaires, Head of Mission, Consular Officer, Pro-consul, Trade Commissioner, or Tourist Commissioner of a Commonwealth country {including New Zealand), who is not: d) related to the customer or person being identified; e) the spouse or partner of the customer or person being identified; or t) a person who lives at the same address as the customer or person being iden??ed. 11 Bentleys Schedule 2: Due Diligence template Please complete fully the personal information requested below for each Beneficial Owner, each party transferring assets to the Trust and each party acting on behalf of another person. Where the relevant party is a company, trust. partnership or other corporate entity, please let us know in advance as we may need to provide an alternative form of due diligence template. Full Name: Maria Teresa Cubria Cavazos Home Address: Phone (Home): (Office); +55 5515 9709 Facsimile: E-mail address: Nationality: Mexican Domicile (include information if Resident but non-Domiciled): Mexican Fiscal Residence: Mexico Date Place of birth: 3 February 1934 Mexico Passport Nor Occupation: Retired Relationship to Settlor/customer/T rust: Client Is the person a Bene?cial Owner (as defined in Schedule Is the person a Politically Exposed Person (as de?ned in Schedule YESQB) If the person is a Bene?cial Owner and a Politically Exposed Person. please provide a brief description of the source of funds or wealth of the person: Other persons (if any) acting on behalf of the person (please complete a due diligence questionnaire for each): . Bentleys (Please enclose: a} a photocopy of the identification pages of the person's passport that has been b) d) 9) certi?ed as a true copy of the original by a Trusted Referee (as defined in Schedule 1), such certi?cation to have been carried out within the preceding three months; and to con?rm that it represents a true representation of the person; and a photocopy of a utilities bill that is no more than three months old, con?rming the person?s address and that has been certified as a true copy of the original by a Trusted Referee; and evidence of the enquiries you have carried out in order to satisfy yourself whether either the person, or any person acting on his or her behalf, is a Politically Exposed Person; and copies of information con?rming the source of funds or wealth of the person; and if the person is acting on behalf of another person, evidence of hisfher authority to do so) Bentleys Schedule 2: Due Diligence template Please complete fully the personal information requested below for each Beneficial Owner, each party transferring assets to the Trust and each party acting on behalf of another person. Where the relevant party is a company, trust, partnership or other corporate entity, please let us know in advance as we may need to provide an alternative form of due diligence template. Full Name: Ma Teresa Garcia Cubria Home Addr 8581 Mexico Citv. Mexico. Phone (Home): (Of?ce): Facsimile: E-mail address: Nationality: Mexican Domicile (include information if Resident but non-Domiciled): Fiscal Residence: Mexico Date Place of birth: 17 February 1959/ Mexico Occupation: Relationship to Settlor/customer/T rust: Settlor's daughter ls the person a Bene?cial Owner (as defined in Schedule .. ?3 Is the person a Politically Exposed Person (as de?ned in Schedule If the person is a Bene?cial Owner and a Politically Exposed Person, please provide a brief description of the source of funds or wealth of the person: Other persons (if any) acting on behalf of the person (please complete a due diligence questionnaire for each): .II Bentleys (Please enclose: a) a photocopy of the identi?cation pages of the person?s passport that has been certi?ed as a true copy of the original by a Trusted Referee {as defined in Schedule 1), such certi?cation to have been carried out within the preceding three months; and to confirm that it represents a true representation of the person; and a photocopy of a utilities bill that is no more than three months old. con?rming the person's address and that has been certi?ed as a true copy of the original by a Trusted Referee; and evidence of the enquiries you have carried out in order to satisfy yourself whether either the person. or any person acting on his or her behalf, is a Politically Exposed Person; and copies of information confirming the source of funds or wealth of the person; and if the person is acting on behaif of another person. evidence of hislher authority to do so.) Ri?es Schedule 2: Due Diligence template Please complete fully the personal information requested below for each Beneficial Owner, each party transferring assets to the Trust and each party acting on behalf of another person. Where the relevant party is a company, trust, partnership or other corporate entity, please let us know in advance as we may need to provide an alternative form of due diligence template. Full Name: Juan Armando Hinoiosa Cantu Home Address: Mexico any, Mexico. Phone (Home): (Of?ce): Facsimile: E-mail address: Nationality: Mexican Domicile (include information if Resident but non-Domiciled): Fiscal Residence: Mexico Date Place of birth: 03 January 1956/ Mexico passponwo; Occupation: Businessman Relationship to Settlor/customer/T rust: Settlor's son-in-law Is the person a Beneficial Owner (as de?ned in Schedule Is the person a Politically Exposed Person (as de?ned in Schedule If the person is a Bene?cial Owner and a Politically Exposed Person. please provide a brief description of the source of funds or wealth of the person: Other persons (if any) acting on behalf of the person (please complete a due diligence questionnaire for each): Bentieys (Please enclose: a) d) e) a photocopy of the identi?cation pages of the person?s passport that has been certified as a true copy of the original by a Trusted Referee {as defined in Schedule 1), such certi?cation to have been carried out within the preceding three months; and to confirm that it represents a true representation of the person; and a photocopy of a utilities bill that is no more than three months old; confirming the person's address and that has been certified as a true copy of the original by a Trusted Referee; and evidence of the enquiries you have carried out in order to satisfy yourself whether either the person; or any person acting on his or her behalf, is a Politically Exposed Person; and copies of information confirming the source of funds or wealth of the person; and if the person is acting on behalf of another person, evidence of hisfher authority to do so.) Bentleys Schedule 2: Due Diligence template Please complete fully the personal information requested below for each Beneficial Owner, each party transferring assets to the Trust and each party acting on behalf of another person. Where the relevant party is a company, trust. partnership or other corporate entity, please let us know in advance as we may need to provide an alternative form of due diligence template. Full Name: Maria Teresa Hinoiosa Garcia Home Address: Mexico City, Mexico. Phone (Home): (Of?ce): Facsimile: E-mail address: Nationality: Mexican Domicile (include information if Resident but non-Domiciled): Fiscal Residence: Mexico Date 8 Place of birth: 28 September 1979/ Mexico Passport No: Occupation: Relationship to Settlor/customerfl' rust: Settlor's qranddauqhter Is the person a Bene?cial Owner (as de?ned in Schedule Is the person a Politically Exposed Person (as de?ned in Schedule If the person is a Bene?cial Owner and a Politically Exposed Person, please provide a brief description of the source of funds or wealth of the person: Other persons (if any) acting on behalf of the person (please complete a due diligence questionnaire for each): Bentleys (Please enclose: a) b) C) a photocopy of the identification pages of the person?s passport that has been certi?ed as a true copy of the original by a Trusted Referee {as defined in Schedule 1), such certi?cation to have been carried out within the preceding three months; and to con?rm that it represents a true representation of the person; and a photocopy of a utilities bill that is no more than three months old, con?rming the person's address and that has been certified as a true copy of the original by a Trusted Referee; and evidence of the enquiries you have carried out in order to satisfy yourself whether either the person, or any person acting on his or her behalf, is a Politically Exposed Person; and copies of information confirming the source of funds or wealth of the person; and if the person is acting on behalf of another person, evidence of hisfher authority to do so.) Schedule 2: Due Diligence template Please complete fully the personal information requested below for each Beneficial Owner, each party transferring assets to the Trust and each party acting on behalf of another person. Where the relevant party is a company, trust, partnership or other corporate entity, please let us know in advance as we may need to provide an alternative form of due diligence template. Full Name: Maria Fernanda Hinoiosa Garcia Home Address: Mexico City, Mexico. Phone (Home): (Office): Facsimile; E-mail address: Nationality: Mexican Domicile (include information if Resident but non-Domiciled): Fiscal Residence: Mexico Date Place of birth: 27 August 1987/ Mexico Occupation: Relationship to Settlor/customer/Trust: Settlor's granddaughter Is the person a Bene?cial Owner (as de?ned in Schedule Is the person a Politically Exposed Person (as de?ned in Schedule If the person is a Beneficial Owner and a Politically Exposed Person. please provide a brief description of the source of funds or wealth of the person: Other persons (if any) acting on behalf of the person (please complete a due diligence questionnaire for each): Bentleys I a "I'r (Please enclosephotocopy of the identification pages of the person?s passport that has been certi?ed as a true copy of the original by a Trusted Referee (as de?ned in Schedule 1), such certi?cation to have been carried out within the preceding three months; and to con?rm that it represents a true representation of the person; and a photocopy of a utilities bill that is no more than three months old, con?rming the person's address and that has been certified as a true copy of the original by a Trusted Referee; and evidence of the enquiries you have carried out in order to satisfy yourself whether either the person, or any person acting on his or her behalf, is a Politically Exposed Person; and copies of information confirming the source of funds or wealth of the person; and if the person is acting on behalf of another person. evidence of hislher authority to do so.) CONTRATO OE OONACION A TITULO GRATLIITO QUE OTORGA LA SRA. TERESA CUORIA A OE su MAORE LA SERORA MARIA TERESA CUORIA COMO EN TERMINDS DE LOS PREVISTO POR EL COOIGO PARA EL DISTRITO FEDERAL, OE CONFORMIOAO CON LAs SIGUIENTES OECLARACIONES CLAUSULAS. -- A A I -- I.- Declare que es titular de Ias aCCfOnes activps de la empresa Provence Limited. -- II.- Declara que a partlr de la feCha del presente instrumentO, trasladara vl'a transferencia depositO a cualquier cuenta a hombre de su maOlre TERESA CAVAZOS, bajO la ?gure juridica de la donaci?n gratuita, de las cuentas bancarias de las empresas, refe?das en la daclaraCiOn primera del presente inetrumento. -- For su parte declare que acepta la donacl?n que hace en su favor, su se?ora hija, reconpce haber recibidO la denaci?n a partir del mes de marzo del dos mil quince a su Favor. -- -- ExpuestO IO anterior, los comparecientes otorgan las siguientes: A A -- PRIMERA: Las partes rati?can en tOdos sus terminus la donatic?nn efeCtuaCla con anterioridad a la firma del presente instrumentp, reconOCiendO el haber reCibidO las Cantidades a ella ministradas, bajO la ?gura juridica cle [a dpnaci?n. -- -- SEGUNDA.- 0 A A las cantidades en diversas ministraciones cle acuerdo a la estahlecldo en Ias declaraciones del presente instrumentO, en un periOdO n0 mayor a 2 Contados a partir de la firma del presente instrumentO. -- -- L05 otOrgantes mani?estan que la donaCiOn que ahOra se realiza es 3 tl'tulo gratuito, manifestandp que nO Obstante la donaci?n que aqul' ptorga 5e reserve bienes medias Suficientes para subsistir agregando nO encontrarse en el supuestO a que se refiere El COdigO Civil clel Distrito Federal. -- -- CUARTA.- Las partes manlfiestan, que en la celebraci?n del presente contrato nO existe errOr, drain 0 male Fe que pudiera invalidarlo, aceptan someterse a la jurisdiCCiOn de Ios tribunales del DistritO Federal, para el case cle controversia derivada por la interpretaci?n del mismo. -- -- A 5 -- L05 comparecientes mani?estan por sue generales ser: h) -- La Sra. TERESA CUBRIA, mexicana por nacimiento, originaria de Reynosa, Tamps. Lugar donde naci? el 17 de Febrero de 1959, casada, empresaria, con domicilio en Calle Juan Trasmonte No. 800, Col. Villas de la Ca?ada, Santa Fe en la Ciudad de M?xico, D.F., identi?c?ndose con el documento que en este acto exhibe. -- -- La se?ora TERESA CUBRIA CAVAZOS, mexlcana por nacumlento, originaria de Reynosa, Tamaulipas, lugar donde naci? el dia 3 de febrero de 1934, soltera, empresaria, con domicilio en ?Reynosa Tam. Mexico, identific?ndose con el documento que en este acto exhibe. Se firma el presente a los 20 dfas del mes de marzo del dos rnil quince. .4 :35. 4_ (v u? SRA. MARIA TERESA GARCIA CUBRIA SRA. MARIA TERESA CUBRIA TRANSLATION GRATUITOUS GIFT CONTRACT GRANTED BY MRS. MARIA TERESA GARCIA CUBRIA, IN FAVOR OF HER MOTHER, MRS. MARIA TERESA CUBRIA CAVAZOS, AS PROVIDED FOR IN THE CIVIL CODE FOR THE FEDERAL DISTRICT, IN ACCORDANCE WITH THE FOLLOWING STATEMENTS AND CLAUSES. STATEM ENTS I. states that she is the holder of shares and assets of the company Provance Limited. II. states that as of the date of this document, she will assign by means of a transfer or deposit to any account in the name of her mother MARIA TERESA CUBRIA CAVAZOS, the checking account of the company referred to in statement number 1 above, under the legal concept of a gratuitous donation. declares that she accepts the gift made to her by her daughter and acknowledges having received the gift in her favor as of the month of March two thousand fifteen. Having expressed the above, the appearers set forth the following CLAUSES: FIRST: The parties ratify in all of its terms the gift made prior to the signing of this document, and acknowledges having received the amounts provided to her by means of the legal concept known as the Gift. SECOND: GIFTS TO the amounts in various donations or disbursements, according to the provisions of the statements contained herein, within a period not exceeding 2 years as of the signing of this document. THIRD: The grantors state that the gift that is being made is done gratuitously and THE DONOR declares that notwithstanding the donation hereby granted, she reserves sufficient assets and means to survive economically, adding that she does not fall within the definition or assumption referred to in the Civil Code of the Federal District. FOURTH: The parties declare that in entering into this agreement there is no error, fraud or bad faith that could invalidate it and that they accept to submit themselves to the jurisdiction of the Federal District courts in case of any dispute arising from its interpretation. GENERAL CONSIDERATIONS The appearers make the following general statements: Mrs. MARIA TERESA GARCIA CUBRIA is Mexican by birth, a native of Reynosa, Tamps, where she was born on the 17th of February 1959, married, businesswoman, domiciled at? State of Mexico, Federal District, bearing the document number shown in this act. Mrs. MARIA TERESA CUBRIA CAVAZOS is Mexican by birth, a native of Reynosa, Tamaulipas, where she was born on the 3rd of March 1934, single, businesswoman, domiciled in? ?Reynosa Tam, Mexico, bearing the identification document shown in this act. This document has been signed on the 20?h day of the month of March of the year two thousand fifteen. (II/egib/e signature) (I/Iegib/e signature) Mrs. Maria Teresa Garca Cubria Mrs. Maria Teresa Cubria Cavazos TI 11?: FOREGOING TEXT IS A TRUE AND TRANSLATION OF AN ORIGINAL DOCUMENT IN THE SPANISH LANGUAGE. PANAMA. 30?? OCTOBER 2015 YESENIA I. 'o RROCHA CERTIFIEDP IISLATOR it . zolvnm Panama Panarra