TRUST

?Ugh-mud? '7?77" 13,71; 31%? mi? 

FOUNDATION QUESTIONNAIRE FORM

Required Information tor the of the Foundation

1. Suggested Names
in Powomw



 

2. Jurisdiction of the Foundation

3. Principal obiects and tull description of proposed activities

4. Pro (I Bene?ciaries

 

Please provide the foliowing information in respect of ALL Bene?ciaries using a separate sheet if necessary.

(1)
Surnames 0 Ir FF
Forenames JURGEN IMIM

 

 

Full Address

woiE 
Uig

DaieofBirth Ii ICI 

 

Nationality

 

Passport No

 

Occupation