Common use of CERTIFICATION OF BENEFICIAL Clause in Contracts

CERTIFICATION OF BENEFICIAL. OWNER(S) Persons transacting business on behalf of a legal entity must provide the following information: a. Name and Title of Natural Person: __________________________________________________________________ b. Name and Address of Legal Entity: __________________________________________________________________ c. The following information for each individual, if any, who, directly or indirectly, through any contract, arrangement, understanding, relationship or otherwise, owns 25 percent or more of the equity interests of the legal entity listed above: Name Date of Birth Address (Residential or Business Street Address) For U.S. Persons: Social Security Number For Foreign Persons: Passport Number and Country of Issuance, or other similar identification number d. The following information for one individual with significant responsibility for managing the legal entity listed above, such as: · An executive officer or senior manager (e.g., Chief Executive Officer, Chief Financial Officer, Chief Operating Officer, Managing Member, General Partner, President, Vice President, Treasurer); or · Any other individual who regularly performs similar functions. (If appropriate, an individual listed under section (c) above may also be listed in this section (d)). Name Date of Birth Address (Residential or Business Street Address) For U.S. Persons: Social Security Number For Foreign Persons: Passport Number and Country of Issuance, or other similar identification number I, (name of natural person), hereby certify, to the best of my knowledge, that the information provided above is complete and correct. Signature: _____________________________ Date: _________________________________

CERTIFICATION OF BENEFICIAL. OWNER(S) Persons transacting business on behalf of a legal entity must provide the following information: a. Name and Title of Natural Person: __________________________________________________________________ b. Name and Address of Legal Entity: __________________________________________________________________ c. The following information for each individual, if any, who, directly or indirectly, through any contract, arrangement, understanding, relationship or otherwise, owns 25 percent or more of the equity interests of the legal entity listed above: Name Date of Birth Address (Residential or Business Street Address) For U.S. Persons: Social Security Number For Foreign Persons: Passport Number and Country of Issuance, or other similar identification number d. The following information for one individual with significant responsibility for managing the legal entity listed above, such as: · • An executive officer or senior manager (e.g., Chief Executive Officer, Chief Financial Officer, Chief Operating Officer, Managing Member, General Partner, President, Vice President, Treasurer); or · • Any other individual who regularly performs similar functions. (If appropriate, an individual listed under section (c) above may also be listed in this section (d)). Name Date of Birth Address (Residential or Business Street Address) For U.S. Persons: Social Security Number For Foreign Persons: Passport Number and Country of Issuance, or other similar identification number I, (name of natural person), hereby certify, to the best of my knowledge, that the information provided above is complete and correct. Signature: _____________________________ Date: _________________________________

CERTIFICATION OF BENEFICIAL. OWNER(S) Persons transacting business on behalf of a legal entity must provide the following information: a. Name and Title of Natural Person: __________________________________________________________________ b. Name and Address of Legal Entity: __________________________________________________________________ c. The following information for each individual, if any, who, directly or indirectly, through any contract, arrangement, understanding, relationship or otherwise, owns 25 percent or more of the equity interests of the legal entity listed above: Name Date of Birth Address (Residential or Business Street Address) For U.S. Persons: Social Security Number For Foreign Persons: Passport Number and Country of Issuance, or other similar identification number d. The following information for one individual with significant responsibility for managing the legal entity listed above, such as: · • An executive officer or senior manager (e.g., Chief Executive Officer, Chief Financial Officer, Chief Operating Officer, Managing Member, General Partner, President, Vice President, Treasurer); or · • Any other individual who regularly performs similar functions. (If appropriate, an individual listed under section (c) above may also be listed in this section (d)). Name Date of Birth Address (Residential or Business Street Address) For U.S. Persons: Social Security Number For Foreign Persons: Passport Number and Country of Issuance, or other similar identification number I, (name of natural person), hereby certify, to the best of my knowledge, that the information provided above is complete and correct. Signature: _____________________________ Date: _________________________________.