Type of Controlling Person. (ONLY to be completed by any individual who is a Controlling Person of an entity investor which is a Passive Non-Financial Entity or an Investment Entity located in a Non-Participating Jurisdiction and managed by another Financial Institution). For joint or multiple Controlling Persons please complete a separate Self-Certification form for each Controlling Person. Please confirm what type of Controlling Person applicable under CRS that applies to you/the investor by ticking the appropriate box. Please tick Entity Name Controlling Person of a legal person – control by ownership ☐ Controlling Person of a legal person – control by other means ☐ Controlling Person of a legal person – senior managing official ☐ Controlling Person of a trust – settlor ☐ Controlling Person of a trust – trustee ☐ Controlling Person of a trust – protector ☐ Controlling Person of a trust – beneficiary ☐ Controlling Person of a trust – other ☐ Controlling Person of a legal arrangement (non-trust) – settlor-equivalent ☐ Controlling Person of a legal arrangement (non-trust) – trustee-equivalent ☐ Controlling Person of a legal arrangement (non-trust) – protector-equivalent ☐ Controlling Person of a legal arrangement (non-trust) – beneficiary-equivalent ☐ Controlling Person of a legal arrangement (non-trust) – other-equivalent ☐
Type of Controlling Person. If the Controlling Person is tax resident in more than three jurisdictions please use a separate sheet Jurisdiction(s) of tax residency Tax reference number type Tax reference number (e.g. TIN) If applicable, please specify the reason for non-availability of a tax reference number: 18 The Controlling Person's TIN is not required to be collected if the Controlling Person is not a Reportable Jurisdiction Person.
Type of Controlling Person. (Please only complete this section if you are tax resident in one or more Reportable Jurisdictions)
Type of Controlling Person. Tick the appropriate box to indicate the type of controlling person for each entity stated in Part 2. Type of Entity Type of Controlling Person Entity (1) Entity (2) Entity (3) Legal Person Individual who has a controlling ownership interest (i.e. not less than 25% of issued share capital) Individual who exercises control/is entitled to exercise control through other means (i.e. not less than 25% of voting rights) Individual who holds the position of senior managing official/ exercises ultimate control over the management of the entity Trust Settlor Trustee Protector Beneficiary or member of the class of beneficiaries Other (e.g. individual who exercises control over another entity being the settlor/trustee/protector/beneficiary) Legal Arrangement Individual in a position equivalent/similar to settlor other than Trust Individual in a position equivalent/similar to trustee Individual in a position equivalent/similar to protector Individual in a position equivalent/similar to beneficiary or member of the class of beneficiaries Other (e.g. individual who exercises control over another entity being equivalent/similar to settlor/trustee/protector/beneficiary)
Type of Controlling Person. If the Controlling Person is tax resident in more than three countries please use a separate sheet Country/countries of tax residency Tax reference number type Tax reference number (e.g. TIN) If applicable, please specify the reason for non-availability of a tax reference number:
Type of Controlling Person. (ONLY to be completed by any individual who is a Controlling Person of an entity investor which is a Passive Non-Financial Entity or an Investment Entity located in a Non-Participating Jurisdiction and managed by another Financial Institution) For joint or multiple Controlling Persons please complete a separate Self-Certification Form for each Controlling Person Please Confirm what type of Controlling Person applicable under CRS that applies to you/the investor by ticking the appropriate box. Please Tick Entity Name Controlling Person of a legal person – control byownership Controlling Person of a legal person – control by othermeans Controlling Person of a legal person – senior managingofficial Controlling Person of a trust - settlor Controlling Person of a trust – trustee Controlling Person of a trust – protector Controlling Person of a trust – beneficiary Controlling Person of a trust – other Controlling Person of a legal arrangement (non-trust) –settlor-equivalent Controlling Person of a legal arrangement (non-trust) –trustee-equivalent Controlling Person of a legal arrangement (non-trust) –protector-equivalent Controlling Person of a legal arrangement (non-trust) –beneficiary-equivalent Controlling Person of a legal arrangement (non-trust) –other-equivalent
Type of Controlling Person. If the Controlling Person is tax resident in more than three jurisdictions please use a separate sheet Jurisdiction(s) of tax residency Tax reference number type Tax reference number (e.g. TIN) If applicable, please specify the reason for non-availability of a tax reference number using one of these choices: • Reason 1: The entity will apply or has applied for a tax reference number but has not yet received it • Reason 2: The entity’s jurisdiction of tax residence does not issue tax reference numbers to its residents • Reason 3: Other reason (please specify) 28 The Controlling Person’s TIN is not required to be collected if the Controlling Person is not a Reportable Jurisdiction Person. (Please only complete this section if you are tax resident in one or more Reportable Jurisdictions)
Type of Controlling Person a. Controlling Person of a legal person – control by ownership
Type of Controlling Person. If the Controlling Person is tax resident in more than three jurisdictions please use a separate sheet Jurisdiction(s) of tax residency Tax reference number type Tax reference number (e.g. TIN) If applicable, please specify the reason for non-availability of a tax reference number: 12 The Controlling Person’s TIN is not required to be collected if the Controlling Person is not a Reportable Jurisdiction Person. Section 8 – Type of Controlling Person (Please only complete this section if you are tax resident in one or more Reportable Jurisdictions) Please provide the Controlling Person's Status by ticking the appropriate box. Entity 1 Entity 2 Entity 3
Type of Controlling Person. If the Controlling Person is tax resident in more than three jurisdictions please use a separate sheet. Jurisdiction(s) of tax residency Tax reference number type Tax reference number (e.g. TIN) Jurisdiction(s) of tax residency Tax reference number type Tax reference number (e.g. TIN) Jurisdiction(s) of tax residency Tax reference number type Tax reference number (e.g. TIN) If applicable, please specify the reason for non-availability of a tax reference number: NOT FOR DISTRIBUTION Reason for non-availability of a tax reference number 18The Controlling Person’s TIN is not required to be collected if the Controlling Person is not a Reportable Jurisdiction Person.