The Asia Gold Mining Asset Corporation (AGMAC) Skyper Villa, Taunusanlage 1, 60329 Frankfurt am Main, Germany.

AGMAC Shareholder Declaration Form - 118A/5/13

I, Mister/Miss* JAMIL BIN AHMAD, a holder of Malaysia Passport/National Identification Card* Number 630905025445, date of expiry on ____________ (if applicable) hereby declare that I am the sole beneficiary of all AGMAC shares and options as stated in my online shareholder account number 155544569307. I also declare that, my permanent address is: Address: F 16 KAMPUNG KEPALA BUKIT Address: TOBIAR City: PENDANG, KEDAH Zip/Post Code: 06700 Country: MALAYSIA I can be reached at: Mobile Number: 0194665823 Land Line Phone Number: Fax Number: Email Address: I prefer to be reached by: Email Mobile Phone

8 PM and _______ 12 AM (local time) The best time to reach me is between: ______
I declare that all the information provided above is true to my knowledge, and that I will be held accountable should I purposely provide false information.

--------------------------------------Signature JAMIL BIN AHMAD

JAMIL

27 Day _____ 2013Year 5 Month _____ Date: ____

* Cross out whichever is not applicable * Fill up in BLOCK LETTERS only