On Letterhead

INDIVIDUAL’S AUTHORIZATION TO VER IFY

DATE: MONDAY, JULY 23, 2018

TO: ENTER THE CLIENT’S NAME - enter email address

INVESTOR TRANSACTION CODE: xxxx

I, Mr. ENTER THE CLIENT’S NAME at the address shown above give George Coutts and
Assigns my direct permission and full authority to do all matters necessary to confirm, verify,
and authenticate my beneficially owned describe the asset in full, with a face value in United
States Dollars/Euro at that time of $XXXXXX (XXXXX million Dollars/Euro). The below stated
beneficially owned describe the asset but in short form ie cash deposit is of good, clean, and
cleared funds obtained via legal means, and is currently available at the bank coordinates
below:

Asset:

Amount:

Issued by:

Rating:

Issued Date:

Maturity Date:

Depository Bank Name:

Depository Bank Address:

Account Name:

Account Number:

Account Signatory:

Bank Officer & Title:

 On Letterhead

A copy of this Authorization will be lodged with my Bank Officer. My Bank Officer will
then email me a copy of this Authorization and cc that email to both George Coutts and
Assigns who shall then have my Authority and the Bank’s Authority to both call and
otherwise communicate with the Bank for the purpose intended by this letter (to verify
the Asset).

In witness hereof I, ENTER THE CLIENT’S NAME hereby swear under penalty of perjury, that
the information provided herein is accurate and true as of this date:

For and on behalf of myself

Signature: __________________________________

Name: ENTER THE CLIENT’S NAME

Passport Number: XX

Date of Issue: XX

Date of Expiry: XX

Country of Issuance: XX