THE COMPANIES ACT

(CHAPTER 50)
SECTION 173C(a)

CONSENT TO ACT AS DIRECTOR

AND STATEMENT OF NON
DISQUALIFICATION TO ACT AS
DIRECTOR

Name of Company : EMEDISURE PTE. LTD.

Company No :

I, the undermentioned person, hereby consent to act as a director of the abovenamed

company with effect from ……………… (date) and declare that:

(a) I am not disqualified from acting as a director, in that:

(i) I am not below 18 years of age and that I am otherwise of full legal capacity.

(ii) Within a period of 3 years preceding the date of this statement I have not had any
disqualification order made by the High Court of Singapore against me under section
149A(1) of the Companies Act (“the Act”).

(iii) Within a period of 5 years preceding the date of this statement I have not had any
disqualification order made by the High Court of Singapore against me under section
149(1) or 154(2) of the Act.

*(iv) That within a period of 5 years preceding 12th November 1993 I have not been
convicted whether within or without Singapore, of any offence —
(A) in connection with the promotion, formation or management of a corporation;

(B) involving fraud or dishonesty punishable on conviction with imprisonment for

3 months or more; or

(C) under section 157 (failure to act honestly and diligently as a director or making
improper use of company information for gain) or under section 339 (failure to
keep proper company accounts books) of the Act.

*(v) That within a period of 5 years preceding the date of this statement I have not been
convicted, in Singapore or elsewhere, of any offence involving fraud or dishonesty
punishable on conviction with imprisonment for 3 months or more.
 (vi) That —
(A) I have not been convicted of 3 or more offences under the Act in relation to the
requirements on the filing of returns, accounts or other documents with the
Registrar of Companies and have not had 3 or more orders of the High Court
of Singapore made against me under section 13 or 399 of the Act in relation to
such requirements;

(B) the last of any such conviction did not take place or the last of any such order
was not made during the period of 5 years preceding the date of this statement;
and
(C) I am not an undischarged bankrupt under section 148(1) of the Act.

(vii) By virtue of the foregoing I am not disqualified from acting as a director of the
abovenamed company.

(b) I am aware of and undertake to abide by my duties, responsibilities and liabilities specified
in the Act as well as under the common law where applicable, including the following key
administrative and substantive duties, that is, to:

(i) discharge my responsibilities in the company;

(ii) ensure that I have a reasonable degree of skill and knowledge to handle the affairs of
the company;

(iii) act honestly and be reasonably diligent in discharging my duties and act in the interest
of the company without putting myself in a position of conflict of interest;

(iv) employ the powers and assets that I am entrusted with for the proper purposes of the
company and not for any collateral purpose;

(v) ensure that the company and I comply with all the requirements and obligations under
the Act including those in respect of meetings, requisitions, resolutions, accounts, reports,
statements, records and other documents on the company, filing and notices and any other
prerequisites; and

(vi) account to the shareholders for my conduct of the affairs of the company and make
such disclosures that are incumbent upon me under the Act.
 (c) That —
*(i) I have read and understood the above statements; or
*(ii) the above statements were interpreted to me in

……………………………………………………
(state language/dialect)

by…………………………………………………
(state name)

NRIC NO: ……………………………………….

before I executed this form and I confirm that the statements are true. I am also aware that I
can be prosecuted in Court if I willfully give any information on this form which is false.

Name : KESAV SREE KUMAR

Address : DLF GARDEN CITY - C05064, TOWER - 5, 6TH FLOOR, DOOR NO. 064,
THAZHAMPUR POST, SEMMANJERI, KANCHEEPURAM, TAMIL NADU
INDIA 600119

*NRIC/ Passport : Z4851340 Nationality : INDIAN (354)

No
Signature : X .............................

Dated this ………. day of ……………., ……….

* Delete where inapplicable.

Witness to the above signature:-

Signature : X ...............................

TAN ZONGYANG, AARON

 Shareholder / Director Declaration Form
EMEDISURE PTE. LTD.
Company Registration No. _______________

I, KESAV SREE KUMAR ID NO: Z4851340 of EMEDISURE PTE. LTD., proposed to be

appointed as a Director and/or shareholder of the Company, do solemnly and sincerely
declare as follows:

☐ I am not a Politically Exposed Person

☐ I am not a relative or associate of any Politically Exposed Person
☐ I have not been convicted of any financial crime in any jurisdiction
☐ I am not under trial for any financial crime in any jurisdiction

Director Declaration
☐ I am not holding this directorship in any nominee capacity
☐ I am a Nominee Director and my nominator is ________________

Shareholder Declaration
☐ I am the Shareholder and the ultimate Beneficial Owner
☐ I am a Nominee Shareholder and holding the shares in trust for _____________

I solemnly declare the statements contained in this declaration to be true. I may be subject to
prosecution if I am found to have made any false statement or intentionally suppressed any
material fact. I will update you within 14 days if there are any changes to the above
information.

________________________
KESAV SREE KUMAR

*Please tick if applicable

** politically exposed person is a person who is or has been entrusted with any prominent
public function (includes the role held by a head of state, head of government, government
minister, senior civil or public servant, senior judicial or military official, senior executive of
a state-owned corporation or senior political party official, a member of the legislature but
excludes the role held by middle-ranking or more junior officials) in Singapore, a country or
territory outside Singapore, or by an international organisation at present or anytime in past.
***Includes a spouse, a child, an adopted child, a step-child, a sibling or a parent or a close
associate of a Politically Exposed Person.
To Board of Directors
EMEDISURE PTE. LTD.

*NOTICE OF INTEREST OF DIRECTOR IN SHARES, DEBENTURES, ETC.

In accordance with Section 165 of the Singapore Companies Act, Cap. 50, I give notice of my interests in shares,
debentures, participatory interests, rights, options and contracts relating to the shares of the Company and/or related
corporation/s on the ______ day of _________________ , being the day on which I was appointed a director of the
Company.

In the event of any changes in any of the above, I shall notify the Company in writing within 2 days after the
occurrence of the event.
The Company Date of acquisition Nature of interest Price or other How held (i.e. holder,
*** consideration in trust, right to become
holder)

** Related corporation/s
Name of Date of acquisition Nature of interest Price or other How held (i.e. holder,
Corporation *** consideration in trust, right to become
holder)

*GENERAL NOTICE OF DISCLOSURE OF INTEREST (SECTION 156 OF THE SINGAPORE

COMPANIES ACT, CAP. 50)
In accordance with Section 156 of the Singapore Companies Act, Cap. 50, I give notice that I am also a
director/shareholder of the undermentioned corporation/s and firm/s, and I am to be regarded as interested in any
contract/s which may be made with this/these corporation/s or firm/s. I will notify the Company of any changes in
respect of this notification as soon as practicable.

Name of Corporation or Firm Date of acquisition

PARTICULARS OF OTHER DIRECTORSHIPS IN PUBLIC COMPANIES OR SUBSIDIARIES OF PUBLIC

COMPANIES INCORPORATED IN SINGAPORE
I am a director of the following public company/ies or subsidiary/ies of public company/ies and I will notify the
Company of any change in respect of my directorship/s in such company/ies.

No. Name of Company Company No Date of Registration

.....................................
KESAV SREE KUMAR
DIRECTOR
* Delete if not applicable.
** Where a corporation -
(a) is the holding company of another corporation; (b) is a subsidiary of another corporation; or
(c) is a subsidiary of the holding company of another corporation, that first-mentioned corporation and that other corporation shall be deemed to be
related to each other.
***No. of shares, stocks, rights, options, etc. Please also indicate percentage of shareholdings if the number of shares held is = 20% of the total paid-
up capital