[Insert date]

To whom it may concern,

I, [insert full name], hereby declare the following:

- I do not have any criminal proceeding and have not committed any crimes
- I am not a politically exposed person ("PEP"), or a family member/close associate of a
PEP (including close relatives such as parents, spouses and children, and other natural
persons share common interests through work, life, etc.).

Should there be any change of above statement, I will notify FTX accordingly.

Sincerely,

___________________
[Insert full name]