EO/00040

TPN - LAX00021
Date: 7/1/2021

Membership Certificate

This is to certify that Dasho/Mr/Ms Deepen Sharma is an active member of The Samdrup Jongkhar Initiative,
project under the auspices of Lhomon Society, a registered civil society organization.

1. Address: Pakha Goan, Sipsu, Samtse

2. Name of Organization: DGPC

3. Citizenship Identity Card No. : 21214000776

4. Membership Type: Yearly

5. Total Amount paid during the year 2020: Nu. 1,300.00

Disclaimer::: This computer generated Membership Certificate is meant solely for the purpose of filing Personal Income Tax (PIT) for the income year 2020 with the Department of
Revenue and Customs (DRC) at the time of compiling PIT. Samdrup Jongkhar Initiative shall not be responsible for misuse of this document or alteration or distortion of information
contained in this document.