Professional Documents
Culture Documents
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Passport No: AU210853 of COLOMBIA Date Expiry: 09 OCT/OCT 2027
Address: AV CALLE 26 # 69D - 91, EDIFICIO ARRECIFE OFI 303 TORRE 2 BOGOTA-
COLOMBIA
Postal Code: 110111
. ..
Telephone Mobile: (+57) 3153567544 E-mail: presidencia@cipacificgold.com Pag. 1 de 7.
In accordance with Articles Two (2) through Five (5) of the Due Diligence Convention and the Federal Banking Commission
Circular of December 1998, concerning the prevention of money laundering, and Article 305 of the Swiss Criminal Code,
the following information may be supplied to banks and/orother financial institutions for the purpose of verification of
identity and activities of the investing Member, and the nature and origin of the funds which are to be utilized. All parties
have an obligation to respect professional secrecy and to take all appropriate precautions to protect the confidentiality of
the information each holds in respect of the other's activities. This legal obligation shall remain in full force and effect at
ALL
times. Directions: This document should be completed in full. If a line item does not pertain, then insert the term: "N/A"
(non-applicable).
Corporate Information
Telephone Number
: N/A
Languages/ Translator
Languages
: N/A
Does the Signatory speak English?
: N/A
If No, Name ofTranslator
: N/A
Tel Number
: N/A
Email Address
: N/A
Legal Advisor
Full Name
: N/A
(Please attach copy of the corporate resolution adopted by the Board of Directors appointing and authorizing said
officer(s) below to represent and legally bind the corporation)
(You may duplicate the section above for each Director involved in transaction)
Investment
1. I,WILSON CASTILLO QUILINDO, hereby declare as the undersigned, having the full signatory power to
transfer, assign, pledge or reserve upon terms satisfactory to me, with full authority to execute all documents and
agreements relating to the same.
2. I, WILSON CASTILLO QUILINDO, hereby grant permission to contact all parties and institutions named within
this document, including the authorization to verify these disclosures.
3. I, WILSON CASTILLO QUILINDO, hereby swear under penalty of perjury, that the information provided herein is
accurate and true as of this date: 9 September 2022.
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Signature: _
Name /Title : WILSON CASTILLO QUILINDO
Passport No. : AU210853
Date of Issue : 09 OCT/OCT 2017
Date of Expiry : 09 OCT/OCT 2027
Country of Issuance : COLOMBIA
,shall be: -·
COPY PASSPORT
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► Known as CIS, the (Client Information Sheet) is the document that identifies the investor with all its data.
► This document will beessential to be able to present the transaction in the office of the trader and thus
initiate