WOLFGANG GÜNTER MONSELER GMBH

KRCHFCDSTE 12 94121 SALZWEG

SALZWEG GERMANY

UNIONPAY USD EURO

CLIENT INFORMATION SHEET

In accordance with Articles two (2) through five (5) of the Due Diligence Convention and the Federal
Marketing Commission Circular of December 1998, concerning the prevention of money laundering, the
following information may be supplied to banks and/or other Federal Institutions for purposes of
verification.

UNIONPAY RECEIVER INFORMATION:

Company Name : WOLFGANG GÜNTER MONSELER GMBH

License Number : 11761
Company Address : KRCHFCDSTE 12, 94121 SALZWEG, GERMANY
House Address : AHORNWEG 3, 94121 SALZWEG ,GERMANY
Representative Name : MR. GÜNTER WOLFGANG MONSELER
Passport Number : LFN30VGNW
Passport issue Date : 29-01-2015
Passport Expired Date : 28-01-2025
Passport issue Place : GERMANY

UNIONPAY BANK & CARD INFORMATION:

BANK NAME : UAB PAYTEND EUROPE BANK

BANK ADDRESS : PAMENKALNIO STR. 25-1, VILNIUS
ACCOUNT NAME : GUENTER MONSELER
ACCOUNT NUMBER USD EURO : LT56 3120 0238 1000 5025
SWIFT CODE : UAPULT22XXX
ACCOUNT SIGNATORY : MR. GÜNTER WOLFGANG MONSELER
CARD NAME : UNIONPAY
CARDHOLDER NAME : GUENTER MONSELER
CARD NUMBER : 6229 3454 1000 0435
CARD EXPIRED DATE : 12/2029

Declaration:
I hereby swear under penalty of perjury, that the information provided is both true and accurate. I am the signatory
on the aforementioned bank account. All monies engaged in this transaction are derived from non-criminal origin;
and, are good, clean and cleared. The origin of funds is in compliance with Anti-Money-Laundering Policies as set
forth by the Financial Action task Force (FATF) 6/01.

Receiver Signature: Page No.- 1 of 5

WOLFGANG GÜNTER MONSELER GMBH
KRCHFCDSTE 12 94121 SALZWEG
SALZWEG GERMANY

UNION PAY QR CODE

Receiver Signature: Page No.- 2 of 5

WOLFGANG GÜNTER MONSELER GMBH
KRCHFCDSTE 12 94121 SALZWEG
SALZWEG GERMANY

UNION PAY CARD

Receiver Signature: Page No.- 3 of 5

WOLFGANG GÜNTER MONSELER GMBH
KRCHFCDSTE 12 94121 SALZWEG
SALZWEG GERMANY

PASSPORT COPY:

Receiver Signature: Page No.- 4 of 5

WOLFGANG GÜNTER MONSELER GMBH
KRCHFCDSTE 12 94121 SALZWEG
SALZWEG GERMANY

BUSINESS LICENSE COPY:

Receiver Signature: Page No.- 5 of 5