Date

August 13, 2023

Information of ShopeePay user:

Full name Lady Queen Benitez Angeles
Shopee username ladyqueen_angeles
Date of birth January 10,2010

Information of parent or legal guardian:

Full name
Teresita Benitez Angeles
Valid ID submitted National ID
ID number 3647-2639-1831-4608
Contact number
09638882853

I am the parent or legal guardian of the above-named ShopeePay user. I hereby give my informed consent
for my child to use ShopeePay as an e-wallet and upgrade his/her ShopeePay account in line with the
business’ terms and conditions.

I confirm that all the details above are correct.

______________________________________
Signature over printed name of parent or legal guardian