ABDULAZIZ Y A M

ALRASHED

COMPANY INFORMATION SHEET (CIS) FORM

Issued To: WTC & Orbis Mercatus B.V Ref CIS Number: WTC-CIS/0420
Attention: Mr. Kurt Johann Kaiser
Mr. Farhan Omer

Dear Sir/Madam,

SUBJECT: COMPANY INFORMATION SHEET (CIS)

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, the following
information may be supplied to banks and/or other Federal Institutions for purposes of verification.

PERSONAL INFORMATION

FIRST NAME: ABDULAZIZ

MIDDLE NAME: YOUSEF AHMED
LAST NAME: ALRASHED
GENDER: MALE
DATE OF BIRTH: 16TH JANUARY 1968
COUNTRY OF CITIZENSHIP: KUWAIT
PASSPORT NUMBER: P06062455
DATE OF ISSUE: 26/08/2018
DATE OF EXPIRY: 25/08/2028
ISSUING AUTHORITY: KUWAIT
HOME STREET ADDRESS: 101 FIRST FLOOR, LANSDOWNE HOUSE, 57
BERKELEY SQUARE
CITY: LONDON
COUNTRY: UNITED KINGDOM
POSTAL CODE: W1J 6ER
TELEPHONE NUMBER:
FAX NUMBER:
MOBILE NUMBER: +44 7916 045868
EMAIL ADDRESS: CEO@ INNOVATIVEKW.COM
 ABDULAZIZ Y A M
ALRASHED

BANK INFORMATION

BANK NAME: HSBC BANK

BANK ADDRESS: 9 PICCADILLY, MAYFAIR, LONDON W1J 8EU, UNITED
ACCOUNT NAME: ABDULAZIZ YOUSEF AHMED ALRASHED

ACCOUNT NO: 91892916

IBAN: GB80HBUK40052691892916

SHORT CODE: 40-05-26

SWIFT CODE: HBUKGB4B

BANK OFFICER NAME: SIMON WEST WEALTH MANAGER

BANK OFFICER’s TEL.: 07767 008660

BANK OFFICER’s SIMON.WEST@HSBC.COM

EMAIL:
ABDULAZIZ Y A M
ALRASHED

ATTACHED PASSPORT COPY

 ABDULAZIZ Y A M
ALRASHED

COMPANY INFORMATION SHEET (CIS) FORM

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 origins of funds are in
compliance with Anti-Money-Laundering Policies as set forth by the Financial Action Task Force
(FATF) 6/01

Represented By: ABDULAZIZ YOUSEF AHMED ALRASHED

Company Name:

Passport Number: P06062455

Passport Issue Date: 26/08/2018

Passport Expiry Date: 25/08/2028

Country: KUWAIT

Date: 10/14/2022

Signature