: ___________________________________________________________ Tel No.: _____________________________ Fax No.: _________________________ Part H: Declaration I/We certify the following: 1. I/We am/are under supervision of Home Regulator which has the authority

Companies (ASCO), the Thai Life Assurance Association (TLAA), and the Thai General Insurance Association (TGIA). Following their first declaration of intent of collective anti-corruption on March 11 last year

individual and corporate shareholders, immediately followed by a declaration of intent. • On September 24, 2018, CPN Pattaya made a tender offer to purchase the remaining shares, or 49.57% of total issued and

estimated period of spending such amount. 4. Others: Ex. As working capital Remarks: 1. Disclose the estimated net amount of the proceeds broken down into each principal intended use thereof, which can be

: ___________________________________________________________ Tel No.: _____________________________ Fax No.: _________________________ Part F: Declaration I/We certify the following: 1. I/We am/are under supervision of Home Regulator which has the authority

, 2018. 5. The Company’s Shareholding Proportion: Before the disposal; After the disposal; 20.51 percent 0 percent 6. Objectives of the Disposition: To use the received amount as the Company’s working

the increase of its registered capital) To Baht 1,000 million Company’s Shareholding Percentage: Remain at 99.99% Source of fund: Working capital of the Company Objectives: To utilize as working capital

working capital. 6) Total value of Consideration Obtained 39,998,400 Baht 7) The criteria used to determine the value of the consideration Par Value 8) Source of fund Working capital of the Company. 9) Type

the first issue to be used as working capital for the company. 8 Board’s Opinion The Board of Directors considered the proposed connected transactions to be appropriate, due to provide VIBHA sufficient

0.00000278 Mr. Sirapak Siriviriyakul 1 0.00000823 1 0.00000278 Mr. Sirivuthi Siamphakdee 1 0.00000823 1 0.00000278 Total 12,150,000 100 36,000,000 100 4.) Source of fund Working capital of the Company 5