certified public accountant No.………………..., working with ………….(name of the audit firm)…………., hereby certify as follows: 1. My immediate family members, including spouse and minor children, and I do not hold any

of the country), hereby certify follows; 1. My immediate family member, including spouse (or equivalent) and dependent, and I do not hold any share of my audit clients and or its related entities. 2

No If yes, please summarized the results of inspection in the space below 5. Declaration I hereby declare that all information provided in this application and its attachments are true and correct

: ___________________________________________________________ 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

: ___________________________________________________________ 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

the details of listed companies you have been involved with in the latest year No. Name of entities Industry Your responsibility (Siging Partner/Engagement Partner/EQCR 5. Declaration I hereby declare

the declaration is dated.) Form updated as of June 2021 Name of foreign collective investment scheme (CIS): Date of the constitution of the CIS (dd/mm/yyyy): Home jurisdiction: Name of home regulator

shall ensure the declaration is dated.) Form updated as of June 2021 Name of foreign collective investment scheme (CIS): Home jurisdiction: Name of home regulator: Type of arrangement: ( ASEAN Collective

signs shall state his/her full name and capacity and shall ensure the declaration is dated.) Form updated as of June 2021 Name of foreign collective investment scheme (CIS): Home jurisdiction: Name of

authorised person of the Qualifying CIS Operator. The person who signs shall state his/her full name and capacity, and shall ensure the declaration is dated.) (name of the Qualifying CIS Operator) (name of the