a) I/We am responsible for my own/our tax affairs and hereby declare that I/we have not been convicted of
any serious tax crimes. As appropriate and necessary I/we have taken, or will take, tax and/or legal
advice in relation to the matters referred to in this Declaration;
b) I/We confirm that the assets of the Business Company are beneficially owned by the individuals(s) or
corporation(s) listed herewith;
c) I/We confirm that neither I/we nor any company, I/we have been involved in the management of have
ever been the subject of a regulatory or judicial investigation or money laundering/financing of
terrorism/tax evasion activities;
d) I/We confirm that my/our source of funds for the Business Company are not proceeds stemming from tax
evasion and/or criminal activities and such funds will not be used for money laundering, financing of
terrorism or tax evasion.
e) I/We have examined the information on this form and to the best of my/our knowledge and belief it is true,
correct, and complete.
f) I/We will indemnify Heritage Fiduciary Services Pte Ltd against any actions, damages, costs, claims,
demands or losses arising from you acting in accordance with any fax or email which appears to have
been furnished by me/us or on my/our behalf. This indemnity applies even if any such fax or email was
produced by or contains or has attached any forgery, lack of authority, wrongful alteration or other misuse
of a document, text or file, or if any transmission details or information appearing on it are not genuine.
This indemnity applies even if any such fax or email was not in fact issued by me/us or with my/our
authority.
g) I/We will notify you immediately if there is any change to the circumstances declared above.
I understand that Heritage Fiduciary Services Pte Lt is not responsible for providing me with any legal or
tax advice and I confirm that I have not relied on Heritage Fiduciary Services Pte Ltd to provide me with
such advice.