An account holder who self-certifies with a reporting financial institution who knowingly or recklessly makes a misleading, false or false statement in a particular document is guilty of a crime and is liable if fined level 3 ($10,000). Information about the DBS registration and data collected in this self-certification may be transmitted by DBS (i) to the Tax Department for transmission to the tax authority of another country for the purposes of (1) above; and (ii) for the purposes of (2) above to the U.S. Internal Revenue Service in the case of U.S. persons. A number of sample forms provided for reference and acceptance by reporting financial institutions include: Some jurisdictions do not issue TINs. However, these jurisdictions often use a different number with high integrity and an equivalent level of identification (a “functional equivalent”). Examples of this type of number are (a) (for individuals) a social security/insurance number, a citizen/id/service code/number, and a resident registration number; and (b) (for companies) a company/company registration code/number. This is a self-certification that you provide to DBS Bank (Hong Kong) Limited (“DBS”) for the purpose of (1) the automatic exchange of financial account information; and (2) U.S. federal income tax. According to the due diligence procedures of the Tax Administration Ordinance (Chapter 112), account holder self-certifications would be required for all new accounts (i.e. accounts opened on or after 1 January 2017).

Which accounts already exist (i.e. accounts that were created before 1. January 2017), a reporting financial institution may, if it has doubts about the tax residency of an account holder, obtain self-certification from the account holder to verify their tax residency. Each reporting financial institution can design its own self-certification form, but must ensure that the necessary data is collected. Self-certification is a formal declaration made by the account holder as part of their tax residency. In general, whether or not a natural or legal person resides in a country for tax purposes is determined by taking into account the physical presence or residence of the person in a place (for example.B. if more than 183 days in a tax year). That a person has paid taxes levied by a country (e.B. VAT, withholding tax or capital gains tax), do not automatically make that person a resident of that territory for tax purposes. Special circumstances may result in the person residing simultaneously in another place or in more than one court (dual residence). Each jurisdiction has its own rules for defining tax residency. These jurisdictions have provided information on how to determine if you are a resident of the jurisdiction on the following website: www.oecd.org/tax/automaticexchange/crs-implementation-and-assistance/tax-residency/#d.en.347760.

Please consult your lawyers or tax advisors about your tax residence(s). The relevant data may be transmitted by the reporting financial institution to the tax department for transmission to the tax authority of another country. The tax department can review the details of self-certification if necessary. I confirm that the information contained in this self-certification is true, accurate and complete. I agree to notify DBS of any change in circumstances that affects the tax residency status of the identified person or that renders the information contained herein inaccurate, and to provide DBS with a duly updated self-certification form and supporting documents within 30 days of such change in circumstances. I declare that the information and statements made in this self-certification are true, correct and complete to the best of my knowledge and conviction. Please note that by providing this data, you have confirmed that the information provided is correct and complete. If this information becomes invalid, you agree to notify DBS Bank (Hong Kong) Limited (“DBS”) of such change.

If the information provided is misleading, false or inaccurate in any way, this will be considered a criminal offense and you will have to pay a level 3 fine of HKD 10,000. WARNING: For the purposes of (1) above, it is a criminal offence under Section 80(2E) of the Tax Code if a person makes a self-certification statement that is misleading, false or false in particular material AND knows or is reckless whether the statement is misleading, false or false in particular material. A person who commits the crime will be fined a level 3 (i.e., $10,000) on conviction. The data collected in this self-certification will remain valid unless there is a change in circumstances relating to your tax status (e.g. B a change in your country of residence) or other mandatory fields included in this self-certification. You must notify DBS of the change within 30 calendar days if circumstances change that make any of the information provided in this self-certification incorrect or incomplete and provide an updated self-certification form. As a financial institution, dbS is not permitted to provide tax or legal advice in connection with your tax residency. If you have any questions about your tax residency status, please contact your tax advisor or the national tax administration. “Tax Identification Number (TIN)” (including “functional equivalent”) – The TIN is a unique combination of letters or numbers assigned by a jurisdiction to a natural entity (or company) and used to identify the natural (or legal) person for the purposes of administering the tax laws of that jurisdiction. Further details on acceptable IT CODES can be found on the OECD Automatic Exchange Portal at the following link: www.oecd.org/tax/automatic-exchange/crs-implementation-and-assistance/ I confirm that I am the holder of all accounts to which this self-certification relates and that I have consented to the collection, use, disclosure and processing of my personal data by DBS for the purposes of this self-certification of tax residency Individual…..