New Client Account Opening Forms

BENELUX VENTURE PARTNERS: Portfolio Management Terms of business and Personal Account Opening Forms

OFFICIAL USE ONLY

Account Number

Account Manager

Branch Code

Benelux Venture Partners Head Office: Rue de Neudorf, District De Luxembourg. n560, Benelux Venture Partners Hong Kong, 88 Queens Rd, Central, Hong Kong Kong. Email: admin@Beneluxpartners.com ,

BENELUX VENTURE PARTNERS

Regents Centre, 88 Queens Rd, Central, Hong Kong. Tel 852 5808 2396 Email: admin@beneluxpartners.com

Account Opening Forms (pg 1 of 4)

Title Mr/Mrs/Dr/ other Family Name First Name Middle Date Of Birth

Name Second Applicant (If Applicable)

C L I E N T I N F O R M A T I O N

Address (if less than three years, please state previous address)

Country of Residence / Nationality

//. . //. .

Passport number / ID number

Zip / Post code: Introduced by

Occupation/Profession

For Official Use Only

Marital Status

Second Applicants occupation/profession (if applicable)

For Official use Only

For Official Use Only

Business Tel. No. Home Tel. No. Mobile No.

Fax No. Email Website Applicant(s) Estimated Gross Annual Income Applicant(s) Source of Income

Contact Information

A S S E T I N F O R M A T I O N

Primary Purpose of Account

Source of Funds

Total Assets

Bank Reference Name & Address

Description of Assets (i.e. Stocks, Bonds etc.)

Account Base Currency (USD, GBP, EURO etc.)

Estimated current value of assets

Benelux Venture Partners 2013 all rights reserved

BENELUX VENTURE PARTNERS

Regents Centre, 88 Queens Rd, Central, Hong Kong. Tel 852 5808 2396 Email: admin@beneluxpartners.com

Account Opening Forms (pg. 2 of 4)

Investment goal (s) (retirement/education/car/home/other) List other investments and their current estimated value

Investment objective (capital preservation/income/growth/ speculation/other)

I Investment time horizon (s) N V E S T M Investment liquidity requirements E (current plan to use assets before noted goals are met) N T I Previous Investment experience N (stocks/bonds/time deposits/mutual funds/bank accounts/other) F O R M Years of Investment experience A T I O N
Desired rate of return on investment

For Official Use Only

List other debts/loans and their current estimated balance and rate interest.

Overall investors type/risk tolerance (conservative/balanced/growth/aggressive)

Benelux Venture Partners 2013 all rights reserved

BENELUX VENTURE PARTNERS

Regents Centre, 88 Queens Rd, Central, Hong Kong. Tel 852 5808 2396 Email: admin@beneluxpartners.com

Account Opening Forms (pg. 3 of 4)

1. In this agreement Client means the person signing the Agreement. The Company means Benelux Venture Partners its affiliates, subsidiaries, correspondents or Employees. 2. If this agreement is signed jointly the liabilities and Obligations of each party shall be joint and several. 3. The signature (s) on this Agreement are the true and

Terms & Conditions and Privacy Statement

9. If the client instructs Benelux Venture Partners to hold their Share Certificates in safekeeping, the Company may hold those Securities at its Branches or any other location where it is customary for the company to keep its Securities. The Companys responsibility shall be limited to the same degree of care exercised in the custody of its own securities the same issue and for the same aggregate amounts may be delivered to the Client in lieu of those originally deposited by the client.

official signatures of the aforementioned Account and may be used for verification at all times and for all purposes. 10. Every communication sent by Benelux Venture Partners to 4. All transactions in Securities in this account are subject to the constitutions, by-laws, customs, rules and regulations of the exchanges or markets where the transaction is executed. 5. All trade prices will be quoted in $US the Company is not responsible for exchange rate fluctuations or losses. 6. Any monies held by Benelux Venture Partners from time to time to Customers credit are payable on demand, need not be segregated and may be used by the Company in the ordinary conduct of its business. 7. The client will pay to the Company all commissions and charges for each transaction. 8. The personal information supplied to the Company is deemed to be truthful and accurate. Commitment To Your Privacy: Protecting our clients privacy is important to us. The purpose of this notice is to explain the information we collect about our clients, how we use it, and to state our commitment to inform you, and to respond to any questions you may have. Clients who have read this privacy notice, and have expressed no objections, and have completed the New Account Application, are deemed to have agreed with our privacy policies as outlined below. Information We Collect: In the ordinary course of business, we collect, retain and use information about our clients financial situation in order to service them as well as we can. This information is collected from several sources and may include information we receive from our clients whether in writing, in person, by telephone, electronically or on applications or other forms and may include information about their transactions with us, our affiliates, and others which may consist of information about account balances and counterparties to transactions; information we receive from credit reporting companies such as credit reports; and information collected from self-regulatory organizations in the investment industry. Information We Disclose: We do not sell any information about our clients. Only upon our clients specific request will information such as name, income, and assets be shared with our affiliates. From time to time and when we deem it necessary to facilitate the handling of our relationship with our clients, we will share appropriate information with third parties as permitted by law. We only share information that is required for third parties to perform their job. For example, we may disclose information to third parties such as data processing providers for statement mailing and check printing, and securities broker dealers when using them to execute orders; to government entities, and self-regulatory organizations in the investment industry, in response to obligatory provision of information, and as otherwise requested by our clients. Security of Information: Benelux Venture Partners maintain physical, electronic, and procedural safeguards to guard our clients personal information. We have strict internal policies against unauthorized use or disclosure of client information. Our clients info rmation is accessible only to employees who need it to conduct our client s financial affairs or provide services to them. Our employees, and our account management practices, are governed by extensive regulatory procedures, and by internal procedures. Benelux Venture staff are reminded on a regular basis of their obligations with regard to the confidentiality of client information through employee training, and by operating procedures. 12. This agreement supersedes all previous agreements between the Client and Benelux Venture Partners Its Directors and Officers cannot be held liable for any losses or damages incurred as a result of investment advice provided. 11. The Client may close their Account at any time by giving written notice. Benelux Venture Partners reserves the right to terminate the Clients Account at any time and for any reason the Client shall be deemed to have been received and acknowledged as correct, approved and consented to by the client unless the company receives a written notification objection within 30 days after it has been sent to the Client.

Benelux Venture Partners 2013 all rights reserved

BENELUX VENTURE PARTNERS

Regents Centre, 88 Queens Rd, Central, Hong Kong. Tel 852 5808 2396 Email: admin@beneluxpartners.com

Account Opening Forms (pg 4 of 4)

I/We the undersigned request you to establish an account. 1. For Joint Accounts, instructions may be given by:

Either / any one of us Any two of us All of us jointly Single account Joint tenants

2. The Investments are held by us as:

Beneficiary Details

(Note: Unless otherwise specified, Investments are deemed held as joint tenants, Investment pass automatically to survivor if joint tenants. Investments of deceased tenant in common pass according to terms of will or intestacy) Signature of Primary Applicant Representative Signature: (specify)

Signature of Joint Applicant

Registered Name For Shares Documents Required

(Block Capitals)

For each Beneficial owner and all account signatories we require: (i) Completed Investment Account Opening Form (ii) Completed W8 form for non-U.S. persons (iii) Photo Copy of ID Signature Signature

Name

Name

Signature

Signature

Authorised Signatories

Name

Name

Signature

Signature

Name

Name

Date

Benelux Venture Partners 2013 all rights reserved