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BENEFICIARY DESIGNATION FORM PARSONS INTERNATIONAL & COMPANY L.L.

C
Identity/Resident No.: First Name: Middle Name: Last Name: 77872373 Reynaldo Obille Jornacion Employee No.: Date of Birth: (dd/mm/yyyy) Gender: Marital Status: 66013 09 May 1956 Male Marriage

The Beneficiary designation statement below is for Final Payment payable as a result of the employees death. I authorize payment of my Final Pay to the following beneficiaries. Primary Beneficiary or Beneficiaries: First Name 1 2 3 If more than one primary beneficiary is named, the benefits, unless otherwise stated above, will be paid in equal shares to the designated primary beneficiaries who survive the employee. If no such primary beneficiary survives, the death benefit, unless otherwise state below, will be paid in equal shares to the designated secondary beneficiaries who survive the employee. MARITA Middle Name RAMOS Last Name JORNACION Relationship Wife Percentage (%) Payable 100

Employee Signature:

Reynaldo Jornacion

23 February 2012 Date

EMERGENCY CONTACT FORM PARSONS INTERNATIONAL & COMPANY L.L.C


Employee Name: Accommodation address: House Number: Employee Number: Identity/Resident Number: Date of Birth: (dd/mm/yyyy) Phone No.: REYNALDO JORNACION Way 2339, Building No. 1900, Al Khuwair, Muscat Oman 1900 66013 77872373 09 May 1956 9989-0289 Way Number: Work Location: Passport Number: Date of Hire/Rehire: Phone (Outside Oman): 2339 WAARP, Muscat VV0791982 Aug. 17, 2008 N.A.

Landlord Name & Phone No.: N.A. EMERGENCY CONTACT INFORMATION For local Address Name: Marita Jornacion _______________________________ _______________________________ For Home County Address Name: Kennel Rey Jornacion Relationship: Contact No.: Son +63-9327015196 Relationship: Contact No.: Wife 9729-0931

Please Return This Completed From To: Human Resource Department, PICL I confirm that the personal details recorded above true and accurate. Full Name: Date & Signature: Reynaldo Jornacion 23 February 2012

DOCUMENTS COPIES REQUIRED: 1. Passport copy 2. Identity/Resident Card

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