egy
Appendix A
Declaration for US Persons
Re: Dorado Asset Management Lid. (the “Entity")
|, Pedro Pablo Kuczynski, citizen/resident of the United Stated, with passport number 449872007,
as a US Person hereby declare under oath the following:
1. That I have requisite knowledge and/or have been advised in relation to U.S.A.
and international taxation by duly qualified professionals in foreign related investments
and transactions regarding my legal and tax responsibilities, and know my obligati
under the federal and state laws of the United States for being a director, officer,
attomey-in-fact, sharcholder and/or beneficiary of the Entity, which I am committed to
comply;
2. That Overseas Management Company (“OMC”) or any affiliated company of
OMC has not been my advisor regarding my condition as director, officer, attorney:
fact. shareholder and/or beneficiary of the Entity;
3. hereby release OMC, its directors, officers, employees, nominees, agents,
representatives and any affiliated company of OMC from all liability, be it judicial or
extrajudicial, as a consequence of any actions or omissions related with the
incorporation of the Entity, and any services, Likewise, I will hold harmless and
indemnify OMC, its directors, officers, employees, nominees, agents, representatives and
any affiliated company of OMC from any legal fees, expenses, compensations and
damages arising from any judicial or extra-judicial claim that may be presented by third
parties or competent government authorities against OMC, its directors, officers,
employees, nominees, agents, representatives and any affiliated company of OMC as a
consequence of their actions or omissions related with the
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4. That OMC is hereby authorized, without incurring in any kind of liability, to
provide and disclose any information to any United States government authority when
requested, be it through local competent authorities or not.
, State of
NOTARY
SEAL,
(Commission expiration date)
ANIBAL CORVETTO ROMERO, NOTARIO DE LIMA CERTIFICO: QUE LA FIRMA
QUE ANTECEDE DE PEDRO PABLO KUCZYNSKI GODARD IDENTIFICADO
CON NI. N° 06477277 ES AUTENTICA LA MISMA QUE LEGALIZO.
LIMA, 07 DE OCTUBRE DEL 2,013
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