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Power of Attorney and Declaration of Representative PDF
Power of Attorney and Declaration of Representative PDF
Power of Attorney and Declaration of Representative PDF
PART I
Caution: Form 2848 will not be honored for any purpose other than representation before the UBS Investment Bank London,
United Kingdom.
Client Name(s) & Address: Camila I. Lagos Tapia.
San Francisco 395, Santiago. CHILE.
Hereby appoint the following representative from # 23 Fetter LN, London EC4A 1BR, United Kingdom as attorney in fact:
• Barr. Wilfred Corbett of WILFRED CORBETT LAW SERVICE; # 23 Fetter LN, London EC4A 1BR, United Kingdom.
To represent I, Mr Barr. Wildfred Corbett ..................................................... before UBS Investment Bank; #5 Broadgate, London
EC2M 2QS, United Kingdom for the following Transfer of fund as next of kin/Inheritor.
The representative(s) are authorized to sign and inspect confidential information and to perform any and all acts that I/we can
perform with respect to having my /our fund transfer process matter and approval as next of kin/Inheritor.
The authority does not include the power to receive checks or bank drafts. Neither the power to substitute another
representative, nor the power to execute a request for disclosure of tax returns.
Exceptions: An un-enrolled, actuary may only represent clients to the extent provided in the UBS Investment Bank bulletin section
10.3 (d) of circular 230.
PART II
Declaration of Representative(s)
Under penalties of perjury, I declare that:
• I am not currently under suspension or disbarment from practice before the Supreme High Court of Justice of London,
United Kingdom.
• I am aware of regulations contained in Treasury Department circular No.230 (31 CFR, Part 10) as amended, concerning the
practice of Attorneys Certified Public Accountants Enrolled Agents, enrolled actuaries and others.
• I am authorized to represent the client identified in Part 1(one) for the transfer of fund matters, specified there-in, and I
am one of the following.
• Attorney – a member in good standing of the Bar of the Highest Court of Jurisdiction.
• A bona fide accredited attorney of UK Organization London.
30/03/2023
Date Signature
Representative Attorney: Barr. Wilfred Corbett (QC.) of WILFRED CORBETT LAW SERVICE; # 23 Fetter LN, London EC4A 1BR,
United Kingdom.
................................................... …..........................................................
Date Signature