Template

The form must be completed in full, in English, by Companies with a contract active or not.

Raízen requests that all fields present in the Form be filled with all Company data, with the
purpose of improvement in our internal police of compliance in business relations.

The Company attests that the information provided in this form is correct.

Definitions

i. Organization (1): organization of the Company, with a contract active or not;

a. Company (1.1): entity related directly with Raízen by commercial
relationship;
i. Director (1.2.1, 1.2.2, 1.2.3, 1.2.4 e 1.2.5): a natural person who is
elected or appointed to jointly oversee the activities of a
company. His/Her duties are outlined in the corporate by-laws,
His/Her main responsibility is to act on behalf of shareholders.
Typical duties of the board of directors include governing the
organization by establishing its mission, policies and objectives;
selecting, appointing, supporting and reviewing the officers;
approving annual budgets; and accounting to the shareholders for
the corporation's performance, among others.
ii. Executive Officer (1.2.1, 1.2.2, 1.2.3, 1.2.4 e 1.2.5): natural person
who is responsible for the management and day-to-day operations
of the Company, according to the Article of Corporation. The
corporate officers usually consist of a president, one or more vice
presidents, the secretary, and a treasurer.

ii. Shareholder (2): any person, company or other institution that owns at least
one share of a company’s stock. Inform all Legal Entities Engaged as
Shareholders and the relevant percentage of shares.
a. Natural Person (2.1): if the Shareholder is a natural person.
b. Legal Entity (2.2.1, 2.2.2, 2.2.3, 2.2.4 e 2.2.5): if the Shareholder is a Legal
Entity.
iii. Final Beneficiary: person that holds more than 10% of the group control.

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 Template Raízen
1. Organization
1.1 Counterparty
Name Product
National Taxpayer Number Country
Core Business Relationship with Raizen: () Supplier; () Client;
() Broker () other _________________.
E-mail

1.2. Executive Officer (EO)/ Director (DI)

Full Name ID Number Country Birth Date Gender
☐ EO ☐ DI Unspecified
☐ EO ☐ DI Unspecified
☐ EO ☐ DI Unspecified
☐ EO ☐ DI Unspecified
☐ EO ☐ DI Unspecified
☐ EO ☐ DI Unspecified

2. Shareholder
2.1 Natural Person
Full Name ID Number Country Birth Date Gender
Unspecified
Unspecified
Unspecified
Unspecified
Unspecified

2.2 Legal Entity

Name National Taxpayer Number Country % of Shares

3. Final Benificiary
3.1 Is the Final Benificiary a natural person ( )
Full Name ID Number Country Birth Date Gender
Unspecified
3.2. I certify that it does not exist a Final Beneficiary ( )

4. Trader Information
Trader responsible for this relationship

Interno