Kyc Individual G20 - 230310 - 175656

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February 19, 2023
KYC HISTORICAL BOND/BOX SUBMISSON DOCUMENT TEMPLATE

(Please refer to supporting information document)
USE THIS DOCUMENT FOR INDIVIDUAL PERSON/S
***TO ALL SELLERS/OWNERS OF HISTORICAL BONDS/BOXES,

LEGAL REPRESENTATIVES AND THEIR TRANSLATORS***
IF YOU ARE UNWILLING OR UNABLE TO COMPLY WITH THE INSTRUCTIONS

CONTAINED HEREIN
DO NOT PROCEED ANY FURTHER AS FAILURE TO PROVIDE A COMPLIANT

PACKAGE USING THIS TEMPLATE WILL RESULT IN AUTOMATIC REJECTION OF
YOUR SUBMISSION DOCUMENT.
COMPLIANCE USE ONLY:

PRIVATE OFF MARKET Multiple – Historical Bonds/Boxes Exchange/Swap Program.
CONFIDENTIAL INFORMATION: Not for Publication or distribution. This information is not to be construed as an offer to sell or solicit. It is a
sanctioned transaction intend for a closed audience.
Initials FOR COMPLIANCE PROCESSING Page 1 of 47

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CLIENT COMPLIANCE PACKAGE [CCP]

Date: February 19, 2023
STRICTLY CONFIDENTIAL
The information contained in this document is provided solely and exclusively

for informational purposes only, and for personal use upon a specific request
made by:
NAME OF THE LEGAL CUSTODIAN HOLDER / SIGNATORY FOR

HISTORICAL BONDS/BOXES
INDIVIDUAL NAME :
_______________________
_______________________
_______________________
_______________________
EMAIL ADDRESS :
APP. TYPE & NUMBER :
PHONE #1 :
PHONE #2 :
Signature: ________________________
(Authorized Signatory)
Signed on this Date: February 19, 2023


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HISTORICAL BONDS/BOXES REVALUATION EXCHANGE PROGRAM
This is not intended to be, and must not be construed to be, a solicitation of the herein
referenced assets.
PLEASE READ CAREFULLY:

This is an unofficial response to your request and is for informational purposes only.
By reading beyond this point, you acknowledge that this is a private communication of privileged
confidential information for you only, and you agree to keep it confidential and protect it from disclosure,
except as required for the transaction referred to herein. DO NOT UNDER ANY CIRUMSTANCE SEND
THIS OUTLINE, OR ANY INFORMATION CONCERNING THIS BUSINESS, TO ANYONE. You have
requested specific information outlined below. This material and document regarding the above
referenced transaction are provided solely to serve your interests and purposes, and are not for
distribution. By receiving this information sheet you hereby agree to keep all information received from
us strictly confidential, and will not disclose it to any third party. The following information may change
at any time without notice.
CERTAIN APPLICATION REQUIREMENTS
(PLEASE COMPLY WITH ALL REQUESTS)
THE FOLLOWING DOCUMENTS SHOULD BE FILLED IN AND RETURNED AS A PACKAGE.

PLEASE DO NOT RETURN THE DOCUMENTS INDIVIDUALLY. ALL DOCUMENTS MUST BE
CLEAR AND ALL PROCEDURES MUST BE FOLLOWED.
ONLY THE LEGAL CUSTODIAN HOLDER OR APPROVED SIGNATORY OF THE HISTORIC

BONDS/BOXES SUBMITTED HEREON MAY SIGN THE DOCUMENTS.
ALL SIGNATURES MUST BE ORIGINAL IN WET BLUE INK ONLY
ANY PACKAGE WHICH CONTAINS ELECTRONIC OR `CUT AND PASTED SIGNATURES WILL
BE REJECTED IMMEDIATELY.


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DOCUMENT GLOSSARY
AFFIDAVIT OF NON-SUBMITTAL TO OTHERS: This is to ensure the bank knows that this file is not
being “shopped” in the marketplace and they have an exclusive right to proceed with the transaction.
ATTORNEY ATTESTATION LETTER: This must be completed by your attorney and on their official
company letterhead.
CLEAR COLOR PHOTOGRAPH(S) OF THE BOND(S):
• MUST BE ABLE TO BE READ CLEARLY WHEN ENLARGED BY COMPLIANCE, FORENSIC

AND LEGAL; INCLUDING THE BOND NUMBER AND THE COUPONS.
• CLEAR COLOR SCAN OF THE FRONT AND BACK OF THE BOND/S INCLUDING COUPONS
IF ANY;
• FOR A PROOF OF LIFE, THE BONDS MUST BE CLEAR AND READABLE WHEN INCLUDED
IN A PHOTOGRAPH COMPRISING CURRENT DATED (NO OLDER THAN 3 DAYS)
NEWSPAPER HEADER, THE PASSPORT OF THE OWNER OPEN, A CLEAR HEADSHOT OF
THE OWNER.
CLIENT INFORMATION SHEET: This information must be filled in, in its entirety (two pages), and the
information contained must be accurate and verifiable.
COPY OF PASSPORT: A clean, clear color copy of the Client’s passport must be provided, enlarged
to 8.5” x 11”. This is best achieved by making a laser copy of the original passport enlarged 129%. A
color –scan device will do as well (accepted formats: JPEG, TIFF, PDF, DOC).
GLOBAL CEASE AND DESIST ORDER: This is to C&D all previous KYCs issued and or have been
hijacked or presented without the authorization of the legal holder/custodian of the boxes/bonds. This
is a legal document.
INDEMNIFICATION AND ATTESTATION: The information provided in this form must be accurate and
verifiable.
LETTER OF EXCLUSIVITY: This is to give the Exchanger specified time to conduct compliance,
verifications, forensic, legal, banking and any other due diligence checks on the Seller and the
submission package, in relation to the boxes/bonds/assets issued for Revaluation and Exchange
Settlement.
LETTER OF INTENT TO EXCHANGE: This is to be clear that these boxes/bonds are for Revaluation
and Exchange Settlement.
LETTER OF NON-SOLICITATION: Must be submitted by the Custodian Box/Bond Holder.
NON-CIRCUMVENTION / NON-DISCLOSURE (NCND): Transactions are submitted through the
Global Compliance & Global Intake office, as appointed by the respective and authorized Buyer Group.


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ORIGIN AND HISTORY OF ASSETS: The information provided in this form must be accurate and
verifiable. The information on this form is the confirmation to the Revaluation and Exchange of your
legal custodian holding of the Boxes/Bonds.
PHOTOGRAPHS OF THE BOND(S) – clear front and back images must be included within this
package where at all possible, as well as the SKR and authentication documents.
PORTFOLIO/SERIAL/ PASS-CO / SCRIPOPASS/ PERITO NUMBERS MUST BE CLEAR AND

READABLE
PROGRAM REQUIREMENTS: Minimum Box Custodial period is 3 years
PROOF OF LIFE: POL MUST SHOW CLEARLY THE FACE OF SELLER: Clear Photo, of Bonds
(front and back) submitted with current newspaper (date circled in RED). If submitting boxes; provide
clear unobstructed HEAD SHOTS of the Owner with all Four Corners of the FRONT OF the BOX (FULL
VIEW / UNOBSTRUCTED). To the left of the FRONT of the BOX, all four corners exposed of the
MATCHING Authentication Document (if and where applicable). Take enlarged (close-up) full View
photos and Video of the coupons (clear view of all coupons and numbers) and show photos to determine
the value of the bond(s). The BACK OF BOX, full view with the current newspaper (date circled in red)
with Head shot and PASSPORT to the left OF BOX (no fingers or hands in the pictures. FLAT
PICTURES - Lay the Seller’s PASSPORT flat to the left of the BACK OF BOX on top of current
newspaper (date circled in red), full view all coupons exposed (NO OBSTRUTIONS) (such hand &
fingers). FLAT PICTURES - are the same PICTURES AS THE HEAD SHOTS MINUS THE HEAD. You
need to take photos of the six sides of each Box and front and reversed side of each single Bond, and
Coupons with numbers corresponding to the Box- and Serial Numbers as stated in the Excel
Spreadsheet Inventory-List.
Most critical, all Documents submitted in the KYC Package must show the same date as the
Newspaper DATE as shown in the POL-Head Shots. The data on the boxes/bonds and
authentication reports must be legible, and the passport of the Owner open at the information page.
SKR’s: If boxes/bonds are in Safe Custody of a Bank, Attorney or Security House, then the SKR must
be included in the Photo in lieu of the Boxes/Bonds. The SKR must have full description of all
boxes/bonds and authentication reports. BOXES: The submission of Boxes require Headshots of each
box submitted in the outlined procedures stated above in the POL’s section. These procedures are
required for all Boxes submitted. Each Box must have individual POL’s as described above along with
the authentication documents, newspaper, passport & head shots.


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PROOF OF CUSTODIAL BOX/BOND HOLDER: You must prove you are custodian and provide first
and foremost proof of the History and Origin and the Provenance, supporting the evidence of your
Ownership as Custodian / Holder. Further you shall provide evidence in the form of pictures of all four
sides as well as top and bottom of the each box submitted in series (If submitting more than 10 boxes
of one type (e.g. Chinese Farmer Bonds, Liberty Bonds, Government of Petchili Bonds, Lung Tsing U
Hai Railway Bond (1913), etc.) in one submission, you must provide an unlocked Excel Spreadsheet in
addition to what is being submitted in the KYC Package of each type). Loose bonds require photos of
front and back of a sampling on each bond series being submitted (e.g. Chinese Farmer Bonds, Liberty
Bonds, Government of Petchili Bonds, Lung Tsing U Hai Railway Bond (1913) or any other type of
Historical Chinese, American, German, Mexican Bonds, etc.). The proof of Custodian can be in the
form of an SKR from a secure depository following SKR procedures stated above. A list showing all box
serial numbers and corresponding authentication document numbers is also required.
SAFE KEEPING RECEIPTS: A copy of these must be included showing all pages that make up the
document issued by the Security facility. To have a valid SKR, it must be issued by a recognized security
facility, having a license to operate as Security House. The SKR receipt must be displayed with a Head
Shot, Current Newspaper and full description of the box/bond number and authentication number
following the instructions stated. In the event the Safe Keeping Receipt is issued by a licensed and
regulated Attorney, the Attorney must ensure that the Assets are deposited in a secured Warehouse
under the control and access of the Attorney, and the Custodian, i.e. the Attorney must confirm this with
full responsibility in the Attorney-Safe Keeping Receipt and if and where applicable in the Attorney-
Cover-SKR issued in favor of a nominated beneficiary.
COMPLIANCE WARNING
1. ONLY THE LEGAL CUSTODIAN OR APPROVED SIGNATORY OF THE(SE) BOXES/BONDS

SUBMITTED HEREON MAY SIGN THE DOCUMENTS;
2. ALL SIGNATURES MUST BE ORIGINAL IN WET BLUE INK ONLY;
3. ANY PACKAGE WHICH CONTAINS ELECTRONIC OR CUT, COPIED AND PASTED

SIGNATURES WILL BE REJECTED IMMEDIATELY;
4. ANY SUBMITTED APPLICATION WHICH IS NOT ACCOMPANIED BY A FRESH UP-TO-DATE

AFFIDAVIT OF LEGAL CUSTODIAN WILL BE REJECTED WITH NO FURTHER
CONSIDERATION;
5. ANY SUBMITTED APPLICATION PARTIALLY COMPLETED OR WITH MISSING or SANITISED

DATA WILL BE REJECTED WITH NO FURTHER CONSIDERATION.
6. ANY APPLICATION SUBMITTED WHICH IS SIGNED BY ANY PARTY OTHER THAN THE
CUSTODIAN BOX/BONFD HOLDER/SIGNATORY, WILL BE REJECTED WITH NO FURTHER
CONSIDERATION.
7. ANY SUBMISSION / APPLICATION SUBMITTED WITH MISSING OR WRONG CONTACT

DETAILS, PHONE NUMBER, EMAIL, APP-ADDRESS WILL BE REJECTED WITH NO
FURTHER CONSIDERATION.


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POWER OF ATTORNEY, WHETHER LIMITED OR FULL, AND MANDATES ARE NOT ACCEPTED
FOR THE SUBMISSION OF THIS KYC PACKAGE -- ONLY THE CUSTODIAN BOX/BOND HOLDER
OF THE IS ACCEPTED.
DECLARATION:
I, ________________ , have read the above requirements, and by signing below accept full
responsibility for all the information delineated on this application to be true to the best of my knowledge
and belief.
SIGNATURE OF THE LEGAL CUSTODIAN BOX / BOND(S) HOLDER:
Signed on this date: February 19, 2023
Historical Bonds/Boxes Seller/Owner ______________
NAME of SIGNATORY:
TITLE: OWNER /SELLER GB BOX
PASSPORT: :
Date of Issue:
Date of Expiry:
COUNTRY:
[Space left intentionally blank]


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INDEX
1. Client Compliance Package (CCP) Introductions

2. Document Glossary
3. Compliance Warning & Acknowledgement Declaration
4. Index and Annexures
5. Client Information Sheet (CIS)
6. Declaration
7. Letter of Non Solicitation
8. Letter of Exclusivity (1 & 2)
9. Letter of Intent to Exchange
10. Ready Willing and Able Declaration (RWA)
11. Origin and History of Assets (Provenance) – MUST BE THOROUGH.
12. Indemnification and Attestation
13. Authorization to Verify (Custodial ATV)
14. Affidavit of Non-Submittal to Others
15. Global Cease and Desist (C&D) Order Effective Immediate
16. Non Circumvention – Non Disclosure ICC
17. Passport Page
ANNEXURES
Annex A : Attorney Attestation of Assets (Affidavit)

Annex B : Proof of Life (POL)
Annex C : Proof of Custody (Bank Statements and/or SKR)
Annex D : Provenance Support (Support Docs/Receipts) – STRONGLY PREFERRED
Annex E : Local Excel Summary (Stripped/Extracted from the Global Summary)
Annex F : Excel of all Serial Numbers of all submitted Historical Bonds/Boxes Assets


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CLIENT INFORMATION SHEET

To: ASSET EXCHANGE ATT: COMPLIANCE PERSONNEL
In accordance with Articles 2 to 5 of the Due Diligence Convention and the Federal Banking Commission Circular of December
1998, and under the US Patriot Act of 2002, as amended in February 2003 concerning the prevention of money laundering
and 305 of the Swiss Criminal Code, the following information may be supplied to banks and/or other financial institutions for
purposes of verification of identity and activities of the Client described below, and the nature and origin of the funds which
are to be utilized. The foregoing is subject to agreement by all parties to whom this information is provided that they are
obligated to respect the privacy rights of the Client and all individuals described herein, as well as the generally accepted
professional standards relating to the maintenance of confidential information, and to take all appropriate precautions to protect
the confidentiality of the information contained herein, This legal obligation shall remain in full force indefinitely without
restriction.
All Questions must be completed in written English.
Individual Asset owner information
Name
Address
City, Country, Post (Zip) Code
Date and Place of Birth
Passport Number and Country of Issue
Date of Issue of the Passport
Expiry Date of the Passport
Telephone Number
Cell phone
E-mail Address
Skype --
Corporate Information // FOUNDATION

Full Name of Institution N/A
Registration Number
Date of Registration
Domicile / Jurisdiction
Postal Address
Registration Address
Physical Address (if different from
Registration Address)
Business Telephone Number
Business Facsimile Number
E-mail Address
Website
Corporate Officers and Titles
Details of Signatory to Contract – if applicant is a Corporation/Foundation

Name N/A


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Date and Place of Birth

Passport Number and Country of Issue:
Date of Issue of the Passport
Expiry Date of the Passport
Title Within the Corporation/Company
Office Phone Number
Cell Phone Number
Home Address
Home Phone Number
Home Facsimile Number
Skype Address
E-Mail Address
Languages English but have translators for 120 Languages
Do you speak English?

If NO, what language/s do you speak?
Translator’s Name
Translator’s Address
Translator’s Phone Number/s
Translator’s Facsimile Number
Translator’s E-mail Address
Translator’s Skype Address
Legal Advisor
Legal Advisor Name
Legal Advisor Address
Legal Advisor Phone Number/s
Legal Advisor Facsimile Number
Leal Advisor Email Address
Legal Advisor Skype Address
Details of Bank Account to receive Federal Wire/Deposit payment for herein stated Historical Bonds/Boxes (If more than
one bank account, please insert additional lines or add an additional page with bank details and desired Historical
Bonds/Boxes.) - OR - In case of system related payments, please assist in opening system accounts.
Bank Name N/A
Bank Address
Bank Swift Code
Account Name
Account Number
Account Signatory Name and Title
Bank Officer Name and Title
Bank Officer Phone Number
Bank Officer Facsimile Number
Bank Officer E-Mail Address


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Security warehouse/facility where funds are held. If in multiple locations (Cities, Countries) please list all locations
separately with volumes and type of Historical Bonds/Boxes at each. (Funds owner is not required to move the Cash
funds from a Bank or Secure Storage Facility). Please include copies (PDF SCAN) of ALL SKRs/Custodial Receipts,
packing lists, photos, inventory documents and other supporting evidence stated must be included in your submission
documents. Historical Bonds/Boxes:
1. Security Facility Name as per
SKR/Custodial Receipts
Type of Historical Bonds/Boxes
Address
City and Country
Phone
Email
Contact Person
Address
City and Country
Phone
Email
Contact Person

Address
City and Country
Phone
Email
Contact Person
Address
City and Country
Phone
Email
Contact Person
A. Has the funds owner ever presented their TYPE OF HISTORIC

BONDS/BOXES asserts to the market on previous occasions?  YES / X NO
If Yes: please state the reason for not succeeding with a transaction
and the name of the party the funds owner attempted to engage with.
(Government master files will be checked for any previous
engagement).
Please confirm you have issued advice to withdraw from that entity.


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If NO. Please confirm in writing, this is the first time the Historical _____________________________________
Bonds/Boxes is presented for Revaluation Exchange/Swap
B. Describe Corporate Activity:

(nature of the business, years involved in industry, products & nature
of activity)
C. What is the overall total amount available for Historical 1 Bond Box
Bonds/Boxes Exchange/Swap, and in what denomination is it?
D. Describe how the Funds were earned or obtained by you or the N°: xxxxxxx
corporate entity you represent? I became the owner of my bonds by way of
legitimate and legal means and of noncriminal
origin. I bought five years ago the Bonds from
the previous owner and paid
him with my piece of land with higher value.
E. Are the Cash funds beneficially owned by the undersigned? Yes

F. Are the cash funds free and clear with no liens or encumbrances or governing restrictions? Yes
G. Are the cash funds governed and/or restricted by any “Depository Agreement(s)” that would No
affect its implementation in a Historical Bonds/Boxes Exchange/Swap opportunity?
H. I, as authorized signatory and beneficial owner/trustee, hereby grant the TRANSACTING Yes
PRINCIPALS including their Compliance Department full permission and authority as part
of the compliance and verification process in assessing my/our submission, to verify, confirm,
and reconfirm said information presented in my submission including but not limited to
verification of SKR’s, verify account information with bank officers, verify cash funds by email,
phone and on a bank-to-bank basis, and conduct standard background checks of the cash
funds and the corporate entity owning such.
I. I warrant and attest that I have not authorized any other party to place these cash funds
and/or asset(s) into a Trade or Buy/Sell program. Yes
J. I certify and attest that at no time has your organization or any agent and/or appointee on
your behalf, made any offer or solicitation. Yes
K. I, warrant and attest, with full personal and corporate responsibility that as the beneficial
owner/trustee/authorized signatory, I have full legal title and authority with no governing Yes
restrictions over the herein described cash funds and am also acknowledged as such by my
secure depository/financial institution. I declare under penalty of perjury that the information
given above is accurate and true to the best of my knowledge.


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NAME of SIGNATORY:
PASSPORT: :
Date of Issue:
Date of Expiry:
COUNTRY:
DECLARATION
Origin of Historical Bonds/Boxes: Multi Year History and I am the Owner/Seller of the Historical
Bonds/Boxes.
Note: Comprehensive Provenance regarding the History and Origin of the Assets is included in this
KYC or attached as a Sworn Affidavit of Provenance.
Are these Historical Bonds/Boxes free and clear: YES
I, ______________ , hereby swear under penalty of perjury, that I, acting for and on behalf of myself
as the authorized signatory and I am the Owner/Seller of these Historical Bonds/Boxes. The information
provided herein is accurate and true as of this date:


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NAME of SIGNATORY:
PASSPORT: :
Date of Issue:
Date of Expiry:
COUNTRY:


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LETTER OF NON-SOLICITATION
To: Historical Bonds/Boxes Exchanger
Ref:…....................................
Dear Sir,
I, ______________ , residing at _______________________________ (hereinafter referred to as the

undersigned), hereby confirm that I have requested of you and your organization specific confidential
information and documentation on behalf of ourselves.
I hereby declare that I am fully aware of the information received from you is in direct response to my
request, and is not in any way considered or intended to be a solicitation of any sort and is proposed
for our general knowledge only. I hereby affirm under penalty of perjury that you have not solicited me
in any way. I understand that the contemplated transaction is strictly one of a private transaction, and
does not in any way rely upon, or related to, the United States Securities Act of 1933, as amended or
related regulations, and does not involve the sale of securities.
That affiant makes this affidavit knowing that the recipients will rely on the contents hereof, and hereby
agrees to indemnify and hold-harmless all recipients and all other parties, including intermediaries,
against any and all claims resulting from any applicant misrepresentation of a material fact or any loss
of asset value or any act (legal or not) of a bank or other financial institution, governing authority or
agency, the Federal Reserve or an official or other insider of any such entity. Further, I hereby declare
we are not licensed brokers or Government employees, and understand that neither are you or your
organization. We mutually agree that this private transaction is exempt from the Securities Act, and not
intended for the general public, and all materials are for private use only.
IN AS MUCH, as the names, identities, coordinates and other identifying information of persons or
entities which are a party to this transaction, or subsequent similar transaction(s), or learned hereafter,
shall be considered Corporate / Trade Secrets and shall not be disseminated other than as provided
for herein, or as allowed under law.
Any unauthorized disclosure of all transaction(s) parties to, or other material fact of, such transaction(s)
shall subject the violator to criminal prosecution.
IN AS MUCH, as any document passed through the hands, or electronic equipment of any person,
Broker, Intermediary or Entity not signatory to this / these transaction(s), or authorized by said
Signatories, and any material fact provided to any person, Broker, Intermediary, or Entity not signatory
to any transaction, allowed herein, or as required by applicable law, will immediately VOID the
transaction and subject the violator to criminal prosecution.
By signing this document, I, the undersigned, take full responsibility and hereby indemnifies and holds
harmless Buyer, the Exchanger, as well as, where applicable, his respective officers, directors,

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partners, shareholders, associates, affiliates and employees against any and all improprieties,
misrepresentations or omissions arising out of my completion of this document.
I, the undersigned, further undertake to guarantee that all facts and information, written and/or verbal,
which has been rendered regarding these Historical Bonds/Boxes are accurate, correct and true, and
can be relied upon completely, fully and totally by all parties involved.
NAME of SIGNATORY:
PASSPORT: :
Date of Issue:
Date of Expiry:
COUNTRY:


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LETTER OF EXCLUSIVITY
Historical Bonds/Boxes
To: Historical Bonds/Boxes Exchange/Swap Manager

Attn: Compliance Department
Dear Sirs,
I, _______________ the undersigned, hereby confirm, under penalty of perjury and with individual
and/or full corporate responsibility here by grant to YOUR PROGRAM exclusivity of our Historical
Bonds/Boxes Assets for the off market private Exchange/Swap.
TYPE OF HISTORICAL BONDS/BOXES
Historical Value/Denomination Total Name of Bank or Security City Country

Bonds/Boxes per Box Amount Depository
Type per location (must match SKRS)
For supporting BANK STATEMENT AND/OR SKRs for the cash assets are included in this
submission REFER TO ANNEX C; AND,
FOR EXPANDED LIST, REFER TO LINE-ENTRY SPREADSHEET ANNEX E – LOCAL EXCEL

SUMMARY.
I warrant and attest these asset(s) are not involved, submitted for or involved in any other transaction
and are free of liens, are not encumbered and that there is no third party interest or JV Agreements, or
POA, or Mandate letters with any party connected to this asset.
Upon request, we can provide or issue any Cease and Desist to prior groups through whom I have
attempted to exchange my Historical Bonds/Boxes if applicable.


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I hereby authorize you on my/our behalf to communicate with authorized parties to bring the transaction
to a completion. I further understand and am fully aware that this transaction will be registered with the
necessary authorities including an Exchanger and or Trade Entity and their bank and the submitted
private and confidential paperwork will be forwarded to the proper authorities for the sole purpose of
establishing the necessary dossier for the due diligence and clearance required for this transaction.
I agree that this is a private transaction that it is in no way relying upon and is exempt from the US
Security act of 1933, and any and all amendments and / or revisions and regulations related thereto,
and does not involve the purchase or sale of securities
This exclusivity is granted and effective for a thirty-one (31) business days from date signed and will
remain in effect until cancelled by me in writing.
Facsimile documents, when properly endorsed are hereby declared as originals, and originals may be
obtained upon request. All statements made herein are made under penalty of perjury.
NAME of SIGNATORY:
PASSPORT: :
Date of Issue:
Date of Expiry:
COUNTRY:


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LETTER OF EXCLUSIVITY
Historical Bonds/Box
To: Historical Bonds/Boxes Exchange/Swap Manager

Attn: Compliance Department
Dear Sirs,
I, _______________ the undersigned, hereby confirm, under penalty of perjury and with individual
and/or full corporate responsibility here by grant to YOUR PROGRAM exclusivity of our Historical
Bonds/Boxes assets for the off market private Exchange/Swap.

Historical Value/Denomination Total Name of Bank or Security City Country
Bonds/Boxes per Box Amount Depository
Type per location (must match SKRS)
For supporting BANK STATEMENT AND/OR SKRs for the cash assets are included in this
submission REFER TO ANNEX B; AND,
FOR EXPANDED LIST, REFER TO LINE-ENTRY SPREADSHEET ANNEX E – LOCAL EXCEL

SUMMARY.
I warrant and attest these asset(s) are not involved, submitted for or involved in any other transaction
and are free of liens, are not encumbered and that there is no third party interest or JV Agreements, or
POA, or Mandate letters with any party connected to this asset.
Upon request, we can provide or issue any Cease and Desist to prior groups through whom I have
attempted to exchange my Historical Bonds/Boxes if applicable.
I hereby authorize you on my/our behalf to communicate with authorized parties to bring the transaction
to a completion. I further understand and am fully aware that this transaction will be registered with the
necessary authorities including a Exchanger and or Trade Entity and their bank and the submitted
private and confidential paperwork will be forwarded to the proper authorities for the sole purpose of
establishing the necessary dossier for the due diligence and clearance required for this transaction.

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I agree that this is a private transaction that it is in no way relying upon and is exempt from the US
Security act of 1933, and any and all amendments and / or revisions and regulations related thereto,
and does not involve the purchase or sale of securities
This exclusivity is granted and effective for a thirty-one (31) business days from date signed and will
remain in effect until cancelled by me in writing.
obtained upon request. All statements made herein are made under penalty of perjury.
NAME of SIGNATORY:
PASSPORT: :
Date of Issue:
Date of Expiry:
COUNTRY:


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LETTER OF INTENT TO EXCHANGE HISTORICAL

BONDS/BOXES
Ref: …………………… Revaluation and Exchange of [Insert details of Historical Bonds/Boxes]
Dear Sir,
I, _________________ , as the authorized Signatory, holder of ___________- Passport No.:

__________________, of address ________________________________________ , the
undersigned, hereby confirm under penalty of perjury, my full commitment and agreement to exchange
these Historical Bonds/Boxes, subject to negotiations.
The price is to be approved by the Seller upon engagement. Because this transaction is extremely
large, it is important that all aspects are discussed between the Historical Bonds/Boxes Seller/Owner
and Trustee/Exchanger only (not mandates) for security and privacy purposes.
NAME of SIGNATORY:
PASSPORT: :
Date of Issue:
Date of Expiry:
COUNTRY:


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READY, WILLING AND ABLE DECLARATION

TO: Historical Bonds/Boxes Exchange/Swap Manager

ATTN: Compliance Department
Dear Sir,
I, the undersigned, _______________ with passport no: ____________ , issued by ______________

on the _____________ expiry until ____________________ ; hereby confirm and acknowledge that I
am in possession and control of the following:
HISTORICAL BONDS/BOXES Serial no.: ________________
I am immediately Ready, Willing and Able (RWA) to present myself with the above specified boxes at
such time as may be agreed to and appropriate.
I am prepared to present these assets for Revaluation and Exchange, at the bank offices as may be
instructed by the Exchange director. My Historical Bonds/Boxes assets are currently located in Zürich
Swiss and prefer to conduct the transaction in Zürich.
The information provided herein is accurate and true as of this date: February 19, 2023.
NAME of SIGNATORY:
PASSPORT: :
Date of Issue:
Date of Expiry:
COUNTRY:


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ORIGIN AND HISTORY OF HISTORICAL BONDS/BOX

ASSETS
To : Historical Bonds/Boxes Exchange/Swap Manager

Attn : Compliance Department
I VIOREL ROMAN having full legal corporate and/or personal authority and responsibility for this Origin
/ History of Funds affirm all responses as follows as being accurate and true:
Current Location of Funds :

City, Country)
Bank Name / Address :
Or Security Facility/Address
Account Holder’s Name :
Account Number : ___________________________
Safe Keeping Receipt/s :
(If in multiple locations please list each location and the volume/quantum amount and details for each
site)
HISTORY OF FUNDS:
Funds have been on deposit at _______________ and issued at _______________

Note: If the subject funds were not on deposit for a minimum of THREE (3) years applicant must state
below the previous location of where the funds were held on deposit and for how long.
Previous Location of Funds : Private clause at my home

Bank Name / Address : __________________________
Account Holder’s Name : __________________________
Account Number : __________________________
Date funds held : The GB box has been in my custody for 5 years.
The GB assets (1 box with serial numbers _____________________), became the owner of my
bonds by way of legitimate and legal means and of noncriminal
origin. I bought five years ago the Bonds from the previous owner and paid
him with my piece of land with higher value.
The Nº C __________________ have no liens, commercial obligations or encumbrances of any kind

related to said cash and are my beneficial property with free availability and in my custody


-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
The information provided herein is accurate and true as of this date: February 19, 2023
NAME of SIGNATORY:
PASSPORT: :
Date of Issue:
Date of Expiry:
COUNTRY:
CERTIFICATION:


-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
1. Funds are legally earned, beneficially owned, taxed, and includes no independent third-party
management situation and/or any governing restrictions whatsoever.
2. All information supplied in the documentation submitted and the cash involved, are not in
violation of the Patriot Act of October 26, 2001, and amendments thereto, with its related
financial crimes counterparts, however interpreted, defined and enacted, whether within the
United States its host jurisdiction of this statement or internationally.
3. Subject cash funds have no liens, commercial obligations, or encumbrances of any kind
pertaining to said cash and is beneficially owned with free availability.
4. Cash Funds owner is not a party to a law suit or pending adverse legal action, further, there are
no pending contracts existing, or about to exist, that could affect said cash assets.
5. ANNEX D: PROOF OF PROVENANCE SETTLEMENTS (SUPPORT DOCUMENTS)
NAME of SIGNATORY:
PASSPORT: :
Date of Issue:
Date of Expiry:
COUNTRY:
INDEMNIFICATION AND ATTESTATION


-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Ref: Revaluation and Exchange of ………………..
I , __________________- , holder of ______________ passport no: ____________ , residing at

__________________________________, hereby affirm, attest and certify, under penalty of perjury,
that the boxes/bonds described below:
BONDS/BOXES BOND/BOX AUTHENTICATION Location of

TYPE NUMBER Details Bonds/Boxes
PassCo, Perito, Scripo City and Country
Pass or any other
accepted expertise
Type and Certificate
Number
1
2
3
4
5
6
7
8
9
10
held at ____________________, __________ are authentic, valid and available for immediate
Revaluation and Exchange.
These boxes/bonds were lawfully acquired through commercial enterprise of non-criminal origin being
free and are clear of any and all liens and encumbrances and I am authorized to offer them for
Revaluation and Exchange.
I also affirm, attest and certify that the proceeds derived from any use of the funds shall be utilized in a
legal manner for either commercial, personal or charitable purposes at my election.
I further acknowledge that the Exchanger, with its Directors, as well as their respective officers,
directors, partners, shareholders, associates, affiliates, employees, partners and assigns, has no direct
knowledge that the Historical Bonds/Boxes Seller/Owner Holder is legal or valid at this time and
Exchanger is relying upon the representations and warranties of the undersigned.
I further affirm, attest and certify that I am not affiliated, associated or employed, either directly or
indirectly, with any governmental agency, either officially or unofficially, or under duress. I further affirm,
attest and certify that my actions, either directly or indirectly, with respect to the Revaluation and
Exchange of these Historical Bonds/Boxes are not a part of any governmental investigation, covert or
otherwise.

-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
WHEREAS; The President of the United States of America did sign H. R. 3723 on October 11, 1996
thus protecting all transactions conducted in currency of the United States of America by allowing
Corporations the right to declare their Contracts, Clients, Internal Procedures, Information, and the
transactions in which they engage, to be classified as Corporate, or Trade Secrets fully protected under
the Economic and Industrial Espionage Laws of the United States of America and the International
Economic Community.
IN AS MUCH, as the names, identities, coordinates and other identifying information of persons or
entities that are a party to this transaction, or subsequent similar transaction(s), or learned hereafter,
shall be considered Corporate / Trade Secrets and shall not be disseminated other than as provided
for herein, or as allowed under law.
Any unauthorized disclosure of all transaction(s) parties to, or other material fact of, such transaction(s)
shall subject the violator to criminal prosecution.
IN AS MUCH, as any document passed through the hands, or electronic equipment of any person,
Broker, Intermediary or Entity not signatory to this / these transaction(s), or authorized by said
signatories, and any material fact provided to any person, Broker, Intermediary, Professional Consultant
or Entity not signatory to any transaction, allowed herein, or as required by applicable law, will
immediately VOID the transaction and subject the violator to criminal prosecution.
By signing this document, the undersigned takes full responsibility and hereby indemnifies and holds
harmless The Buyer, Exchanger, as well as, where applicable, his respective officers, directors,
partners, shareholders, associates, affiliates and employees against any and all improprieties or
misrepresentations or omissions arising out of my completion of this document.
The undersigned further undertakes to guarantee that all facts and information, written and/or verbal,
which has been rendered regarding these Historical Bonds/Boxes are accurate, correct and true, and
can be relied upon completely, fully and totally by VIOREL ROMAN
I hereby swear under penalty of perjury, that the information provided herein is accurate and true.


-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
NAME of SIGNATORY:
PASSPORT: :
Date of Issue:
Date of Expiry:
COUNTRY:
AUTHORIZATION TO VERIFY HISTORIC BONDS/BOXES


-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

Dear Sir,
I, _____________________, holder of ___________________ passport number ______________

with full corporate/ personal responsibility and under penalty of perjury, authorize you and those running
the off market private Historical Bonds/Boxes Exchange/Swap opportunity, to verify the availability of
our funds located in _______________ Security Warehouse as per SKR/S: _____________________
through a banking institution or their designated entities.
Type of Asset:
Name of Security Storage
Facility
Address:
Telephone:
Facsimile:
Contact Name:
Account Number:
Account Name:
Safe Keeping Receipt SEE ANNEX C: FOR PROOF OF CUSTODY (BANK STATEMENTS
information AND/OR SKR)
Signed facsimile and emailed copies of this Authorization to verify Historical Bonds/Boxes Assets in the
nominated Bank or Security Storage Facility shall be construed equal to the original and deemed legal
and binding. UNDER PENALTY OF PERJURY, I have hereunder subscribed my name to this
Authorization to verify as the Historical Bonds/Boxes owner, authorized signatory, on this day, 19
February 2023


-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
NAME of SIGNATORY:
PASSPORT: :
Date of Issue:
Date of Expiry:
COUNTRY:
AFFIDAVIT OF NON-SUBMITTAL TO OTHERS



-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Client (Seller) Transaction Code: ______________________________

Ref:……………………………..
Dear Sir,
I, ___________________, holder of _________________ passport number _______________

residing at __________________________________________, hereby affirm, attest and certify,
under penalty of perjury and with full corporate & personal responsibility, that the Historical
Bonds/Boxes Package submitted to you for processing, including, but not limited to the Historical
Bonds/Boxes, has not and is not currently submitted to any other source for consideration of my
proposed private Revaluation and Exchange.
I furthermore hereby warrant and represent that, in the event that I have previously submitted our
Historical Bonds/Boxes Package to any other source for application for the “Revaluation and Exchange
of the Historical Bonds/Boxes”, for the procurement of the aforementioned and herein desired sale, that
we subsequently have issued the required “Cease and Desist Order” to that other source, canceling all
activities thereto.
obtained upon request.
NAME of SIGNATORY:
PASSPORT: :
Date of Issue:
Date of Expiry:
COUNTRY:
GLOBAL CEASE AND DESIST ORDER EFFECTIVE

IMMEDIATELY


-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Ref: ………………………………………….
Dear Sir,
Notification of our Official “Global Cease and Desist” to all Parties and all the unknown people and
companies that are working on my/our file, on the Revaluation and Exchange of our Historical
Bonds/Boxes as further described below:
Transaction Code: Any code that has been used without our knowledge
Any Historical Bonds/Boxes Packages and Related Documentation issued to any party.
As of today the Exchanger and his mandates, ALL other parties working with above Historical
Bonds/Boxes are hereby instructed to immediately cease and desist any and all further efforts to place
or use in any manner, the above described assets in any connection with a Revaluation and Exchange,
or Investment transaction, or any other transactions which any other associated party (ies), or any
associates (Internationally) may have considered or have proposed.
All copies and originals of all our papers, documents, statements, and other pertinent information,
submitted to any individuals or companies with the intention of entering in to a Private Investment
Program are hereby declared Null and Void for the following:
1. The inability to place this/these transaction/ Historical Bonds/Boxes into a successful

Revaluation and Exchange as per discussions and the deadlines discussed in our
conversations.
2. A general lack of communication on all aspects of this transaction, and our lack of confidence
in proceeding forward with any of the people, known or unknown to us.
This cancellation is effective immediately as of the date of this letter. Accordingly, all parties hereby
instructed to Cease and Desist from any further action with the intention to cause Revaluation and
Exchange of Private Placement on our Instruments or any other document in support of our application.
Demand is further made that all Parties other than the above referenced, Corporate Directors and/or
Signatories must immediately destroy any and all copies of any documents that have been provided in
connection with the above described Instruments/ Historical Bonds/Boxes.
All parties further served notice that in the event we become aware that any of you and any of your
associates, group or entity, have, after the issuance of this “international Cease and Desist Instruction”
attempted to continue in the subject matter, then we reserve the right to seek and obtain, in addition to
any legal remedy or claim for damages, injunctive relief to restrain the unauthorized distribution of our
confidential documents, as unlicensed distribution of our confidential documents, as unlicensed
negotiation of the investment envisaged in this instruction.


-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Finally, demand is made that this “Global Cease and Desist” is to be forwarded to any persons or entity
(ies) to whom any documents or other pertinent information regarding this account may have been
obtained: That any such person comply with this order, the demands, and directions contained herein,
and that each and every one of them forward this “Cease and Desist” to any persons or entity (ies), to
whom they may have given or received any information regarding this account. Appropriate action will
be taken in the event of failure to comply with this demand to “International Cease and Desist.”
A facsimile, email, scanned copy of this document with scanned signature shall have the same force
and effect as the original.
NAME of SIGNATORY:
PASSPORT: :
Date of Issue:
Date of Expiry:
COUNTRY:


-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
NON-CIRCUMVENTION / NON-DISCLOSURE
INTERNATIONAL CHAMBER OF COMMERCE (I.C.C.)
WHEREAS, the Undersigned wish to enter into this Agreement to define certain parameters of the
future legal obligations, are bound by a duty of Non-Circumvention and Non-Disclosure and
Confidentiality (NDA) with respect to their sources and contacts. This duty is in accordance with the
latest rules and regulations of the International Chamber of Commerce Convention Paris, France, which
applies to this transaction.
WHEREAS, the Undersigned desire to enter a working business relationship to the mutual and common
benefit of the parties hereto, including their affiliates, subsidiaries, stockholders, partners, co-ventures,
trading partners, and other associated organizations (herein after referred to as Affiliates).
NOW THEREFORE in consideration of the mutual promises, assertions and covenants herein and
other good and valuable considerations, the receipts of which is acknowledged hereby, the parties
hereby agree as follows:
I. TERMS AND CONDITIONS:

The parties will not in any manner, solicit, nor accept any business in any manner from sources nor
their Affiliates, which sources were made available through this agreement, without the express
permission of the party who made available the source and,
The parties will maintain complete confidentiality regarding each other’s business sources and/or their
Affiliates and will disclose such business sources only to named parties pursuant to the express written
permission of this party who made available the source; and
That they will not in any of the transactions the parties are desirous of entering into and do, to the best
of their abilities assure that the transaction codes established will not be affected and
That they will not disclose names, addresses, email address, telephone and facsimile or telex numbers
to any contacts by either party to third parties and that they each recognize such contracts as the
exclusive property of the respective parties and that they will not enter into any direct negotiations or
transactions with such contracts revealed by the other party and
That they further undertake not to enter into business transaction with banks, investors, sources of
funds or other bodies, the names of which have been provided by one of the parties to this agreement,
unless written permission has been obtained from the other party (is) to do so. For the sake of this
agreement, it does not matter whether information obtained from a natural or a legal person. The parties
also undertake not to make use of a third party to circumvent this clause.
That in the event of circumvention of this Agreement by either party, directly or indirectly, the
circumvented party shall be entitled to a legal monetary penalty equal to maximum service it should
realize from such a transaction plus any and all expenses, including but not limited to all legal costs and
expenses incurred to recover the lost revenue. All consideration, benefits, bonuses, participation fees
and/or commissions received as a result of the contributions of the parties in the Agreement, relating to
any and all transactions will be allocated as mutually agreed.


-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
This agreement is valid for any and all transactions between the parties herein and shall be governed
by the enforceable law in Australian Courts, Canadian Courts, USA Courts, English Courts, German
Courts, French Courts, Singapore Courts, Hong Kong (SAR) or under Swiss Laws in Zurich.
For any disputes, the arbitration laws of the ICC in London, United Kingdom, or Paris, France shall
apply.
The signing parties hereby accept such selected jurisdictions as the exclusive venue. The duration of
the Agreement shall perpetuate for five (5) years from the date hereof and will supersede any and all
other documents dated and issued later and cannot be cancelled by issuance of any Global Cease and
Desist Orders or any other documents intended to void, cancel or supersede this document. All
Consultants of Record who are listed on the Genealogy Form or Genealogy List and are involved with
the initial submission of the Historical Bonds/Boxes Holder/Custodian’s documents will be covered by
this NCND and cannot be eliminated from getting paid by subsequent updates or re-submissions of
other documents to the Buyer.
NAME of SIGNATORY:
PASSPORT: :
Date of Issue:
Date of Expiry:
COUNTRY:


-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
COLOUR COPY OF PASSPORT OF THE HISTORICAL BONDS/BOXES

OWNER/SELLER


-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
I, _______________ declare that this is my official passport issued by the Government of ________.
Historical Bonds/Boxes Seller/Owner _____________
_______________________________________________________
NAME of SIGNATORY:
TITLE:
PASSPORT:
DATE OF ISSUE:
EXPIRATION DATE:
COUNTRY:


-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
ANNEXURE INDEX
Note: Throughout this KYC submission, various components contain references of ‘Annexures’.
1. ANNEX A: ATTORNEY ATTESTATION OF ASSETS (AFFIDAVIT)

2. ANNEX B: PROOF OF LIFE (PHOTOS)
3. ANNEX C: AUTHENTICATION REPORTS
4. ANNEX D: PROOF OF CUSTODY (BANK STATEMENTS AND/OR SKR)
5. ANNEX E: PROOF OF PROVENANCE (SUPPORT DOCUMENTS/RECEIPTS)
6. ANNEX F: LOCAL EXCEL SPREADHEET SUMMARY
7. ANNEX G: SERIAL EXCEL SPREADSHEET OF ALL HISTORICAL BONDS/BOXES
[Space left Intentionally Blank]


-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
ANNEX A
ATTORNEY ATTESTATION LETTER (OFFICIAL STATIONARY)
Ref: Revaluation and Exchange of _________________ [Insert details of Historical Bonds/Boxes]
RE: Client Name:

Client Address:
We, (Name of Law firm), represented by the attorney whose name is subscribed to this Certificate and
who is licensed, and registered in the (Name of Jurisdiction)........., and domiciled
at.........................(Street Address of law firm and/or attorney) hereby confirm with full legal
accountability and responsibility we certify that......(Name of Custodian Historical Bonds/Boxes
Owner/Seller). ___________, holder and bearer of currently valid _______), Passport Number
_______________, are the legal Seller/Owner Historical Bonds/Boxes of the following financial
instrument or Historical Bonds/Boxes:
BONDS/BOXES BOND/BOX AUTHENTICATION Location of

TYPE, NUMBER Details Historical
DENOMINATION PassCo, Perito, Scripo Bonds/Boxes
Pass or any other City and Country
accepted expertise
Type and Certificate
Number
1
2
3
4
5
6
7
8
9
10
Please be advised that while we are able to confirm the legal authority of the Historical Bonds/Boxes
Owner/Seller of the herein described Historical Bonds/Boxes based on our information and belief, we
are not able to verify the authenticity of the instrument itself. Therefore, please be advised that neither
we nor __________________ (Owner/Seller Historical Bonds/Boxes), hold any insurance for these
Historical Bonds/Boxes.


-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
We confirm that the above described Historical Bonds/Boxes are currently in custodial safekeeping
with______________.
(Name and Street Address of Depository/Bank) _____________, as evidenced by the attached

Safekeeping Receipt Number ____________ are deposited under SKR at ____ Security Facility, in a
private warehouse / Safe Deposit Box # ____________ at ______________. (Name and Street
Address of location).
The above described Historical Bonds/Boxes are available at any time, upon a request to
_____________ instructions.
Please do not hesitate to contact us, should you have any questions with respect to this Certificate or
its content.
(WET BLUE INK SIGNATURE ONLY)
_______________________________________________________
NAME of SIGNATORY:
TITLE:
PASSPORT:
DATE OF ISSUE:
EXPIRATION DATE:
COUNTRY:


-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
ANNEX B
PROOF OF LIFE
IF HISTORIC BONDS/BOXES IS/ARE STORED IN A FACILITY OTHER THAN A BANK OR

SECURITY WAREHOUSE AND THERE ARE NO SUPPORTING SAFE KEEPING RECEIPTS,OR
BANK STATEMENTS PROOF OF LIFE PICTURES must be provided.
ONE PICTURE OF LIFE – SHOWING THE OWNER, HOLDING HIS PASSPORT AND THE HISTORIC
BONDS/BOXES AND A NEWS PAPER – DATE CIRCLED IN RED AND CLEARLY VISIBLE. (NOT
OLDER THAN THREE DAYS OF SUBMISSION DATE – IF POSSIBLE AT TIME OF THIS
SUBMISSION EXECUTION)
COPY OF THE HISTORICAL BONDS/BOXES

Must be provided, enlarged to 8.5” x 11”.
CLEAR CLEAN PHOTOS IN HIGH-DEFINITION DETAIL
DETAILED INSTRUCTIONS (DO NOT IGNORE OR DISMISS):
1. Photo must show Historical Bonds/Boxes Seller/Owner face in full view;
2. If Historical Bonds/Boxes: Photos of the actual Bonds front and back (with seller passport, newspaper
header (NOT OLDER THAN 3 DAYS FROM SUBMISSION DATE). If Historical Bonds/Boxes: Photos
of all four side and top and bottom (6 total) (with seller passport, newspaper header (NOT OLDER
THAN 3 DAYS FROM SUBMISSION DATE);
3. If Historical Bonds/Boxes in Secure storage the photo of seller with SKR/s newspaper header and
passport;


-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
4. CLEAR COLOUR COPY OF BOND (FRONT);
5. Historical Bonds/Boxes images must be clear and readable and show the Historical Bonds/Boxes
numbers clearly;
6. BOXES REQUIRE CLEAR PHOTOS OF ALL (6) SIX SIDES;
7. CLEAR COLOUR COPY OF BOND (BACK);
8. HISTORIC BONDS/BOXES REQUIRE CLEAR PHOTOS OF ALL (6) SIX SIDES;
9. PHOTOGRAPH(S) OF ADDITIONAL HISTORIC/BONDS BOXES
ANNEX B – PROOF OF LIFE PHOTOS

PLEASE SCAN, COPY AND PASTE THE POL PHOTOS UNDER HERE IN ANNEX B
ANNEX C – PROOF OF POL CUSTODIAL RECEIPTS

PLEASE SCAN, COPY AND PASTE THE POL CUSTODIAL RECEIPTS OF THE PURCHASE IN
ANNEX C
_______________________________________________________
NAME of SIGNATORY:
TITLE:
PASSPORT:
DATE OF ISSUE:
EXPIRATION DATE:
COUNTRY:


-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
ANNEX C
Authentication Reports in Full (e.g. PassCo, Scripo, Perito)


-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
ANNEX D:
PROOF OF CUSTODY (BANK STATEMENTS AND/OR SKR)
_______________________________________________________
NAME of SIGNATORY:
TITLE:
PASSPORT:
DATE OF ISSUE:
EXPIRATION DATE:
COUNTRY:


-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
ANNEX E:
PROOF OF PROVENANCE (SUPPORT DOCUMENTS/RECEIPTS)
_______________________________________________________
NAME of SIGNATORY:
TITLE:
PASSPORT:
DATE OF ISSUE:
EXPIRATION DATE:
COUNTRY:


-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
ANNEX F:
LOCAL EXCEL SPREADHEET SUMMARY
NOTE: ATTACH ON SEPARATE EXCEL SPREADSHEET
_______________________________________________________
NAME of SIGNATORY:
TITLE:
PASSPORT:
DATE OF ISSUE:
EXPIRATION DATE:
COUNTRY:


-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
ANNEX G:
SERIAL EXCEL SPREADHEET SUMMARY
NOTE: ATTACH ON SEPARATE EXCEL SPREADSHEET
_______________________________________________________
NAME of SIGNATORY:
TITLE:
PASSPORT:
DATE OF ISSUE:
EXPIRATION DATE:
COUNTRY:
END OF KYC

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February 19, 2023

KYC HISTORICAL BOND/BOX SUBMISSON DOCUMENT TEMPLATE

USE THIS DOCUMENT FOR INDIVIDUAL PERSON/S

***TO ALL SELLERS/OWNERS OF HISTORICAL BONDS/BOXES,

IF YOU ARE UNWILLING OR UNABLE TO COMPLY WITH THE INSTRUCTIONS

DO NOT PROCEED ANY FURTHER AS FAILURE TO PROVIDE A COMPLIANT

COMPLIANCE USE ONLY:

Initials FOR COMPLIANCE PROCESSING Page 1 of 47

CLIENT COMPLIANCE PACKAGE [CCP]

The information contained in this document is provided solely and exclusively

NAME OF THE LEGAL CUSTODIAN HOLDER / SIGNATORY FOR

Signed on this Date: February 19, 2023

COMPLIANCE USE ONLY:

Initials FOR COMPLIANCE PROCESSING Page 2 of 47

HISTORICAL BONDS/BOXES REVALUATION EXCHANGE PROGRAM

PLEASE READ CAREFULLY:

CERTAIN APPLICATION REQUIREMENTS

(PLEASE COMPLY WITH ALL REQUESTS)

THE FOLLOWING DOCUMENTS SHOULD BE FILLED IN AND RETURNED AS A PACKAGE.

ONLY THE LEGAL CUSTODIAN HOLDER OR APPROVED SIGNATORY OF THE HISTORIC

ALL SIGNATURES MUST BE ORIGINAL IN WET BLUE INK ONLY

COMPLIANCE USE ONLY:

Initials FOR COMPLIANCE PROCESSING Page 3 of 47

CLEAR COLOR PHOTOGRAPH(S) OF THE BOND(S):

• MUST BE ABLE TO BE READ CLEARLY WHEN ENLARGED BY COMPLIANCE, FORENSIC

COMPLIANCE USE ONLY:

Initials FOR COMPLIANCE PROCESSING Page 4 of 47

PORTFOLIO/SERIAL/ PASS-CO / SCRIPOPASS/ PERITO NUMBERS MUST BE CLEAR AND

PROGRAM REQUIREMENTS: Minimum Box Custodial period is 3 years

COMPLIANCE USE ONLY:

Initials FOR COMPLIANCE PROCESSING Page 5 of 47

1. ONLY THE LEGAL CUSTODIAN OR APPROVED SIGNATORY OF THE(SE) BOXES/BONDS

2. ALL SIGNATURES MUST BE ORIGINAL IN WET BLUE INK ONLY;

3. ANY PACKAGE WHICH CONTAINS ELECTRONIC OR CUT, COPIED AND PASTED

4. ANY SUBMITTED APPLICATION WHICH IS NOT ACCOMPANIED BY A FRESH UP-TO-DATE

5. ANY SUBMITTED APPLICATION PARTIALLY COMPLETED OR WITH MISSING or SANITISED

7. ANY SUBMISSION / APPLICATION SUBMITTED WITH MISSING OR WRONG CONTACT

COMPLIANCE USE ONLY:

Initials FOR COMPLIANCE PROCESSING Page 6 of 47

SIGNATURE OF THE LEGAL CUSTODIAN BOX / BOND(S) HOLDER:

Signed on this date: February 19, 2023

Historical Bonds/Boxes Seller/Owner ______________

[Space left intentionally blank]

COMPLIANCE USE ONLY:

Initials FOR COMPLIANCE PROCESSING Page 7 of 47

1. Client Compliance Package (CCP) Introductions

Annex A : Attorney Attestation of Assets (Affidavit)

[Space left intentionally blank]

COMPLIANCE USE ONLY:

Initials FOR COMPLIANCE PROCESSING Page 8 of 47

CLIENT INFORMATION SHEET

Corporate Information // FOUNDATION

Details of Signatory to Contract – if applicant is a Corporation/Foundation

COMPLIANCE USE ONLY:

Initials FOR COMPLIANCE PROCESSING Page 9 of 47

Date and Place of Birth

Languages English but have translators for 120 Languages

Do you speak English?

COMPLIANCE USE ONLY:

Initials FOR COMPLIANCE PROCESSING Page 10 of 47

3. Security Facility Name as per

A. Has the funds owner ever presented their TYPE OF HISTORIC

I, , residing at _________________ (hereinafter referred to as the

I, _______ , as the authorized Signatory, holder of _- Passport No.:

I, the undersigned, _ with passport no: , issued by