Reference Letter Sample

SAMOA Form: DDSAM - P2 Due Diligence Verification of Identity Form for Individual Clients The information below is required to comply with the Anti-Money Laundering Laws of the relevant jurisdiction, and to eliminate the risk that the legal operation of your company is affected in the future.

Name of Samoa Company: ______Nature of Business: (please ‘’ as appropriate)

(i)  IT  Import/Export Commercial Shipping  Investments  Trading & Manufacturing  Others (please specify): ______

(ii) Please provide a brief description of Company’s business activities: ______

Origin and destination of the funds generated: ______

Beneficial Owner / Applicant for Business ( Full Name: a ) ( Business address: b )

( Permanent Residential c Address: )

( Telephone: d ) ( Fax: e ) ( Email: f ) ( Date of Birth: g ) ( Nationality: h ) ( Occupation: i )

Please attach: (1) a certified copy* of Current Passport or Identity Card; and (2) One of the following: - Residential address proof (e.g. original or certified copy* of utility bill / bank statement); or - Reference from bank or qualified professional (see attached sample wording) The information in this document is of a general nature only. OIL has made every effort to ensure the information is correct and up-to-date and does not accept any responsibility for any errors or omission. OIL strongly recommends that applicable professional advice be taken prior to purchasing a company or establishing any corporate structure. www.oilglobal.com © Copyright November 2012 / 1 of 3 A Vistra Group Company

* Copy may be certified by Lawyer/CPA/Bank in the attached format

I / We confirm that the above information is true and accurate, and you are authorised to supply any or all of such information for due diligence purposes to the Regulators if so requested by them. We also undertake to notify you of any future changes to the above information.

Client Signature: Print Name: Date:

Please return this form and attachments to: Compliance Department Vistra Hong Kong 19/F, Lee Garden One, 33 Hysan Avenue, Causeway Bay, Hong Kong

The information in this document is of a general nature only. OIL has made every effort to ensure the information is correct and up-to-date and does not accept any responsibility for any errors or omission. OIL strongly recommends that applicable professional advice be taken prior to purchasing a company or establishing any corporate structure. www.oilglobal.com © Copyright November 2012 / 2 of 3 A Vistra Group Company REFERENCE LETTER SAMPLE

TO BE PROVIDED ON REFEROR’S LETTERHEAD ______

TO: Vistra Hong Kong 19/F, Lee Garden One 33 Hysan Avenue Causeway Bay, Hong Kong

Re: residing at

I/We write to advise you that we are familiar with the principal and his business operations, and we consider to be of good standing. I/We have known for a period of ______years. We trust that the above recommendation is sufficient for your purposes.

Yours faithfully,

For and on behalf of

______(*please print signer’s name and position)

Notes: If the reference letter does not include permanent address details, proof of address, such as a utility bill must be provided separately.

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