Form F-80 - Registration Statement Under The Securities Act Of 1933 Page 11

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SIGNATURES
Pursuant to the requirements of the Securities Act, the Registrant certifies that it has reasonable grounds to believe that it
meets all of the requirements for filing on Form F-80 and has duly caused this registration statement to be signed on its behalf
by the undersigned, thereunto duly authorized, in the
City of _____________________________________,
Country of __________________________________________,
on ____________________.
(date)
Registrant _________________________________________________________________________________________
By ______________________________________________________________________________________________
(Signature and Title)
Pursuant to the requirements of the Securities Act, this registration statement has been signed by the following persons in
the capacities and on the dates indicated.
__________________________________________________________________________________________________
(Signature)
___________________________________________________________________________________________________
(Name and Title)
___________________________________________________________________________________________________
(Date)
Instructions:
A.
The registration statement shall be signed by the Registrant, its principal executive officer or officers, its principal
financial officer, its controller or principal accounting officer, at least a majority of the board of directors or
persons performing similar functions and its authorized representative in the United States. Where the Registrant
is a limited partnership, the registration statement shall be signed by a majority of the board of directors of any
corporate general partner signing the registration statement.
B.
The name of each person who signs the registration statement shall be typed or printed beneath his signature. Any
person who occupies more than one of the specified positions shall indicate each capacity in which the registration
statement is signed.
C.
If the securities to be offered are those of a corporation not yet in existence at the time the registration statement
is filed and which will be a party to a consolidation involving two or more existing corporations, then each such
existing corporation shall be deemed a Registrant and shall be so designated on the cover page of this Form, and
the registration statement shall be signed by each such existing corporation and by the officers and directors of
each such existing corporation as if each such existing corporation were the sole Registrant.
D.
By signing this Form, the Registrant consents without power of revocation that any administrative subpoena may be
served, or any administrative proceeding, civil suit or civil action where the cause of action arises out of or relates
to or concerns any offering made or purported to be made in connection with the securities registered pursuant
to Form F-80 or any purchases or sales of any security in connection therewith, may be commenced against it in
any administrative tribunal or in any appropriate court in any place subject to the jurisdiction of any state or of
the United States or of the District of Columbia or Puerto Rico by service of said subpoena or process upon the
Registrant’s designated agent.
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