EP 200 IG 2
FORM B
(PERSON ACTING ON BEHALF OF CLIENT)
Declaration by Person Acting on Behalf of Client
I declare that the information provided in this form is true and correct. I am aware that I may be subject to
prosecution and criminal sanctions under written law if I am found to have made any false statement
which I know to be false or which I do not believe to be true, or if I have intentionally suppressed any
material fact.
Signature:
Name of person acting on
behalf of client:
Position in or relationship
with the client:
Date:
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