OTC CAPITAL ONLINE FORM

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REGISTRATION OF PARTICULARS

PERSONAL INFORMATION NAME NRIC/PASSPORT NO CONTACT NO Do you have Phillip Trading Account No?   PHILLIP TRADING ACCOUNT NO SECRET QUESTION What town was your father born in?What is the last name of your closest childhood friend?What was the name of your primary school?What was the name of your first pet?What town was your mother born in?What was your favorite childhoot cartoon?Who is your favorite author?What is the title of your favorite book? SECRET ANSWER EMAIL * Please, provide the email address if you do not have PHILLIP TRADING ACCOUNT NO otherwise you no need to enter the email address

Brought to you by Phillip Securities Pte Ltd (Member of PhillipCapital). Company Registration number: 197501035Z