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EXHIBIT C - CONTINUED

CLIENT DUE DILIGENCE FORM (CDD Form)

D. Declaration

By signing this Client Due Diligence Form, I / we declare and confirm that:
a. that he / she is fully aware, that AAA will base its decision to enter into an agreement (the
“Decision”) with the Client in reliance that the information provided by the Client and/or third parties
in his behalf for the consideration of AAA entering into an agreement, i.a. the information provided in
this Client Due Diligence Form, is in all respects true, accurate and complete and that it was
furnished with the intent that it be relied upon by AAA for the purpose of entering into an agreement.
Client understands that if and when needed, AAA may ask for more detailed (personal) information.
Client further warrants and represents that no information which might affect AAA’s Decision has
been withheld. Client further consents to and irrevocably authorizes AAA to obtain information from
any other party, including without limitation financial institutions, franchisors, licensors, creditors,
government agencies, both in Aruba and abroad, as AAA may require for the purpose of verifying the
above.

b. the Company is ultimately beneficially owned by the UBO’s listed under Section B in this form;
c. I / we have not been investigated, arrested, charged with and/or convicted of any crime;

d. neither I / we, nor any other company belonging to the same group of companies that I / we form
part of (if applicable), have ever been involved in the directorship or management of, have ever
been the subject of a regulatory and/or judicial investigation;

e. I / we have never been disqualified from acting as director(s) of a company in any jurisdiction;

f. the funds, with which the company is or will be funded, do not have their origin in illegal activities
(including but not limited to human trafficking, drugs related crimes, money laundering and tax
fraud);

g. my (indirect) ownership in this company, if applicable and as far as legally required, has been or
will be properly reported by me to the (tax) authorities in my jurisdiction of residence and, as far
as legally required, in any other jurisdiction.

h. I have read and understood AAA’s Code of Ethical Conduct which can be found on AAA’s company
website and warrant that my company upholds the same standards included in alluded code.

i. I / we will provide the required compliance documents to AAA N.V. that result from this form. If
there are material changes in the future, I / we will duly notify AAA N.V. hereof.

ARUBA JULY 21st, 2022
Signed in on
Country Date

By:

ANGELIQUE R-A DE CUBA
Name UBO: ________________________ Name authorized signatory: ______________________
OR

Function UBO: ______________________ Function authorized signatory: MANAGING DIRECTOR