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EXHIBIT C - CONTINUED

CLIENT DUE DILIGENCE FORM (CDD Form)

B. Information required on shareholder(s) / UBO(s) (THIS SECTION NOT APPLICABLE IF
STOCK LISTED)

B1. Shareholder and UBO (natural person)

x x Shareholder Shareholder %: 50 ____*
UBO
Names PATRICK R.
Surname(s) PASKEL

Address STA HELENASTRAAT 9

Phone number 297-6999924

E-mail patrick@firstclassaruba.com
Nationality DUTCH Dual
nationality
Date of birth 16-9-1975 Place of birth ARUBA

Would you consider yourself,
spouse or close family x Yes / No
member a Politically
Exposed Person
(PEP )?
3
WELL-KNOWN JOURNALIST AND NEWS-PROGRAMS PRESENTER, WHO
If yes, please explain:
DEALS A LOT WITH POLITICS .
* if not 100% shareholder, provide same information for the other shareholder(s)

B2. Shareholder and UBO (Corporate)
UBO Shareholder Shareholder %: *

Company name
Jurisdiction

Business address Business telephone

Business e-mail
Name contact E-mail
person
Phone number
* if not 100% shareholder, provide same information for the other shareholder(s)

NOTE:
Duplicate this page as many times as needed in order to provide same information for other
Shareholders or Ultimate Beneficiary Owners (UBO’s). The end goal is to provide information on
the UBO’s being natural persons. If UBO’s are foundations then a letter of wishes or a certified
document/declaration (verklaring) that states where the proceeds/funds go.

3 A person who holds or held a prominent public position, as well as direct family members and direct associates of
such a person.