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Are you a Philippine or non-Philippine citizen residing in the Philippines or a corporation, association, partnership or other juridical entity, or fund organized and existing under Philippine law and/or licensed to do business in the Philippines?

I hereby certify that :

• I am a resident of the Philippines, or a Corporation, association, partnership or other juridical entity, or fund organized and existing under Philippine law and/or licensed to do business in the Philippines,
• I am not in the United States, nor acting for the account of a person in the United States.
• I will not transmit or otherwise send, directly or indirectly, any information contained behind this gatepost to any person in the United States.

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