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...as at October 13, 2008

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CORPORATE INVESTOR'S INFORMATION FORM

 
 
Business Information
Business Name
Address
Telephone No.
Telefax
Correspondence Address
 
Signatory 1
Name
Designation
Nationality
Sex
Telephone
International Passport/Driver's License no
 
Signatory 2
Name
Designation
Nationality
Sex
Telephone No
International Passport/Driver's license
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