Company Name Kubera PriveeK-TAM, SwedenK-TAM, IndiaKubera Assets Company Registration Number : Date of Incorporation : Ownership Structure (Please Describe) : Company Name : Company Addresses: City : Country : Company Telephone : Company Website : Trading Name (If different from above) : Trading Address (If different from above) : Name of Primary Counterparty Contact : Position of Primary Contact : Telephone of Primary Contact : Does the Counterparty provide regulated products? If yes, please detail : Regulator/Country : Licence Number : Who are the Counterparty Customers ? Where do these customers originate ? What is the source of funds that will be funding our account ? Which jurisdiction(s) will the funds originate ? Has the business/directors/executive management experienced any regulatory action? If yes, please detail: Products & Services What is the purpose of the account with us? Please detail all services including treasury/banking: Do you have a requirement for other services that we have not mentioned? If yes, please detail: Thank you for completing this questionnaire. Kubera Companies aims to have a much deeper understanding of your objectives, constraints along with a perspective that fully meet your needs and expectations.