For office use Please complete all details of the boxes. Name Family name First name Middle name Beneficiary account name Account holder name Bank/bra

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しおりふじがわ
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1 For office use Add / Change of Beneficiary Account Details (individual) Please make sure to submit this form in case the registered information changes. Please fill in all relevant information with your registered signature or seal and return this document to us. Details you filled in will be verified and examined by the Bank. Your application may be declined based on the Bank's specific criteria. If you need more spaces, please copy and use the second page. We ask that a processing time of approximately one week be allowed for when registering new beneficiary accounts, or changes in existing beneficiary account information. When all registration requirements have been satisfied, we will send you a Registration Letter / Account Amendment Confirmation Letter. Please complete all details and seal / signature inside of the bold highlighted boxes. Please tick either add or change. Add Change If you wish to change the details of an existing beneficiary account, please write the B-Link number below. B-Link number: Expected date of first remittance Customer Details Family name First name Middle name Tel: Home address Fax: Mobile: I declare that all information I have provided here is correct. I will submit this 'Add/Change of Beneficiary Account Details form again if there are changes or additions to the registered information already submitted. Registered signature or seal Date Address : Shinsei Bank GoRemit 4-3, Nihombashi-muromachi 2-chome, Chuo-ku, Tokyo Japan

2 For office use Please complete all details of the boxes. Name Family name First name Middle name Beneficiary account name Account holder name Bank/branch code e.g. ABA No., Sort code, BSB No. No.No. Beneficiary s current country of residence Account number Beneficiary s address Beneficiary bank : branch name and address Beneficiary s relationship to yourself SWIFT code IBAN Source of funds Special instruction Purpose of remittance Please choose your purpose of remittance from the following. Import, Purchase of Goods 1 Intermediary Trade 1 Investment Family Support Tuition, Educational Fee Travel & Living Expenses Gift Loan Payment Savings OthersPlease provide details. If purpose of remittance is payment for purchasing or importing goods or intermediary trade, please fill in the following four boxes. Kind of goods Country of origin Place of shipment Destination If purpose of remittance is investment, please fill in the following box. Kind of investment products stocksfixed income securities funds Are you dealing with a counterparty directly or via an intermediary? Dealing directlydealing via an intermediary Intermediary name If via an intermediary, did you confirm that such an intermediary is registered with the Japanese FSA? (If no, we cannot handle your remittance.) If purpose of remittance is Tuition or Travel fee, please fill in the following box. Date of departure Length of stay Please submit the Add / Change of Beneficiary Account Details (individual) in case you change information. (If we cannot confirm submission of this document, the GoRemit Shinsei Overseas Remittance Service may not be available.) If you wish to add more beneficiaries, please copy and use this page. For office use

5 Certain bank codes are required when sending funds to the following countries. If you are unsure of the correct bank branch code please contact the relevant bank directly or have the beneficiary confirm for you. The format of this code is different from the bank account number. Providing the Bank code helps ensure quick and safe credit of funds to the beneficiary bank. Failure to provide correct information to GoRemit may result in a delay in delivery, or non-delivery of funds into the intended beneficiary s account. Country in which bank branch is situated IBAN Bank / Branch code SWIFT Number of digit United States / USD ABA number Fed wire / Routing number 9 Great Britain / GBP Sort code Canada / CAD Transit number + Institution number or / Routing number Transit number + Institution number : 5+3 Routing number : 9 Australia / AUD BSB number New Zealand / NZD BSB number India / Europe / Sweden / Switzerland / Mexico / UAE / Croatia / Jordan / Kuwait / Pakistan / Qatar / Guatemala / INR EUR SEK CHF Regardless of the IFSC IFSC : 11 SWIFT : 8 or / 11 IBAN : Max34 SWIFT : 8 or / 11 IBAN : Max34 SWIFT : 8 or / 11 IBAN : Max34 SWIFT : 8 or / Please fill CLABE in the account number field. IBAN : Max34 SWIFT : 8 or / 11 Regarding remittances to China China In order for individuals in China to work in the trading business, they must be registered in accordance with their local regulations. If their bank account type and the purpose of the remittance do not match, remittances may be delayed or rejected altogether. Please confirm in advance with the beneficiary that they are able to receive remittances for the purpose of trade.

4-1. 海外送金限度額申請変更送金先を追加される場合や現在登録されている送金先の海外送金限度額を変更する場合は必ず下記よりご申請ください外国為替及び外国貿易法に基づき所定の送金先にかかる海外送金限度額を超える海外送金取引については当該お取引が北朝鮮及びイラン関連規制の対象取引では

4-1. 海外送金限度額申請変更送金先を追加される場合や現在登録されている送金先の海外送金限度額を変更する場合は必ず下記よりご申請ください外国為替及び外国貿易法に基づき所定の送金先にかかる海外送金限度額を超える海外送金取引については当該お取引が北朝鮮及びイラン関連規制の対象取引では海外送金先情報等追加変更申込書 ( 法人個人事業主用 ) 銀行使用欄株式会社新生銀行御中新規に海外送金先を追加する場合や既にご登録頂いている海外送金先の受取口座送金目的限度額等の情報に変更が生じる場合は必ずオンライン送金サービスから追加変更するか本申込書をご提出ください本申込書を用いて追加変更する場合必要事項をご記入のうえ当行宛にお送りくださいご記入いただいた内容について当行で確認