LDF and Swiss-UK Tax Agreement 
discretion, direction regarding the same from the authorities in Liechtenstein) in accordance with the 
provisions of the Implementing Legislation. 
4.2 I acknowledge that: 
(i) the Financial Intermediary will be subject to an audit procedure by a duly qualified 
and independent auditor, including in respect of this certification, in accordance with 
the provisions of the Implementing Legislation, and 
(ii) in certain circumstances (e.g. in the context of a criminal investigation or other action), 
HM Revenue & Customs in the UK may submit a specific request to the authorities in 
Liechtenstein under the provisions of the TIEA to obtain relevant data from the Finan- 
cial Intermediary, including a copy of this certification, following certain procedures 
in Liechtenstein. 
5. Ihereby DECLARE that: 
5.1 as appropriate and necessary, I have taken tax and/or legal advice in relation to the matters 
referred to herein; and 
5.2 the information contained herein is accurate, true and complete to the best of my knowledge 
and belief. 
6. I acknowledge and AGREE that this certification is subject to the laws of Liechtenstein and 
that the courts of Liechtenstein shall have jurisdiction in relation to any issue or dispute arising in rela- 
tion to the matters referred to herein. 
(Note: Section A below should be completed if this certification is made by the Relevant Person. 
Section B below should be completed and the requested documents provided if this certification is 
made on behalf of a Relevant Person by a parent or a legally appointed guardian or power of attorney 
where the Relevant Person is a minor (under 18 years of age) or is mentally or physically incapacitat- 
ed). 
Section A 
Name:....sssssssssss eni BLOCK CAPITALS) 
(the Relevant Person) 
Principal permanent residential address of the Relevant Person: 
es (BLOCK CAPITALS) 
Signature... ee 
Date: ee eese 
120