MEMBERSHIP APPLICATION FORM - asiacommodity.market filePT. Asia Commodity Marketplace (“ACM”) Sampoerna Strategic Square, South Tower Level 22 Jalan Jenderal Sudirman Kavling 45-46

ASIA COMMODITY CLEARING HOUSE | MEMBERSHIP APPLICATION FORM | NOV 2017

MEMBERSHIP APPLICATION FORM For Broker Clearing Members and Trader Clearing Members

ASIA COMMODITY CLEARING HOUSE | MEMBERSHIP APPLICATION FORM | Page 2 of 16

APPLICATION CHECKLIST Application Documents Please ensure that all relevant fields are completed correctly and clearly. Please countersign against any amendments. Please certified true copy for all supporting documents.

Documents to be provided by the Applicant Enclosed

a. Completed Application Form (duly signed and dated by the authorized person)

b. Board Resolution and Sample of Authorized Signatories

c. Copy of Certificate of Incorporation (Certified True Copy)

d. Copy of Memorandum and Articles of Association (Certified True Copy)

e. Copy of Identity Card/Passport (Certified True Copy)

• Directors

• Shareholders

• Authorized Traders/Persons

f. Copy of Deed (Certified True Copy)

g. Copy of Business License (SIUP in Indonesia) (Certified True Copy)

h. Copy of Company Registration (TDP in Indonesia) (Certified True Copy)

i. Copy of Tax Number (Certified True Copy)

j. Non-consolidated Audited Accounts (Past 3 years)

k. Group Corporate Structure and Organization Chart

l. Information on the Roles and Responsibility of Key Functions

m. Business Contingency Plan (Broker Member Only)

n. Details of IT System (Broker Member Only)

o. Standard Operating Procedure / Code of Conduct / Policy (Broker Member Only)

• Customer Onboarding

• Customer Compliance

• Risk Management and Monitoring System

• Warehousing and Commodity Sampling

Please send the completed application and the relevant supporting documents to us by:

POST Membership Team PT. Asia Commodity Marketplace (“ACM”) Sampoerna Strategic Square, South Tower Level 22 Jalan Jenderal Sudirman Kavling 45-46 Jakarta, Indonesia 12930

CONTACT Tel: (+6221) 5795 2388 Fax: (+6221) 5795 2387 Email: [email protected]


1. MEMBERSHIP CATEGORIES / KATEGORI KEANGGOTAAN

Broker Member / Anggota Pialang Trade Member / Anggota Dagang

2. APPLICANT PARTICULARS / KETERANGAN PEMOHON

Company Name / Nama Perusahaan:

Company Type / Jenis perusahaan

Private Limited Public Listed Company Sole Proprietorship Sole Proprietorship

Others. Please Specify:

Business Registration Number / Nomor Pendaftaran Bisnis: Date of Incorporation / Tanggal Pendirian:

(DD/MM/YYYY) Country of Incorporation / Negara Pendirian: Country of Business Operations:

Nature of Business / Sifat Bisnis:

Registered Address / Alamat Terdaftar:

City / Kota: State/Province / Provinsi: Country / Negara: Postal Code / Kode Pos:

Mailing Address (if different from above) / Alamat Mailing (jika berbeda dari atas):


Phone Number / Nomor Telepon: Fax Number / Nomor Fax:

Website Address / Alamat Website:

Contact Person 1 / Orang Yang Dapat Dihubungi 1

Name of Contact Person / Nama Contact Person:

(Mr/Ms/Miss/Mrs) Designation of Contact Person:


Email:


Contact Person 2 / Orang Yang Dapat Dihubungi 2

Name of Contact Person / Nama Contact Person:

(Mr/Ms/Miss/Mrs)

Designation of Contact Person:


Email:

3. FINANCIAL INFORMATION / INFORMASI KEUANGAN

Please provide details of financials of the Applicant based on the latest audited financial statements. Please state the currency.

Authorised Capital / Paid-up Capital / Net Annual Income / Liquid Assets / Modal Dasar: Modal Disetor: Pendapatan Tahunan Bersih: Aset Cair:

Net Assets / Aktiva Bersih: Source of Funds / Sumber Dana:

Particulars of Share Capital / Partikular Modal

Saham Class of Shares / Kelas Saham:

Ordinary / Biasa Preference / Utama Others / Lainnya

Number of issued shares / Jumlah saham yang diterbitkan: Issued share capital / Mengeluarkan modal saham:

Bank Details 1 / Rincian Bank 1

Name of Bank / Nama Bank:

Address / Alamat:


Account Number / Nomor Akun: Currency / Mata Uang: Swift Code/BIC / Kode Swift / BIC:

Bank Details 2 / Rincian Bank 2

Name of Bank / Nama Bank:

Address / Alamat:

Please Specify / Harap Tentukan:



Account Number / Nomor Akun: Currency / Mata Uang: Swift Code/BIC / Kode Swift / BIC:

Invoicing Information / Informasi Faktur

Name / Nama:

Invoicing Address (if different from registered office address) / Alamat Faktur (jika berbeda dengan alamat kantor terdaftar): City / Kota: State/Province / Provinsi: Country / Negara: Postal Code / Kode Pos:

Telephone / Telepon: Tax Number / Nomor Pajak:

( ) ( ) Email:

Please indicate how you would like to receive invoices / Tolong tunjukkan bagaimana Anda ingin menerima faktur:

Auditor’s Information / Informasi Auditor

Full Name / Nama Lengkap: Address / Alamat: City / Kota: State/Province / Provinsi: Country / Negara: Postal Code / Kode Pos:

Website Address / Alamat Website:

Contact Name / Nama Kontak: Telephone / Telepon:

( ) Email:

Frequency of Audit / Frekuensi Audit: (e.g. annual / tahunan)


4. OTHER INFORMATION / INFORMASI LAINNYA

1. Is the Applicant or any of the Applicant’s corporate shareholders regulated by any financial or governmental regulatory authority? Apakah perusahaan anda atau pemegang saham perusahaan anda yang diatur oleh otoritas pengatur keuangan atau pemerintah? If yes / Jika ya, Please specify the regulator / Tolong tentukan regulatornya:

Name of the corporation that is regulated / Nama perusahaan yang diatur:

Please specify the type of regulated activity / Mohon sebutkan aktivitas yang diatur:

Please specify the license held (if any*) / Harap tentukan lisensi yang dipegang (jika ada*):

License No. / Nomor Lisensi: Expiry Date / Tanggal kadaluarsa

Yes / Ya No / Tidak

Is the Applicant a part of a group of companies? Apakah pemohon merupakan bagian dari suatu grup perusahaan? If yes / Jika ya, Please provide a separate “Corporate Structure” covering the whole group showing percentage of holdings. Mohon untuk melampirkan secara terpisah “Struktur Perusahaan” menggambarkan kseluruhan grup perusahaan beserta persentase kepemilikan pada induk, dan grup utama inti lainnya berikut detail mengenai instansi pengawasan.

Yes / Ya No / Tidak

Is the Applicant a member of any other securities, futures or commodity exchanges/clearing houses within the past 10 years? If yes / Jika ya, Please list them in the table below.

Name of the exchange / clearing house

Type of Membership Date of Commencement

Date of cessation (if applicable)

Yes / Ya No / Tidak

2. Does the Applicant have a dedicated Compliance department? Apakah pemohon memiliki departemen Kepatuhan yang berdedikasi?

Yes / Ya No / Tidak

3. Does the Compliance department have a direct reporting line to the board of directors? Apakah departemen Kepatuhan memiliki garis pelaporan langsung ke dewan direksi?

Yes / Ya No / Tidak

4. Does the Compliance department from perform reviews to ensure compliance with relevant rules and regulatons? Apakah departemen Kepatuhan melakukan tinjauan untuk memastikan kepatuhan terhadap peraturan dan peraturan yang relevan? If yes, please state the type and frequency of reviews. Jika ya, sebutkan jenis dan frekuensi ulasannya.

If no, please advise how does the Applicant ensure compliance with relevant rules? Jika tidak, mohon saran bagaimana Pemohon memastikan kepatuhan terhadap peraturan yang relevan?

Yes / Ya No / Tidak


5. DIRECTORS INFORMATION / INFORMASI DIREKSI

Please provide copies of ID/Passport. Kindly copy this page and attach list if there are more than 4 directors. Berikan salinan ID / Paspor. Mohon salin halaman ini dan lampirkan daftar jika ada lebih dari 4 sutradara. Full Name / Nama Lengkap:

ID/Passport No. / Nomor ID/Paspor Nationality / Kebangsaan: Telephone / Telepon:

Residential Address / Alamat Tempat Tinggal:

Full Name / Nama Lengkap:










6. SHAREHOLDERS INFORMATION / INFORMASI PEMEGANG SAHAM

Kindly copy this page and attach list if there are more than 4 shareholders. If the shareholding structure is more than 1 level, please provide a shareholding structure certified by any 1 Director of the Company. Mohon salin halaman ini dan lampirkan daftar jika ada lebih dari 4 pemegang saham.Jika struktur pemegang saham lebih dari 1 tingkat, berikan struktur pemangku kepentingan yang disertifikasi oleh 1 Direktur Perusahaan.

Shareholders Shareholding % / Kepemilikan Saham %


ID/Passport No. / Nomor ID/Paspor Nationality / Country of Incorporation Business Registration No. / Nomor Pendaftaran Bisnis: Kebangsaan / Negara Pendirian

Residential Address/Registered Address / Alamat Hunian/Alamat Terdaftar:











7. KEY APPOINTMENTS / PENUNJUKAN KUNCI

Please provide an organization chart and a brief career summary for key appointed personnel. Berikan bagan organisasi dan ringkasan karir singkat untuk personil yang ditunjuk. Commissioner / Komisaris Full Name / Nama Lengkap:

Date of Appointment / Tanggal Penunjukan: Telephone / Telepon: Email:


Brief Career Summary / Ringkasan Karir Singkat:

President Director / Direktur Utama Full Name / Nama Lengkap:




Chief Operating Officer Full Name / Nama Lengkap:





Chief Financial Officer / Kepala Bagian Keuangan Full Name / Nama Lengkap:




Head of Legal / Kepala Bagian Hukum Full Name / Nama Lengkap:




Compliance Officer / Petugas Kepatuhan Full Name / Nama Lengkap:





9. FIT AND PROPER DECLARATION

If the answer to any of the following questions is “YES”, please provide supporting documents, where appropriate, to demonstrate that the Applicant, it’s shareholders, all its Members of the Board, and its key officers (collectively known as “relevant parties”) are fit and proper.

1. Within the past 10 years, has any of the relevant parties

(a) been a shareholder of any corporation which holds membership of any class or description of any operator of a market or clearing facility in any jurisdiction?

Yes / Ya No / Tidak

(b) carried on business under any name other than the name stated in this application in any jurisdiction?

Yes / Ya No / Tidak

(c) been refused the right or restricted in its or his right to carry on any trade, business or profession for which a specific license, registration or other authorization is required by law in any jurisdiction?

Yes / Ya No / Tidak

(d) been prohibited from operating in any jurisdiction by any financial services regulatory authority?

Yes / Ya No / Tidak

(e) been censured, disciplined, involuntarily suspended or refused membership or registration by any regulatory authority, an Exchange or operator of a market or clearing facility, whether in Indonesia or elsewhere?

Yes / Ya No / Tidak

(f) been convicted of any offence, served any term of imprisonment or is being subject to any pending proceedings which may lead to a conviction of any offence, under any law in any jurisdiction? (excluding juvenile delinquency, motor and traffic offences)?

Yes / Ya No / Tidak

(g) had any civil penalty enforcement action taken against it or him by any regulatory authority under any law in any jurisdiction associated with a finding of fraud, misrepresentation or dishonesty?

Yes / Ya No / Tidak

(h) contravened or abetted another person in breach of any laws or regulations, business rules or codes of conduct, whether in Indonesia or elsewhere?

Yes / Ya No / Tidak

(i) been the subject of any investigations or disciplinary proceedings or been issued a warning or reprimand by any regulatory authority, an Exchange or operator of a market or clearing facility, or government agency, whether in Indonesia or elsewhere?

Yes / Ya No / Tidak

(j) been refused a fidelity or surety bond, whether in Indonesia or elsewhere? Yes / Ya No / Tidak

(k)

been or is a director, partner, substantial shareholder or concerned in the management of a business that has been censured, disciplined, prosecuted or convicted of a criminal offence, or been the subject of any disciplinary or criminal investigation or proceeding, whether in Indonesia or elsewhere, in relation to any matter that took place while he was a director, partner, substantial shareholder or concerned in the management of the business?

Yes / Ya No / Tidak

(l) been or is a director, partner, substantial shareholder or concerned in the management of a business that has been suspended or refused membership or registration by any regulatory authority, an operator of a market or clearing facility, any professional body or government agency, whether in Indonesia or elsewhere?

Yes / Ya No / Tidak

(m) been dismissed or asked to resign from office, employment, a position of trust, or a fiduciary appointment or similar position, whether in Indonesia or elsewhere other than retrenchment?

Yes / Ya No / Tidak

(n) been or is subject to disciplinary proceedings by his current or former employer(s), whether in Indonesia or elsewhere?

Yes / Ya No / Tidak

(o) been disqualified from acting as a director or disqualified from acting in any managerial capacity, whether in Indonesia or elsewhere?

Yes / Ya No / Tidak

(p) been an officer found liable for an offence committed by a body corporate as a result of the offence having proved to have been committed with the consent or connivance of, or neglect attributable to, the officer, whether in Indonesia or elsewhere?

Yes / Ya No / Tidak

(q) had any judgment in particular, that associated with a finding of fraud, misrepresentation or dishonesty entered against it or him in any civil proceedings or is a party to any pending proceedings which may lead to such a judgment, under any law in any jurisdiction?

Yes / Ya No / Tidak

(r) accepted civil liability for fraud, misrepresentation or dishonesty under any law in any jurisdiction?

Yes / Ya No / Tidak


2. Within the past 10 years, has any of the relevant parties

(a) been or is unable to fulfill any of its or his financial obligations, whether in Indonesia orelsewhere?

Yes / Ya No / Tidak

(b)

entered into a compromise or scheme of arrangement (including a debt repaymentscheme) with its or his creditors, or made an assignment for the benefit of its or hiscreditors, being a compromise, scheme of arrangement or assignment that is still inoperation, whether in Indonesia or elsewhere?

Yes / Ya No / Tidak

(c) been or is subject to a judgment debt which is unsatisfied, either in whole or in part,whether in Indonesia or elsewhere?

Yes / Ya No / Tidak

(d) been or is the subject of a bankruptcy petition, adjudicated a bankrupt and the bankruptcyis undischarged, whether in Indonesia or elsewhere?

Yes / Ya No / Tidak

(e) been or is the subject of a winding up petition, whether in Indonesia or elsewhere? Yes / Ya No / Tidak

(f) been dissolved or is in the course of being wound-up, whether in Indonesia orelsewhere?

Yes / Ya No / Tidak

(g)

been or is a corporation where a receiver, receiver and manager, judicial manager, orsuch other person having the powers and duties of a receiver, receiver and manager, orjudicial manager, has been appointed in relation to, or in respect of any property of, thecorporation, whether in Indonesia or elsewhere?

Yes / Ya No / Tidak

10. CONFIRMATION / KONFIRMASI

By signing this application, you have confirmed: Dengan menandatangani permohonan ini, kami menyatakan bahwa:

i. that the applicant has all necessary authorizations, licenses, permissions, approvals or equivalent in respect of eachregulatory authority whose jurisdiction the applicant falls under and the applicant is in good standing under, and incompliance with, all applicable laws and the requirements of each regulatory authority which has jurisdiction over theapplicant;pemohon telah memperoleh persetujuan, izin atau surat kewenangan serupa dari instansi pengatur dan/atau pengawasdalam yurisdiksi dimana pemohon melakukan kegiatan usahanya dan memiliki reputasi yang baik dan patuh padaperaturan perundang-undangan dan semua ketentuan yang diterbitkan oleh instansi pengatur dan/atau pengawas.

ii. that the applicant satisfies (and shall continue to satisfy on an ongoing basis) each of the Membership Criteria (as set out inRules) and the applicant is not subject to any restrictions that would prohibit it from becoming a Member;pemohon telah memenuhi (dan akan terus berusaha untuk memenuhi) seluruh ketentuan Keanggotaan (sebagaimanadiatur dalam Peraturan) dan pemohon tidak dalam status larangan apapun yang membuatnya tidak dapat menjadiAnggota.

iii. that the applicant has not, to the best of your knowledge, nor have any of its senior representatives, ever been deniedregistration, or had a registration suspended, revoked, or conditioned by a regulatory authority;pemohon, sepanjang yang diketahuinya, tidak juga perwakilan resminya, pernah ditolak permohonannya, ataupermohonannya ditangguhkan, dibatalkan atau dalam persyaratan tertentu oleh suatu intansi pengatur;

iv. that the applicant has not, to the best of its knowledge, nor have any of its senior representatives ever been deniedmembership of any trading venue or clearing organization, or had any such membership suspended, revoked, orconditioned; pemohon, sepanjang yang diketahuinya, tidak juga perwakilan resminya, pernah ditolak permohonankeanggotaan dari suatu wadah usaha atau lembaga kliring, atau keanggotaanya ditangguhkan;

v. that neither the applicant nor any of its affiliates have ever been subject to an insolvency event or event of default inrelation to any organized market or clearing organization;pemohon dan juga afiliasinya tidak sedang pernah menjadi subyek pailit atau cidera janji dalam kaitannya dengan pasarterorganisir atau lembaga kliring;

vi. that neither the applicant nor, to the best of its knowledge, any of its representatives, are currently subject to anyinvestigation (excluding routine financial audits and examinations) or disciplinary or other formal action by any regulatoryauthority or trading venue or clearing organization nor does the applicant have reason to believe that any regulatoryauthority or trading venue or clearing organization is considering such action;pemohon, sepanjang yang diketahui, juga perwakilan resminya bukan merupakan subyek dari suatu penyidikan(dikecualikan ialah audit pemeriksaan keuangan rutin pemeriksaan) atau tindakan disiplin atau tindakan formal lainnya olehinstansi yang berwenang atau penyelenggara pasar atau lembaga kliring tidak juga pemohon mengetahui bahwa instansiyang berwenang atau penyelenggara pasar atau lembaga kliring akan melakukan tindakan tersebut dalam waktu dekatkepada Pemohon.

vii. that neither the applicant nor, to the best of its knowledge, any of its senior representatives have ever been convicted ofany offence involving fraud, theft, false accounting, offences against the administration of public justice, serious taxoffences or other dishonesty or an offence relating to companies, insurance, banking, other financial services, consumercredit or consumer protection, money laundering, market abuse or insider dealing;pemohon, sepanjang yang diketahui, juga perwakilan resminya pernah dipidana yang berkaitan dengan penipuan,pencurian, penggelapan, pemalsuan laporan, tindak pidana berkaitan instansi penegak hukum, tindak pidana pajak atautindakan kecurangan lainnya atau tindak pidana yang berkaitan dengan perusahaan, asuransi, perbankan, penyedia jasa


keuangan lainnya, kredit konsumen atau perlindungan konsumen, pencucian uang , kecurangan dalam pasar dan perdagangan dalam;

viii. that the applicant is fit and proper and has such financial, operational, technical and risk management capacity,competence, facilities and organizational arrangements to be able to satisfy its obligations under Rules and candemonstrate, to the satisfaction of ACM, that its systems and controls ensure that all personnel, agents andrepresentatives who act on behalf of or in the name of the Member in the conduct of business on ACM are fit and properwith appropriate qualifications and experience and are trained and properly supervised to perform such functions inconnection with the conduct of business on ACM;pemohon mampu dan/atau memiliki kemampuan dalam pengelolaan, kompetensi, fasilitas dan pengaturan manajemenkeuangan, operasional, teknis, dan manajemen untuk dapat memenuhi kewajibannya sebagaimana tercantum dalamPeraturan dan dapat menunjukkan, dalam rangka kepatuhan kepada ACM, bahwa sistem dan kontrolnya memastikanbahwa semua personil, agen dan perwakilan yang bertindak atas nama atau atas nama Anggota dalam menjalankanbisnis di ACM sesuai dengan kualifikasi dan pengalaman yang dilatih dan diawasi dengan benar untuk melakukan fungsitersebut sehubungan dengan kegiatannya yang dilakukannya di ACM;

ix. that the applicant has in place adequate written anti-money laundering, anti-terrorist financing, customer identityverification, anti-corruption, risk management and disaster recovery and business continuity policies and procedures toensure that it is able to perform its obligations under Rules and applicable law and regulations;pendanaan teroris, verifikasi identitas pelanggan, anti-korupsi, manajemen risiko dan pemulihan bencana serta kebijakandan prosedur kelangsungan usaha untuk memastikan bahwa pihaknya dapat menjalankan kewajibannya berdasarkanPeraturan dan perundang-undangan yang berlaku;

x. that the applicant permits ACM to obtain information relating to the applicant from sources that ACM deems appropriate inorder to adequately evaluate and process this application form;pemohon memberikan persetujuan kepada ACM untuk memperoleh informasi mengenai pemohon dari sumber yang ACManggap benar dan teruji untuk ujian pemeriksaan dan proses permohonan;

xi. that ACM can disclose or release any information regarding the applicant to any applicable regulatory authority where suchdisclosure or release is necessary or desirable for the purposes of compliance with applicable laws and regulations or withthe requirements of a regulatory authority;ACM dapat mengungkap atau memberikan informasi apapun mengenai pemohon kepada instansi pengatur dimanapengungkapan atau pemberian infromasi tersebut diperlukan atau diinginkan untuk tujuan kepatuhan terhadap undang-undang dan peraturan yang berlaku atau dengan persyaratan dari instansi pengatur;

xii. that you consent to ACM publicly disclosing the applicant’s name, in accordance with the regulatory requirementsapplicable to ACM, and using the applicant’s name for marketing purposes;and Pemohon memberikan persetujuan kepada ACM untuk mempublikasikan nama pemohon, dalam hal dibutuhkan olehintansi pengatur dan pengawasa dari ACM, dan dalam hal pemasaran; dan

xiii. that the applicant shall provide any additional documentation which ACM may request to enable ACM to undertakeMember due diligence checks for anti-money laundering purposes.pemohon akan menyampaikan dokumen tambahan yang diminta oleh ACM dalam rangka proses audit kepatuhan Anggotadan pencegahan tindak pidana pencucian uang.

For and on behalf of:

Authorized Signatory & Company Stamp Authorized Signatory

Printed Name Printed Name

Designation Designation

Date (DD/MM/YYYY)


11. DECLARATION / PERNYATAAN

The applicant declares that: Pemohon menyatakan bahwa:

i. the information provided in and in connection with, this application form is accurate and complete as at the date below. informasi yang disampaikan dan berhubungan dengan permohonan keanggotaan ini adalah benar dan lengkap pada tanggal yang tercantum di bawah ini.

ii. the applicant will provide updated information during the course of the application process if any of the information changes. pemohon akan menyampaikan informasi terbaru dalam proses permohonan apabila terdapat perubahan informasi.

iii. the applicant will be able to comply all of its obligations under Rules, any other agreements/covenants/ contracts applicable to ACM and applicable laws and regulations from the date on which it is confirmed as a Member.;pemohon akan akan mematuhi seluruh kewajiban sebagaimana terdapat dalam Peraturan, perjanjian/konvensi/kontrak yang disusun oleh ACM serta peraturan perundang-undangan sejak tanggal ditetapkan sebagai Anggota.

iv. the person signing this application form has full authority to sign on behalf of the applicant.pihak yang menandatangani permohonan ini telah memperoleh kewenangan penuh untuk menandatangani atas nama pemohon.

12. ASIA COMMODITY MARKETPLACE RULES COMPLIANCE

All member of ACM has specific rights and obligations under the Rules and Regulations of Forward Market ACM (Rules). The applicant has read and understand rights and obligations of each member, and agree to be bound and comply with the Rules.

☐ We understand and agree to be bound by and comply with the terms and conditions in PTT ACM.

For and on behalf of:

Authorized Signatory & Company Stamp Authorized Signatory

Printed Name Printed Name

Designation Designation

Date (DD/MM/YYYY)


Appendix A: Letter of Guarantee (Limited to Member’s Exposures with CDP and/or SGX-DC)

Please print on Company letterhead.

To: PT. Asia Commodity Clearing House (“ACCH”) Sampoerna Strategic Square, South Tower Level 22 Jalan Jenderal Sudirman Kavling 45-46 Jakarta, Indonesia 12930

In consideration of PT. Asia Commodity Clearing House (“ACCH”) admitting <Name of Clearing Member> as a Clearing Member, we, <Ultimate Parent Company of Clearing Member>, unconditionally accept full responsibility for the operations of <Name of Clearing Member>. In addition to our legal responsibility deriving from our shareholding in <Name of Clearing Member>, we will ensure that <Name of Clearing Member>, maintains a sound liquidity and financial position at all times, and we hereby unconditionally guarantee to ACCH that on demand, we shall not only provide adequate funds (in such form as may be acceptable to ACCH) to make up for any liquidity shortfall in <Name of Clearing Member> but we shall continue to meet, pay and settle all obligations and liabilities of <Name of the Clearing Member> as its guarantor.

The guarantee is issued subject to, and shall be governed by and construed in accordance with, the laws of the Republic of Indonesian. The parties hereby submit to the jurisdiction of the Singapore courts.

IN WITNESS WHEREBY, <Ultimate Parent Company of Clearing Member> has caused its common seal to be affixed to this guarantee this ____day of ________20XX.

THE COMMON SEAL OF ) <Ultimate Parent Company > ) was affixed pursuant to a ) resolution of its Board of ) Directors in the presence of: )

______________________________ Director

(Insert full name)

______________________________ Director

(Insert full name)

Note

1. This Guarantee should be furnished on the company letterhead of <Ultimate Parent Company of Clearing Member> andbears its corporate seal; and

2. This Guarantee should be accompanied by a certified copy of the Board Resolution of the <Ultimate Parent Company ofClearing Member> authorizing the execution of this Guarantee by the authorized signatories.