| Certificate of Registration as a Supervised Entity |
| Certificate No. |
| Date: |
| THIS IS TO CERTIFY THAT |
| (Name of person engaged in other business activity) |
| has been registered as a supervised entity by the Financial Intelligence Authority in accordance with section 7 of the Registration of Supervised Entities Act. |
| Issued by the Financial Intelligence Authority, this day |
| of , 20 . |
| Valid until the day of , 20 . |
| |
Chairperson Financial Intelligence Authority |