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ly by Non-Israeli Residents and Israeli Brokers.) You arc receiving this form "Declaration of Status for Israeli Income Tax Purposes" us a holder of Ordinary Shares, nominal value €0.011 per share, per share (the "Shares") of Mobileye N.V. (the "Company"), in connection with the tender offer. By completing this
their authorized representatives to exempt you from Israeli withholding tax. ART I 1. Name: Identification and details of Shareholder (including Eligible Israeli Brokers) (see instructions) 2. Type of Shareholder (mom than one box may be applicable): (please print full name) K Corporation (or Limited Liability Co
ly by Non-Israeli Residents and Israeli Brokers.) You arc receiving this form "Declaration of Status for Israeli Income Tax Purposes" us a holder of Ordinary Shares, nominal value €0.011 per share, per share (the "Shares") of Mobileye N.V. (the "Company"), in connection with the tender offer. By completing this
their authorized representatives to exempt you from Israeli withholding tax. ART I 1. Name: Identification and details of Shareholder (including Eligible Israeli Brokers) (see instructions) 2. Type of Shareholder (mom than one box may be applicable): (please print full name) K Corporation (or Limited Liability Co
ly by Non-Israeli Residents and Israeli Brokers.1 You arc receiving this form "Declaration of Status for Israeli Income Tax Purposes" us a holder of Ordinary Shares, nominal value €0.011 per share, per share (the "Shares") of Mobileye N.V. (the "Company"), in connection with the tender offer. By completing this
their authorized representatives to exempt you from Israeli withholding tax. ART I 1. Name: Identification and details of Shareholder (including Eligible Israeli Brokers) (see instructions) 2. Type of Shareholder (mom than one box may be applicable): (please print full name) K Corporation (or Limited Liability Co
Entities connected to both Ordinary Shares and Eligible Israeli Brokers