5 — Declaration and Signature Please ensue that you have the authority to sign on behalf of the Entity. Please sign and date the form in this part. SN Cerbluxit00 b Entry Chet' -CRS IVK FATCA -17/2016 CONFIDENTIAL - PURSUANT TO FED. R. CRIM. P. 6(e) DB-SDNY-0043512 CONFIDENTIAL SDNY_GM_00189696 EFTA0135714