NOTIFICATION FORM INFORMATION REQUIRED – This form provides a framework for supplying to the Philippine Competition Commission the information required under Section 17 of the Philippine Competition Act and Rule 4 of the Regulations. This form should be completed separately by each party to the proposed transaction. The requested information may be provided on the form or in appendices identified by the corresponding section number used in the form and should be bound together. It is preferable if parties submit their respective completed forms simultaneously. GENERAL INFORMATION Is this filing for a cash tender offer? Bankruptcy? Yes No Yes No Ultimate Parent Name: Entity (UPE) Mailing address of head office: Web site: Telephone number: Fax number: The filing UPE is: an acquiring party an acquired party both The filing UPE is: a corporation an unincorporated entity a natural person other (specify) Entity Acquiring or Not applicable Acquired (if Name: different from UPE) Mailing address: Is this Form being filed on behalf of the UPE by another entity authorized by it to file pursuant to Rule 4, Section 2 of the Regulations? If Yes, attach to this Form the certified copy of the authorization from the UPE. Yes No Entity Filing Not applicable Notification (if Name: different from UPE) Mailing address: IDENTIFICATION OF PERSONS TO CONTACT REGARDING THIS FORM Individual to Contact Alternate Individual to Contact Name: Name: Title: Title: Mailing address: Mailing address: Telephone Telephone number: number: Fax number: Fax number: Email address: Email address: Is this Form being filed on behalf of a foreign UPE? Not applicable Yes No Name: If yes, provide contact information of an individual Mailing address: located in the Philippines authorized to receive Telephone communications on behalf of the UPE regarding this number: notification and related proceedings. Fax number: Email address: FEE INFORMATION Payment of fees: Included in full Not included but will be remitted by the party supplying this notice Will be made in full by another party to the transaction Partly included, remaining payment to be remitted by another party to the transaction Method of payment: Check Wire transfer If paying by wire transfer: Not applicable Name of financial institution:
NOTIFICATION FORM INFORMATION REQUIRED – This form provides a framework for supplying to the Philippine Competition Commission the information required under Section 17 of the Philippine Competition Act and Rule 4 of the Regulations. This form should be completed separately by each party to the proposed transaction. The requested information may be provided on the form or in appendices identified by the corresponding section number used in the form and should be bound together. It is preferable if parties submit their respective completed forms simultaneously. GENERAL INFORMATION Is this filing for a cash tender offer? Yes No Bankruptcy? Yes No Ultimate Parent Entity (UPE) Name: Mailing address of head office: Web site: Telephone number: Fax number: The filing UPE is: an acquiring party an acquired party both The filing UPE is: a corporation an unincorporated entity a natural person other (specify) Entity Acquiring or Acquired (if different from UPE) Not applicable Name: Mailing address: Is this Form being filed on behalf of the UPE by another entity authorized by it to file pursuant to Rule 4, Section 2 of the Regulations? If Yes, attach to this Form the certified copy of the authorization from the UPE. Yes No Entity Filing Notification (if different from UPE) Not applicable Name: Mailing address: IDENTIFICATION OF PERSONS TO CONTACT REGARDING THIS FORM Individual to Contact Alternate Individual to Contact Name: Name: Title: Title: Mailing address: Mailing address: Telephone number: Telephone number: Fax number: Fax number: Email address: Email address: Is this Form being filed on behalf of a foreign UPE? Yes No If yes, provide contact information of an individual located in the Philippines authorized to receive communications on behalf of the UPE regarding this notification and related proceedings. Not applicable Name: Mailing address: Telephone number: Fax number: Email address: FEE INFORMATION Payment of fees: Included in full Not included but will be remitted by the party supplying this notice Will be made in full by another party to the transaction Partly included, remaining payment to be remitted by another party to the transaction Method of payment: Check Wire transfer If paying by wire transfer: Name of financial institution: Not applicable