A sort of hybrid document letter arrives. Oddly, the footer advertising line is for a UK email service.

CITI BANKERâS FINANCIAL & SECURITY TRUST

B(CBFSTDIRECT)B
1515 Golfview Rd. Fourseasons Plaza 1st Flr,

Toronto, Ontario, Canada. M4C 6H4

Tel:(647) 722-0890 Fax:(416) 322-2753

E-MAIL: cbfst@mail.net

ATTN: Manfred Von Richthofen

DATE: Jan. 11, 2005

PAYMENT VERIFICATION/DECLARATION FORM

PURSUANT TO THE PAYMENT AND COMPLETE VERIFICATION OF YOUR IDENTITY AS THE TRUE BENEFICIARY OF THESE FUNDS. PLEASE TAKE NOTE THAT YOU ARE HEREBY REQUIRED TO MAKE THIS DECLARATION AND SEND IT BACK TO US VIA E-MAIL OR FAX ALONG WITH A COPY OF YOUR DRIVERâS LICENCE OR PASSPORT FOR PROPER IDENTIFICATION.

YOUR NAME/NAME OF COMPANY·······························...

NAME OF COMPANYâS AUTHORISED REPRESENTATIVE·····················..

YOUR ADDRESS/ADDRESS OF COMPANY(INCLUDING PHONE & FAX No.)·············... ···········································

CONTRACT AMOUNT················CONTRACT No··········

PAYMENT RECEIVED(IF ANY, STATE AMOUNT)····················...

PAYMENT MADE(IF ANY, STATE AMOUNT)······················...

NAME OF YOUR BANK································..

ADDRESS OF BANK(INCLUDING PHONE AND FAX No.)·················...

BANK ACCOUNT PARTICULARS····························

PERSONAL IDENTIFICATION(DRIVERâS LICENCE OR PASSPORT)-SEND A COPY······. ···········································

THIS DECLARATION MUST BE COMPLETED AND SIGNED BY YOU OR THE COMPANYâS AUTHORISED REPRESENTATIVE.

I·············.ON BEHALF OF··········..DO SOLEMNLY DECLARE THAT THE INFORMATION PROVIDED ABOVE CONTAINS TRUE AND CORRECT IDENTITY OF THE BENEFICIARY WITH BFST UPON WHICH I MAKE THIS CLAIM.

THAT I MAKE THIS SOLEMN DECLARATION AND ENTER INTO FIRM UNDERTAKING ACCEPTING THAT ANY FALSIFICATION BY ME SHALL WARRANT THE REPUDIATION OF MY PAYMENT PROCEEDING WITH CBFST.

THAT IN PROOFS OF THIS SOLEMN DECLARATION AND UNDERTAKING BY ME THIS·..DAY OF ·····.2004

SIGNATURE:············

THANKS,

WAYNE PATRICK

(CUSTOMER SERVICE/OVERSEAS ACCOUNT REP.)

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