FORM 43 THE COMPANIES ACT, 2017 THE COMPANIES (GENERAL PROVISIONS AND FORMS) REGULATIONS, 2018 [Section 123A(1) and Regulation 19A(2)] DECLARATION BY MEMBER ABOUT ULTIMATE BENEFICIAL OWNERS (To be submitted to the company by every member as specified under regulation 19A(1) or regulation 19A(2)) Name of Company_____________________________ CUIN_____________________________ Presented by_____________________________ I ____________________ do solemnly declare as follows; 1.I____________________havingCNIC/Passport No.*_______________________and having address at _________________ am a person whose name is entered in the register of members of < name of the company>)as the holder of (state thepercentage of shares or controlling interest)in the company. 2.I (became the holder of the shares)/(acquired control/interest)* in the company on the following date(s) and continue as such at the date of this declaration: ______________________________________Number and classes of shares/nature ofcontrol/interest in the company__________________________________ __ Date of becoming a member of the company 3.I (myself hold/do not hold) [__] %percentage in the said share(s) or controlling interest in the company.