CLIENT LINKAGE FORM

NATURAL PERSON - RENTALS

NIT 860.037.013-6
Date of completion D M A
Calle 33 # 6B - 24, floors 1, 2, and 3
Tel: (601) 285 5600 City
Bogotá D.C. - Colombia Branch
We are Large Contributors
Type of request
VAT Common Regime - Self-withholders

In the event that the potential client does not have the information requested in this form,
you must indicate this circumstance in the corresponding space

Linkage class Taker Insured Beneficiary Engaged Provider Intermediary Another

Indicate the existing links between the policyholder, insured, guarantor, and beneficiary:
(product individualization)

Policyholder Familiar Commercial Labor Another Which one?

Policyholder Familiar Commercial Labor Another Which?
Insured - Beneficiary Familiar Commercial Labor Another Which one?

1. Basic information
First surname Vargas Second surnameOf Steels Names Ana Julia
Type of document CC Number 37825077 Date of issue 17 D 01M A
1976 Place of issueBucaramanga
Date of Birth 26D 07M A
1954 Place of birth Conception Nationality 1 Colombian Nationality 2
E-mail anajvargas10@[Link] Email enabled for electronic billinganajvargas10@[Link]
Address (residence) Transversal del Bosque 17-117 Department Santander City Floridablanca Cell phone3115381030

Main activity Retired Sector CIIU (Code)

Type of activity Which one? Occupation Cargo
Company where you work Address (office)
City Department Phone
Secondary activity CIIU (Code)
What type of product and/or service do you market? (independent or merchants)
Monthly income (pesos) $6,000,000 Monthly expenses (pesos) $2,000,000

Assets (pesos) Liabilities (pesos)

Equity (assets - liabilities, pesos) Other income (pesos)

Concept of other monthly income
Are you a Politically Exposed Person (PEP)*? (see definition in the footer) Yes No
Is there any connection between you and a person considered a PEP? Yes No
If the answer to any of the previous questions is affirmative, please fill out Annex 1 of enhanced knowledge for PEP and related parties.
Due to your position or activity, do you manage public resources? Yes

Are you subject to tax obligations in another country or group of countries? Yes No
Indicate
If located in a jurisdiction other than Colombia, please attach the tax identification certificate issued by the competent authority of the country of residence.

2. Declaration of source of funds

I expressly declare that:
Both my activity, profession or trade is lawful and I carry it out within the legal framework and the resources I possess do not come from illegal activities as outlined in the Penal Code.
Colombian.
The information provided in the application and in this document is true, verifiable, and the company commits to updating it annually.
3. The resources derived from the development of this contract will not be allocated to the financing of terrorism, terrorist groups, or activities.
4. The resources I have come from the following sources (detail occupation, trade, activity or business)
Source of funds Pension

Politically Exposed Person (PEP):

Public servants of any nomenclature and classification system of public administration, national and territorial, when they have assigned or delegated functions.
related in the (Decree 830 of 2021) and the individuals in charge of the direction or management of resources in political movements or parties.

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 CLIENT LINKAGE FORM
NATURAL PERSON - RENTALS

NIT 860.037.013-6
33rd Street # 6B - 24, floors 1, 2, and 3
Tel: (601) 285 5600
Bogotá D.C. - Colombia
We are Major Contributors
VAT Common Regime - Self-withholders

3. Activities in international operations

Do you carry out transactions in foreign currency? Yes No Which one? Indicate other operations
Do you have financial products abroad? Yes No Do you have accounts in foreign currency? Yes No

Product type Product identification or number Entity Amount City Country Coin

4. Information about insurance claims

Have you filed claims or received insurance compensation in the last two years? Yes No

Year Company Value Result

5. Authorization Clause

I declare that the Global Insurance Company S.A. identified with Nit. 860.037.013-6 in its capacity as Responsible for the Processing of Personal Data has informed me: 1) That the Treatment Policy of
Personal Data is found on the [Link].co2) The responses to questions about data on girls, boys, and adolescents are optional, as well as those that concern data.
sensitive and consequently I have not been obliged to respond to them; 3) As the holder of the information, I have the rights provided in laws 1266 of 2008 and 1581 of 2012. In particular, I have the right to
right to know, update, rectify, revoke, and delete my personal data.

I hereby authorize, in advance, expressingly and informedly, the Mundial Insurance Company S.A. and/or any controlled company, directly or indirectly, that has shareholding or is associated.
domiciled in Colombia and/or abroad, third parties contracted by it or representing it, hereinafter THE COMPANY, to process my personal data for the following purposes:

(i) Process my application for registration as a financial consumer and/or client; (ii) Negotiate and conclude the insurance contract and execute it; (iii) Execute and fulfill the contracts that THE COMPANY enters into
entities in Colombia or abroad to fulfill their social purpose; (iv) The control and prevention of fraud, money laundering, financing of terrorism or financing of the proliferation of weapons
mass destruction; (v) Determine and settle insurance claims payments; (vi) Control compliance with requirements related to the Comprehensive Social Security System; (vii) Prepare technical-actuarial studies,
surveys, market trend analysis and in general any technical or field study related to the insurance sector or the provision of services of THE COMPANY; (viii) Send information
about the products, services, events, commercial activities, partnerships, and advertising of THE COMPANY, through registered physical or virtual media; execute profiling actions
commercial; prospecting; consumption habits; analysis; identification of market trends; definition of patterns; business and/or market intelligence; artificial intelligence tasks; surveys of
customer experience satisfaction; risk, statistical and financial research; (ix) Consult, store, manage, transfer, process and report my financial behavior to the Central Banks
of Information or properly constituted databases; (x) Transfer or transmit personal data to contracted third parties located in the national territory or abroad, in compliance with
legal and/or contractual obligations; (xi) Send financial information of tax subjects in the United States to the IRS or other authorities of the United States or other countries, under the terms of FATCA
or rules of a similar nature from third countries or international treaties; (xii) Collect, request, consult, store, update, use, and preserve my sensitive personal data including the
medical history and data about my health status, essential for carrying out the social purpose and economic activity of THE COMPANY; (xiii) Collect, consult, store, update, use, and preserve
the personal data of my minor children in my capacity as their legal representative or guardian, provided that the prevailing interest of the minor is met; (xiv) Access to consult, request, provide,
report, process, use, and in general give treatment to all the information contained in my work history of the RAIS (Individual Savings Regime with Solidarity), which includes my ties
current and non-current labor information, the base contribution income (IBC), contact data, employer information, pension status, date of birth, date of affiliation, and transfer date among others,
for as many times as necessary, and that is managed by the Colombian Association of Pension Fund Administrators (Asofondos de Colombia) and by the Pension Fund Administrators
in which I have been involved; (xv) Process and manage congratulations, requests, petitions, or complaints.

THE COMPANY will keep my personal data as long as necessary to comply with any legal and contractual obligation or to address any judicial or extrajudicial complaint or claim.

SARLAFT Note: According to the instructions of the Anti-Money Laundering and Terrorism Financing Risk Management System hereinafter SARLAFT, as the policyholder I declare that, due to the
The method of marketing the product does not allow for the delivery of the insured's knowledge forms, in which case the insurer will collect them at the time of filing the claim.

I authorize in advance, expressly, and informed the COMPANY to process my personal data for the purposes described above.

Yes No

Version 2022 - Page 2 of 4

 CLIENT LINKAGE FORM
NATURAL PERSON - RENTALS

NIT 860.037.013-6
33rd Street # 6B - 24, floors 1, 2, and 3
Tel: (601) 285 5600
Bogotá D.C. - Colombia
We are Large Contributors
VAT Common Regime - Self-withholders

6. Property information to be leased

Property address and registration number

(According to the certificate of Tradition and Freedom) Carrera 32 #121-44 Registration number300-637352

Purpose of the propertyMark with an X

Housing Annual increase Up to 100% of the CPI (Law 820 of 2003) Trade Annual increase
If the property's destination is 'Commerce', describe the activity.

Validity
Duration of the contract in months Since the day
(It is suggested to be for 12 months) (Contract start date) Until the day

Payment method for the fee

Payment method Cash Consignment Check Another Which one?

Account number29126864033 Place of payment or Entity Bancolombia

Related uses Description (number, location, etc.)

Garage
Deposit

Public services

Mark the public services that the property has. Billing (If the payment for utilities is shared, indicate the percentage)
of billing that must be assumed by the tenant or lessee, otherwise leave 100%)
Aqueduct, sewage system and garbage collection 100%

Electric energy 100%

Phone (register the numbers of telephone lines) 100%

Natural gas 100%

7. Signature and fingerprint

As proof of having read, understood, and accepted the above, I declare that the information I have provided
it is exact in all its parts and I sign the present document.

Client company or legal representative Right index

Version 2022 - Page 3 of 4

 CLIENT LINKAGE FORM
NATURAL PERSON - RENTALS

NIT 860.037.013-6
Calle 33 # 6B - 24, floors 1, 2, and 3
Tel: (601) 285 5600
Bogotá D.C. - Colombia
We are Major Contributors
VAT Common Regime - Self-withholders

8. Interview information 9. Confirmation of the information

Place of the interview Verification date D M A

Date of the interview D M A Confirmation time

Interview time Name and position of the verifier

Observations Company
Observations

Name of the intermediary

Name of the advisor
Interview result Approved Rejected

Annex 1 - Enhanced knowledge of PEP

In compliance with Decree 830 of 2021, the following fields are listed in case of being considered as PEP or related.

Link/ Type of Number of Date of Date of

relationship Name identification identification expedition Nationality Entity Cargo disengagement

Link/relationship
Second degree of consanguinity (parents, grandparents, siblings, children, grandchildren)
2. Second degree of affinity (sons-in-law, daughters-in-law, parents-in-law, siblings-in-law, grandparents of the spouse or permanent partner of the PEP
3. First civil (adoptive children or adoptive parents)
4. De facto or de jure conjugal partnership

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