FATCA Terms and Conditions

I hereby certify that the information provided above is true and accurate. I confirm that under no circumstances shall the bank, its employees or its contractors be liable for any direct, indirect, incidental, special, punitive or consequential damages that may result in any way from their reliance on the information I have provided. I confirm that I have provided this FATCA self-certification willingly without advice or help from Liv. I understand that providing false information, withholding relevant information or responding in a misleading way may result in the rejection of my application or other appropriate action taken against me. I understand that Liv. may be required to make disclosures in relation to the information contained herein to appropriate government authorities and/or other regulatory authorities locally/internationally, and vide this document. I irrevocably permit Liv. to make such disclosures to any such authorities without obtaining further written or oral permission from me. This document shall form an integral part of and always be read in conjunction with the account application form and its underlying terms and conditions.