Billing Address*

Bullion Pick Up Address*
Residential
Office

QUANTITY* (No. of pieces)	DESCRIPTION OF BULLION/CERTIFICATE* (Weight / Brand Name / Type of Metal / Bar, Coin / Minted, Cast)	TYPE OF METAL* (Gold/Silver)	TOTAL WEIGHT* (Gram/Kilogram/Oz)

I hereby confirm that (i) I have and will continue to have control over the precious metals to be purchased from and stored with SGPMX ("Singapore Precious Metals Exchange Pte Ltd"); and (ii) I am and will continue to be the sole beneficial owner of the Precious Metals. I have also read and I accept the Terms and Conditions.