APPLICATION FORM FOR

To: The International Stock Exchange Authority Limited (the Authority)

Date:

Name of issuer:

Name of sponsor:

The issuer hereby applies for the securities detailed below to be admitted to the green segment ( TISE GREEN) of The International Stock Exchange (the Exchange or TISE).

Please submit this completed application form with the third party verification to green@tisegroup.com.

We recommend that you read the Guidance Note and FAQs as published on the Exchange’s website prior to completing this application form. If you have any further questions please contact a member of the Authority via green@tisegroup.com.

SECTION 1 - DETAILS OF SECURITIES IN RELATION TO WHICH THE APPLICATION IS BEING MADE

Details of the security classes:

Security Type: Bond / Fund or Investment Vehicle / Equity - other

SECTION 2 – GREEN CREDENTIALS

Summarise the green nature of the business or security to be admitted:

Outline the details of the third party verification attached to this application:

E.g. The Climate Bonds Initiative Certification / Guernsey Green Flag route 1 details / designation of party completing an external review.

TISE is a registered trademark of The International Stock Exchange Group Limited (Guernsey registered company number 57524). It wholly owns The International Stock Exchange Authority Limited (Guernsey registered company number 57527), which is licensed by the Guernsey Financial Services Commission to operate an investment exchange under the Protection of Investors (Bailiwick of Guernsey) Law, 1987, as amended.

Identify the industry standards to which the nature of business or security can be aligned:

E.g. Green Bond Principles by International Capital Markets Association / Common Principles by the Multinational Development Bank and the International Development Finance Club / Climate Bonds Standard Taxonomy

SECTION 3 – DECLARATIONS TO BE MADE BY THE ISSUER

I/we hereby declare that:

• The information provided in support of this application is accurate and complete to the best of my/our knowledge.

• The third party verification meets the minimum criteria set by the Authority as contained in the Guidance Note available on the Exchange’s website.

• The directors do not know of any future event which will have an adverse effect to the green nature of the business or security.

• The directors agree to supply an annual refresh of third party verification.

• The directors agree to facilitate any request for further information across the course of the life of the security on TISE GREEN.

• The directors agree to provide, without delay, the Authority with any and all information that they become aware of that may cause the security to no longer qualify for TISE GREEN, including (but not limited to) the loss of its third party verification.

• The directors understand that the Authority reserves the right to remove the security from TISE GREEN if any of the above requirements are not met or, the Authority is made aware of any circumstance that renders the security no longer suitable for TISE GREEN.

• The directors understand that decisions made by the Authority regarding TISE GREEN are final and that there is no process for appeal.

Signed:

Dated:

SECTION 4 – DECLARATIONS TO BE MADE BY THE SPONSOR / LISTING AGENT

I/we hereby agree to facilitate the transfer of information and communication between the issuer and the Authority in relation to TISE GREEN.

Signed:

Dated: