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French company registration number (SIREN): 449 847 482.

A Financial Investment Adviser registered with the French register of insurance intermediaries (ORIAS) under No. 13000359, authorised NYSE EURONEXT Listing Sponsor, and member of SFAF, ANACOFI-CIF, and CNCFA.

GDPR

The information you provide on this form is for the purposes of consulting services and recorded on a computerised file by Mr Adrien Tourres. It will be kept for five years after the end of the business relationship and is intended for members of Pax Corporate Finance. In accordance with the Data Protection Act, you can exercise your right of access to the data concerning you and have it rectified by contacting: Mr Adrien Tourres, 3 rue Troyon, 75017 Paris.

You can also file a request concerning the processing of your data with the French Data Protection Authority (CNIL).

In the event we discover a possible conflict of interest, we will immediately inform our customer of this. If our customer does not request any changes, we will assume there is no longer a conflict of interest. We will then inform the parties concerned in writing and offer them a solution to remove the conflict of interest and its consequences.

CLAIMS PROCESSING
(Article 325-12-1 of the French Financial Markets Authority (AMF) general regulation and AMF Directive No. 2012-07 of 13/07/12 as updated on 24/04/13, 20/11/13, and 17/10/2014)

PLEASE NOTE / REMINDER
With regard to claims procedures and processing, please also see the Financial Investment Advisers (FIA) Internal Code / Claims Processing Procedures and Organisation.

REFERRAL PROCEDURES FOR THE COMPANY
For all claims, your adviser or the Company’s complaints department can be contacted as follows:
By letter: …………………………….
By tel or fax: ……………………….
Or by e-mail: ……………………..

Claims processing:
Your adviser shall process your claim within the following timeframes:
– Ten business days maximum from receipt of the claim to acknoledge its receipt unless the response itself is provided to the customer within this timeframe.
– Two months maximum between the date of receipt of the claim and the date the response is sent to the customer, except in case of july justified special circumstances.

Recourse to mediation:
I – Mediator specialising in disputes with a company:
Médiateur de l’Anacofi
92 rue d’Amsterdam
75009 Paris
II – Mediator specialising in disputes with a consumer:
For Financial Investment Adviser (FIA) activities
Ms Marielle Cohen-Branch, Médiateur de l’AMF
17, place de la Bourse 75082 Paris cedex 02
Website: http://www.amf-france.org/The-Mediateur-de-l-AMF/Le-mediateur-mode-d-emploi/Modes-de-saisine.html
For Insurance activites
La Médiation de l’Assurance
TSA 50110
75441 Paris cedex 09
Website: http://www.mediation-assurance.org/Saisir+le+mediateur
For Banking and payment services (IOBSP) and Real Property mediators
Médiation de la consommation – ANM Conso
62 rue Tiquetonne
75002 Paris

IOBSP website: www.anm-conso.com/anacofi-iobsp

Real Property website: www.anm-conso.com/anacofi-immo

DATE AND SIGNATURE The customer
Signed in (city): ____________________
Date: ___________________________
Signature: ________________________

The advisor
Signed in (city): ____________________
Date: ___________________________
Signature: ________________________