<SEC-DOCUMENT>0001178913-22-001220.txt : 20220323
<SEC-HEADER>0001178913-22-001220.hdr.sgml : 20220323
<ACCEPTANCE-DATETIME>20220323080830
ACCESSION NUMBER:		0001178913-22-001220
CONFORMED SUBMISSION TYPE:	6-K
PUBLIC DOCUMENT COUNT:		10
CONFORMED PERIOD OF REPORT:	20220323
FILED AS OF DATE:		20220323
DATE AS OF CHANGE:		20220323

FILER:

	COMPANY DATA:	
		COMPANY CONFORMED NAME:			ZIM Integrated Shipping Services Ltd.
		CENTRAL INDEX KEY:			0001654126
		STANDARD INDUSTRIAL CLASSIFICATION:	DEEP SEA FOREIGN TRANSPORTATION OF FREIGHT [4412]
		IRS NUMBER:				000000000
		STATE OF INCORPORATION:			L3
		FISCAL YEAR END:			1231

	FILING VALUES:
		FORM TYPE:		6-K
		SEC ACT:		1934 Act
		SEC FILE NUMBER:	001-39937
		FILM NUMBER:		22761628

	BUSINESS ADDRESS:	
		STREET 1:		9 ANDREI SAKHAROV STREET
		STREET 2:		P.O. BOX 15067
		CITY:			HAIFA
		STATE:			L3
		ZIP:			3190500
		BUSINESS PHONE:		972 (4) 865-2000

	MAIL ADDRESS:	
		STREET 1:		9 ANDREI SAKHAROV STREET
		STREET 2:		P.O. BOX 15067
		CITY:			HAIFA
		STATE:			L3
		ZIP:			3190500
</SEC-HEADER>
<DOCUMENT>
<TYPE>6-K
<SEQUENCE>1
<FILENAME>zk2227520.htm
<DESCRIPTION>6-K
<TEXT>
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        <div style="text-align: center; line-height: 1.25;">&#160;<br>
        </div>
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      <div style="text-align: center; line-height: 1.25; font-family: 'Times New Roman',Times,serif; font-size: 14pt; font-weight: bold; background-color: rgb(255, 255, 255); color: rgb(0, 0, 0); font-style: normal; font-variant: normal; text-transform: none;">UNITED STATES</div>
      <div style="text-align: center; line-height: 1.25; font-family: 'Times New Roman',Times,serif; font-size: 14pt; font-weight: bold; background-color: rgb(255, 255, 255); color: rgb(0, 0, 0); font-style: normal; font-variant: normal; text-transform: none;">SECURITIES AND EXCHANGE COMMISSION</div>
      <div style="text-align: center; line-height: 1.25; font-weight: bold;">Washington, D.C. 20549</div>
      <div style="text-align: center; line-height: 1.25; font-weight: bold;">&#160;</div>
      <div style="text-align: center; line-height: 1.25; font-family: 'Times New Roman',Times,serif; font-size: 14pt; font-weight: bold; background-color: rgb(255, 255, 255); color: rgb(0, 0, 0); font-style: normal; font-variant: normal; text-transform: none;">FORM 6-K</div>
      <div style="text-align: center; line-height: 1.25; font-weight: bold;">&#160;</div>
      <div style="text-align: center; line-height: 1.25; font-weight: bold;">REPORT OF FOREIGN PRIVATE ISSUER</div>
      <div style="text-align: center; line-height: 1.25; font-weight: bold;">PURSUANT TO RULE 13a-16 OR 15d-16 OF THE</div>
      <div style="text-align: center; line-height: 1.25; font-weight: bold;">SECURITIES EXCHANGE ACT OF 1934</div>
      <div style="text-align: center; line-height: 1.25;">&#160;</div>
      <div style="text-align: center; line-height: 1.25;">For the month of March, 2022</div>
      <div style="text-align: center; line-height: 1.25;"><img width="246" height="1" src="image0.jpg">&#160;</div>
      <div style="text-align: center; line-height: 1.25; font-weight: bold;">Commission File Number: 001-39937</div>
      <div style="text-align: center; line-height: 1.25; font-weight: bold;">&#160;</div>
      <div style="text-align: center; line-height: 1.25; font-family: 'Times New Roman',Times,serif; font-size: 16pt; font-weight: bold; background-color: rgb(255, 255, 255); color: rgb(0, 0, 0); font-style: normal; font-variant: normal; text-transform: none;">ZIM Integrated Shipping Services Ltd.</div>
      <div style="text-align: center; line-height: 1.25;">(<font style="font-style: italic;">Exact Name of Registrant as Specified in Its Charter</font>)</div>
      <div style="text-align: center; line-height: 1.25; font-weight: bold;">&#160;</div>
      <div style="text-align: center; line-height: 1.25; font-weight: bold;">9 Andrei Sakharov Street</div>
      <div style="text-align: center; line-height: 1.25; font-weight: bold;">P.O. Box 15067</div>
      <div style="text-align: center; line-height: 1.25; font-weight: bold;">Matam, Haifa 3190500, Israel</div>
      <div style="text-align: center; line-height: 1.25; font-weight: bold;">+972 (4) 865-2000</div>
      <div style="text-align: center; line-height: 1.25; font-style: italic;">(Address of principal executive office)</div>
      <div style="text-align: center; line-height: 1.25;">&#160; <br>
      </div>
      <div style="text-align: center; line-height: 1.25;">Indicate by check mark whether the registrant files or will file annual reports under cover of Form&#160;20-F or Form 40-F:</div>
      <div style="text-align: center; line-height: 1.25;">&#160;</div>
      <div style="text-align: center; line-height: 1.25;"><font style="font-family: 'Times New Roman',Times,serif;">Form 20-F &#9746;<font class="HorizontalTab" style="width: 9pt; font-size: 1px; display: inline-block;"> </font>Form 40-F &#9744;</font></div>
      <div style="text-align: center; line-height: 1.25;">&#160;</div>
      <div style="text-align: center; line-height: 1.25;">Indicate by check mark if the registrant is submitting the Form 6-K in paper as permitted by Regulation&#160;S-T&#160;Rule&#160;101(b)(1):</div>
      <div style="text-align: center; line-height: 1.25;">&#160;</div>
      <div style="text-align: center; line-height: 1.25;"><font style="font-family: 'Times New Roman',Times,serif;">Yes &#9744;<font class="HorizontalTab" style="width: 9pt; font-size: 1px; display: inline-block;"> </font>No &#9746;</font></div>
      <div style="text-align: center; line-height: 1.25;">&#160;</div>
      <div style="text-align: center; line-height: 1.25;">Indicate by check mark if the registrant is submitting the Form 6-K in paper as permitted by Regulation&#160;S-T&#160;Rule&#160;101(b)(7):</div>
      <div style="text-align: center; line-height: 1.25;">&#160;</div>
      <div style="text-align: center; line-height: 1.25;">
        <div style="line-height: 1.25;"><font style="font-family: 'Times New Roman',Times,serif;">Yes &#9744;<font class="HorizontalTab" style="width: 9pt; font-size: 1px; display: inline-block;">&#160;</font>No &#9746;</font></div>
        <font style="font-family: 'Times New Roman',Times,serif;"></font></div>
      &#160;</div>
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      <div style="text-align: justify; line-height: 1.25;">On March 23, 2022, and in connection with the payment of a dividend previously announced by the Company expected to take place on April 4, 2022 (the &#8220;Dividend&#8221;), the Company has issued a press
        release announcing it has secured an extension of its previously obtained tax ruling from the Israeli Tax Authority (&#8220;ITA&#8221;) with respect to the tax withholding procedures relating to the payment of the Dividend, and to any future dividend
        distributions to be made by the Company on or before December 31, 2022, if declared by the Company (the &#8220;Ruling&#8221;). A copy of this press release is attached herewith as Exhibit 99.1.</div>
      <div style="line-height: 1.25;"><br style="line-height: 1.25;">
      </div>
      <div style="text-align: justify; line-height: 1.25;">In addition, and as in accordance with the Ruling and the Company&#8217;s press release, A copy of the following forms:&#160; (i) &#8220;Declaration of Status For Israeli Income Tax Purposes&#8221;; (ii) &#8220;Beneficiary&#8217;s
        Details&#8221;; and (iii) &#8220;Additional Beneficiary&#8217;s Details &#8211; Controlling Person&#8221; in connection with the payment of the Dividend are attached herewith as Exhibits 99.2, 99.3 and 99.4, respectively.</div>
      <div style="line-height: 1.25;"><br style="line-height: 1.25;">
      </div>
      <div style="text-align: justify; line-height: 1.25;">The information in this Form 6-K (including Exhibits 99.1, 99.2, 99.3 and 99.4) shall not be deemed &#8220;filed&#8221; for purposes of Section 18 of the Securities Exchange Act of 1934 (the &#8220;Exchange Act&#8221;) or
        otherwise subject to the liabilities of that section, nor shall it be deemed incorporated by reference in any filing under the&#160;Securities Act of 1933&#160;or the&#160;Exchange Act.</div>
      <div style="line-height: 1.25;">&#160;</div>
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      <div style="text-align: center; line-height: 1.25; font-weight: bold;">SIGNATURES</div>
      <div style="text-align: center; line-height: 1.25;">&#160;</div>
      <div style="text-align: justify; line-height: 1.25;">Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned, thereunto duly authorized.</div>
      <div style="line-height: 1.25;">&#160;</div>
      <table cellspacing="0" cellpadding="0" border="0" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;" id="z47f6aa98ed014065bc43e95d81feeb21">

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              <div style="line-height: 1.25;">&#160;</div>
            </td>
            <td colspan="2" style="vertical-align: top;">
              <div style="line-height: 1.25;">ZIM INTEGRATED SHIPPING SERVICES LTD.</div>
            </td>
            <td colspan="1" style="width: 17%; vertical-align: top;">&#160;</td>
          </tr>
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            <td style="width: 50%; vertical-align: middle;">
              <div style="line-height: 1.25;">&#160;</div>
            </td>
            <td style="width: 3%; vertical-align: middle;">
              <div style="line-height: 1.25;">&#160;</div>
            </td>
            <td style="width: 30%; vertical-align: middle;">
              <div style="line-height: 1.25;">&#160;</div>
            </td>
            <td colspan="1" style="width: 17%; vertical-align: middle;">&#160;</td>
          </tr>
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              <div style="line-height: 1.25;">&#160;</div>
            </td>
            <td nowrap="nowrap" style="width: 3%; vertical-align: top; padding-bottom: 2px;">
              <div style="line-height: 1.25;">By:&#160;&#160;</div>
            </td>
            <td nowrap="nowrap" style="width: 30%; vertical-align: top; border-bottom: 2px solid rgb(0, 0, 0);">
              <div style="line-height: 1.25;">/s/ Noam Nativ</div>
            </td>
            <td nowrap="nowrap" colspan="1" style="width: 17%; vertical-align: top; padding-bottom: 2px;">&#160;</td>
          </tr>
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              <div style="line-height: 1.25;">&#160;</div>
            </td>
            <td style="width: 3%; vertical-align: top;">
              <div style="line-height: 1.25;">&#160;</div>
            </td>
            <td style="width: 30%; vertical-align: bottom;">
              <div style="line-height: 1.25;">Noam Nativ</div>
            </td>
            <td colspan="1" style="width: 17%; vertical-align: bottom;">&#160;</td>
          </tr>
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              <div style="line-height: 1.25;">&#160;</div>
            </td>
            <td style="width: 3%; vertical-align: top;">
              <div style="line-height: 1.25;">&#160;</div>
            </td>
            <td style="width: 30%; vertical-align: bottom;">
              <div style="line-height: 1.25;">EVP General Counsel and Corporate Secretary</div>
            </td>
            <td colspan="1" style="width: 17%; vertical-align: bottom;">&#160;</td>
          </tr>

      </table>
      <div style="line-height: 1.25;">&#160;</div>
      <div style="line-height: 1.25;">Date: March 23, 2022</div>
      <div style="line-height: 1.25;">&#160;</div>
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      <div style="text-align: center; line-height: 1.25;">EXHIBIT INDEX</div>
      <div style="line-height: 1.25;">&#160;</div>
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              <div style="text-align: center; line-height: 1.25;">EXHIBIT NO.</div>
            </td>
            <td style="width: 1.96%; vertical-align: bottom;"><br>
            </td>
            <td style="width: 90%; vertical-align: bottom; border-bottom: 2px solid rgb(0, 0, 0);">
              <div style="line-height: 1.25;">DESCRIPTION</div>
            </td>
          </tr>
          <tr>
            <td style="width: 8%; vertical-align: bottom;">
              <div style="text-align: center; line-height: 1.25;"><a href="exhibit_99-1.htm">99.1</a></div>
            </td>
            <td style="width: 1.96%; vertical-align: bottom;"><a href="exhibit_99-1.htm"><br>
              </a></td>
            <td style="width: 90%; vertical-align: bottom;">
              <div style="line-height: 1.25;"><a href="exhibit_99-1.htm">Press Release dated March 23, 2022</a></div>
            </td>
          </tr>
          <tr>
            <td style="width: 8%; vertical-align: bottom;">
              <div style="text-align: center; line-height: 1.25;"><a href="exhibit_99-2.htm">99.2</a></div>
            </td>
            <td style="width: 1.96%; vertical-align: bottom;"><a href="exhibit_99-2.htm"><br>
              </a></td>
            <td style="width: 90%; vertical-align: bottom;">
              <div style="line-height: 1.25;"><a href="exhibit_99-2.htm">Form of Declaration of Status For Israeli Income Tax Purposes</a></div>
            </td>
          </tr>
          <tr>
            <td style="width: 8%; vertical-align: bottom;">
              <div style="text-align: center; line-height: 1.25;"><a href="exhibit_99-3.htm">99.3</a></div>
            </td>
            <td style="width: 1.96%; vertical-align: bottom;"><a href="exhibit_99-3.htm"><br>
              </a></td>
            <td style="width: 90%; vertical-align: bottom;">
              <div style="line-height: 1.25;"><a href="exhibit_99-3.htm">Form of Beneficiary&#8217;s Details</a></div>
            </td>
          </tr>
          <tr>
            <td style="width: 8%; vertical-align: bottom;">
              <div style="text-align: center; line-height: 1.25;"><a href="exhibit_99-4.htm">99.4</a></div>
            </td>
            <td style="width: 1.96%; vertical-align: bottom;"><a href="exhibit_99-4.htm"><br>
              </a></td>
            <td style="width: 90%; vertical-align: bottom;">
              <div style="line-height: 1.25;"><a href="exhibit_99-4.htm">Additional Beneficiary&#8217;s Details &#8211; Controlling Person</a></div>
            </td>
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<DOCUMENT>
<TYPE>EX-99.1
<SEQUENCE>2
<FILENAME>exhibit_99-1.htm
<DESCRIPTION>EXHIBIT 99.1
<TEXT>
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         Document created using EDGARfilings PROfile 8.1.0.0
         Copyright 1995 - 2022 Broadridge -->
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<body bgcolor="#ffffff" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; text-align: left; color: #000000;">
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    <div>
      <div style="text-align: right; line-height: 1.25; font-weight: bold;"><u>Exhibit 99.1</u></div>
      <div style="text-align: justify; line-height: 1.25;">&#160;
        <div id="DSPFPageHeader">
          <div style="text-align: left; line-height: 1.25;"><br>
          </div>
          <div style="line-height: 1.25; text-align: center;"><img src="image00004.jpg"></div>
          <div style="line-height: 1.25;"><br style="line-height: 1.25;">
          </div>
        </div>
        <div style="text-align: center; line-height: 1.25; font-family: 'Times New Roman',Times,serif; font-size: 14pt; font-weight: bold; background-color: rgb(255, 255, 255); color: rgb(0, 0, 0); font-style: normal; font-variant: normal; text-transform: none;">ZIM Updates on Withholding Tax Procedures on April 2022 Cash Dividend</div>
        <div style="line-height: 1.25;"><br style="line-height: 1.25;">
        </div>
        <div style="text-align: center; line-height: 1.25; font-family: 'Times New Roman',Times,serif; font-size: 12pt; font-weight: bold; background-color: rgb(255, 255, 255); color: rgb(0, 0, 0); font-style: normal; font-variant: normal; text-transform: none;">Ruling Will Apply to All 2022 Dividend Distributions</div>
        <div style="line-height: 1.25;"><br style="line-height: 1.25;">
        </div>
        <div style="line-height: 1.25;">HAIFA, Israel, March 23, 2022 &#8211; <u>ZIM Integrated Shipping Services Ltd.</u> (NYSE: ZIM) (&#8220;ZIM&#8221; or the &#8220;Company&#8221;) (NYSE: ZIM), a global container liner shipping company, hereby announces that it secured an extension
          of its previously obtained tax ruling (the &#8220;Ruling&#8221;) from the Israeli Tax Authority (&#8220;ITA&#8221;) with respect to the tax withholding procedures relating to the payment of dividend to its shareholders (&#8220;Shareholders&#8221;). The Ruling will apply to the
          dividend distribution expected to take place on April 4, 2022, as previously announced by the Company on March 9, 2022 (the &#8220;Dividend&#8221;), and to any future dividend distributions to be made by the Company on or before December 31, 2022, if
          declared by the Company. As a result of the Ruling, certain Shareholders may be eligible to a reduced Israeli withholding tax rate with respect to their share of this Dividend distribution, in comparison to the generally applicable withholding
          tax rate (the &#8220;Reduced Withholding Tax Rate&#8221;), under certain terms and conditions as set forth below.</div>
        <div style="line-height: 1.25;"><br style="line-height: 1.25;">
        </div>
        <div style="line-height: 1.25; font-weight: bold;">The description provided below is not intended to constitute a complete analysis of withholding tax rate procedures relating to the distribution of the Dividend, nor does it address the actual tax
          liability of any shareholder, but merely relates to the Israeli withholding tax procedures relating to the distribution of the Dividend. Other than the Dividend previously declared by the Company to be paid on April 4, 2022, there is no guarantee
          the Company will declare additional dividends in the future.</div>
        <div style="line-height: 1.25;"><br style="line-height: 1.25;">
        </div>
        <div style="line-height: 1.25; font-weight: bold;">Shareholders are advised to consult their own tax and financial advisors concerning the tax consequences of each particular situation, as well as any tax consequences that may arise under the laws
          of any state, local, foreign or other taxing jurisdiction. For the avoidance of doubt, the Agent (as defined below) has been retained by ZIM for the purpose coordinating certain procedures relating to the Ruling, and it is NOT intended that the
          Agent will provide any tax advice to any Shareholders, who are encouraged to consult their own tax and financial advisors.</div>
        <div style="line-height: 1.25;"><br style="line-height: 1.25;">
        </div>
        <div style="line-height: 1.25; font-weight: bold;">Background</div>
        <div style="line-height: 1.25;">&#160;</div>
        <div style="line-height: 1.25;">On March 9, 2022, ZIM announced a dividend payment of $17.00 per ordinary share (approximately $2.04 billion), to holders of the ordinary shares as of March 23, 2022. Payment of the Dividend is expected to be made on
          April 4, 2022 (the "Payment Date").</div>
        <div style="line-height: 1.25;">&#160;</div>
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          <div style="line-height: 1.25;"><img src="image00004.jpg"></div>
          <div style="line-height: 1.25;"><br style="line-height: 1.25;">
          </div>
        </div>
        <div style="line-height: 1.25; font-weight: bold;"> <br>
        </div>
        <div style="line-height: 1.25; font-weight: bold;">General Withholding Tax Treatment under Israeli Law</div>
        <div style="line-height: 1.25;">&#160;</div>
        <div style="line-height: 1.25;">As set out in the Company&#8217;s Annual Report on Form 20-F filed with the Commission on March 9, 2022, with respect to dividends sourced from regular earnings, under the Israeli Tax Ordinance and regulations issued under
          the Israeli Tax Ordinance (collectively, "ITO"), the current Israeli rate of withholding tax on dividends paid by an Israeli company is 30% for distributions to a "substantial shareholder" (in general, being someone who holds, directly or
          indirectly, by himself or together with others, at least 10% of one or more of the means of control in the company) and 25% with respect to distributions to all other holders of Ordinary Shares (&#8220;Withholding Tax&#8221;). Notwithstanding the foregoing,
          as a result of the Ruling and subject to its terms and conditions, certain Shareholders, both Israeli and non-Israeli, may be eligible to a reduced Israeli withholding tax rate on their share of this dividend distribution, in comparison to the
          generally applicable withholding tax rate described above, (the &#8220;Reduced Withholding Tax Rate&#8221;), under certain terms and conditions as set forth below.</div>
        <div style="line-height: 1.25;"><br style="line-height: 1.25;">
        </div>
        <div style="line-height: 1.25; font-weight: bold;">Summary of the Main Terms of the Ruling</div>
        <div style="line-height: 1.25;"><br style="line-height: 1.25;">
        </div>
        <div style="line-height: 1.25;">The following is a summary of some of the key terms of the Ruling. <font style="font-weight: bold;">It is emphasized that the description below does not purport to exhaust all the terms and conditions included in
            the Ruling and is not a complete translation of the Ruling. In order to enjoy the Reduced Withholding Tax Rate, Shareholders must comply with all the terms of the Ruling, a copy of which in the Hebrew language as well as an unofficial
            non-binding English translation thereof can be obtained free of charge by email by approaching the Agent (as defined below) at the contact details provided below</font>.</div>
        <div style="line-height: 1.25;"><br style="line-height: 1.25;">
        </div>
        <table cellspacing="0" cellpadding="0" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;" class="DSPFListTable" id="z1cd2537c48c04560b644927384167692">

            <tr>
              <td style="width: 18pt;"><br>
              </td>
              <td style="width: 18pt; vertical-align: top; align: right;">1.</td>
              <td style="width: auto; vertical-align: top; text-align: justify;">
                <div>On the Payment Date the Company will withhold 25% of the Dividend amount and will remit the tax amount to the Agent, to be handled by the Agent in accordance with the terms and conditions of the Ruling.</div>
              </td>
            </tr>

        </table>
        <table cellspacing="0" cellpadding="0" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;" class="DSPFListTable" id="zd06883386ee241699f27dded8e83f845">

            <tr>
              <td style="width: 18pt;"><br>
              </td>
              <td style="width: 18pt; vertical-align: top; align: right;">2.</td>
              <td style="width: auto; vertical-align: top; text-align: justify;">
                <div>The remaining 75% of the Dividend amount will be remitted by the Company to its transfer agent, American Stock Transfer &amp; Trust Company, LLC (&#8220;AST&#8221;), which will transfer the said amount to the Shareholders (including through
                  brokers who hold in brokerage accounts ZIM shares on behalf of Shareholders).</div>
              </td>
            </tr>

        </table>
        <table cellspacing="0" cellpadding="0" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;" class="DSPFListTable" id="zddf0d537f4414640b7f774de7a520183">

            <tr>
              <td style="width: 18pt;"><br>
              </td>
              <td style="width: 18pt; vertical-align: top; align: right;">3.</td>
              <td style="width: auto; vertical-align: top; text-align: justify;">
                <div>A Shareholder who is a resident of a country with which Israel has a tax treaty (&#8220;Treaty State&#8221;) (based on a declaration to be provided by such Shareholder) and is the beneficial owner of the Dividend, as well as a Shareholder who is a
                  foreign (<font style="font-style: italic;">i.e.</font>, non-Israeli) resident of a country with which Israel does NOT have a tax treaty and is the beneficial owner of the Dividend, may apply to the Agent requesting a Reduced Tax
                  Withholding Rate. Such application must be received by the Agent between the Payment Date and <font style="font-weight: bold;">May 5, 2022</font> ("Change of Rate Period").</div>
              </td>
            </tr>

        </table>
        <div> <br>
        </div>
        <div id="DSPFPageBreakArea" style="clear: both; margin-top: 10pt; margin-bottom: 10pt;">
          <div id="DSPFPageBreak" style="page-break-after: always;">
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        </div>
        <div style="text-align: center;">
          <div style="line-height: 1.25;"><img src="image00004.jpg"></div>
          <div style="line-height: 1.25;"><br style="line-height: 1.25;">
          </div>
        </div>
        <div style="text-align: center;"> <br>
        </div>
        <table cellspacing="0" cellpadding="0" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;" class="DSPFListTable" id="zb59427fd242a4f93a568cedc182715d7">

            <tr>
              <td style="width: 18pt;"><br>
              </td>
              <td style="width: 18pt; vertical-align: top; align: right;">4.</td>
              <td style="width: auto; vertical-align: top; text-align: justify;">
                <div>A Shareholder who declared that he or she is a resident of a Treaty State and is the beneficial owner of the Dividend may apply to the Agent during the Change of Rate Period only (subject to complying with all the documentation
                  requirements detailed below) requesting the receipt of the monetary difference between the tax amount remitted to the Agent (at a rate of 25%) and the amount represented by the withholding tax rate set forth in the tax treaty between
                  Israel and such Treaty State or by the limited withholding tax rate applicable to such dividend payment under the ITO, to the extent applicable.</div>
              </td>
            </tr>

        </table>
        <table cellspacing="0" cellpadding="0" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;" class="DSPFListTable" id="z60861b4193374db6b0c67bcda43cee76">

            <tr>
              <td style="width: 18pt;"><br>
              </td>
              <td style="width: 18pt; vertical-align: top; align: right;">5.</td>
              <td style="width: auto; vertical-align: top; text-align: justify;">
                <div>A Shareholder who did not declare that it, he or she is a resident of a Treaty State and is the beneficial owner of the Dividend, may apply to the Agent during the Change of Rate Period only (subject to complying with all the
                  documentation requirements detailed below) requesting the receipt of the monetary difference between the tax amount remitted to the Agent (at a rate of 25%) and the amount represented by&#160; the withholding tax rate applicable to such
                  dividend payment under the ITO or by the limited withholding tax rate applicable to such dividend payment under the ITO, to the extent applicable.</div>
              </td>
            </tr>

        </table>
        <table cellspacing="0" cellpadding="0" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;" class="DSPFListTable" id="z0bea66bb2e2f4c5884d3446a20a0604c">

            <tr>
              <td style="width: 18pt;"><br>
              </td>
              <td style="width: 18pt; vertical-align: top; align: right;">6.</td>
              <td style="width: auto; vertical-align: top; text-align: justify;">
                <div><font style="font-weight: bold;">Any Shareholder who claims to be entitled to a Reduced Tax Withholding Rate in accordance with the foregoing, will be required to provide the Agent with all relevant documentation as detailed in the
                    Ruling and attached as exhibits 99.2, 99.3 and 99.4 to the Company&#8217;s Current Report on form 6-K filed on March 23, 2022 with the Securities and Exchange Commission (SEC) on no later than May 5, 2022 (the end of the Change of Rate
                    Period), including but not limited to, bank account details to which the dividend payment should be transferred, number of ZIM shares owned by the Shareholder in such account, identification document, and confirmation of residence
                    issued by the taxing authority of the state of tax residence</font>.</div>
              </td>
            </tr>

        </table>
        <table cellspacing="0" cellpadding="0" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;" class="DSPFListTable" id="zcfe6b2f7dda1493b9bae2e3875ed5c3f">

            <tr>
              <td style="width: 18pt;"><br>
              </td>
              <td style="width: 18pt; vertical-align: top; align: right;">7.</td>
              <td style="width: auto; vertical-align: top; text-align: justify;">
                <div>In addition to the foregoing, the Shareholder will provide a written declaration in the form annexed to this announcement which will include declarations as to the following: (i) the Shareholder's tax residence, (ii) the Shareholder's
                  beneficial ownership of the dividend, (iii) the investment in ZIM shares has not been made through a permanent establishment in Israel, (iv) the holding of ZIM shares is made for the Shareholder's own account and not for the account of
                  others, and (v) the payment will not be made to a permanent establishment of the Shareholder outside of the Shareholder's tax residence.</div>
              </td>
            </tr>

        </table>
        <table cellspacing="0" cellpadding="0" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;" class="DSPFListTable" id="z6f497a5bd81c40b184d1ce4448b4b13b">

            <tr>
              <td style="width: 18pt;"><br>
              </td>
              <td style="width: 18pt; vertical-align: top; align: right;">8.</td>
              <td style="width: auto; vertical-align: top; text-align: justify;">
                <div>A non-Israeli corporate Shareholder (excluding a Shareholder covered by section 9 below) that requests a Reduced Tax Withholding Rate, will also need to provide the Agent with its updated shareholders register as of March 23, 2022, and
                  a statement confirming that more than 75% of its shareholders, directly or indirectly, are individuals of its state of residence.</div>
              </td>
            </tr>

        </table>
        <div> <br>
        </div>
        <div id="DSPFPageBreakArea" style="clear: both; margin-top: 10pt; margin-bottom: 10pt;">
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        </div>
        <div>
          <div style="line-height: 1.25; text-align: center;"><img src="image00004.jpg"></div>
          <div style="line-height: 1.25;"><br style="line-height: 1.25;">
          </div>
        </div>
        <div> <br>
        </div>
        <table cellspacing="0" cellpadding="0" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;" class="DSPFListTable" id="z8f2bd14246c8452eb27f824564798872">

            <tr>
              <td style="width: 18pt;"><br>
              </td>
              <td style="width: 18pt; vertical-align: top; align: right;">9.</td>
              <td style="width: auto; vertical-align: top; text-align: justify;">
                <div>A publicly traded non-Israeli corporate Shareholder whose shares are traded on a stock market outside of Israel and is a resident of a Treaty State, or a direct or indirect subsidiary of such Shareholder, will also provide the Agent
                  with a declaration that it is a resident of such Treaty State or another non-Israeli state, as applicable.</div>
              </td>
            </tr>

        </table>
        <table cellspacing="0" cellpadding="0" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;" class="DSPFListTable" id="z5c5e22d0963c4b828e1c791d2ce91af4">

            <tr>
              <td style="width: 18pt;"><br>
              </td>
              <td style="width: 18pt; vertical-align: top; font-family: 'Times New Roman',Times,serif;">10.</td>
              <td style="width: auto; vertical-align: top; text-align: justify;">
                <div>An Israeli corporate Shareholder which is entitled to a Reduced Tax Withholding Rate (including an exemption from withholding tax at source), will be able to apply to the Agent no later than <font style="font-weight: bold;">May 5,
                    2022</font> (the end of the Change of Rate Period) and enclose an applicable valid ITA issued certificate setting forth a Reduced Tax Withholding Rate or an exemption from withholding tax. In addition, such Shareholder will enclose its
                  certificate of incorporation and all other documents required as set forth above, <font style="font-style: italic;">mutatis mutandis</font> as requested by the Agent.</div>
              </td>
            </tr>

        </table>
        <table cellspacing="0" cellpadding="0" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;" class="DSPFListTable" id="zbabea968ef6e41b4a7a970fc781e3cbb">

            <tr>
              <td style="width: 18pt;"><br>
              </td>
              <td style="width: 18pt; vertical-align: top; font-family: 'Times New Roman',Times,serif;">11.</td>
              <td style="width: auto; vertical-align: top; text-align: justify;">
                <div>The Agent is entitled to request from the Shareholders applying for a Reduced Tax Withholding Rate additional documents in its discretion insofar as they are required to establish the tax residence of the Shareholder or its entitlement
                  to exemption and/or to a Reduced Tax Withholding Rate.</div>
              </td>
            </tr>

        </table>
        <table cellspacing="0" cellpadding="0" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;" class="DSPFListTable" id="z52d05048a4104be3a7a40338248e28f7">

            <tr>
              <td style="width: 18pt;"><br>
              </td>
              <td style="width: 18pt; vertical-align: top; font-family: 'Times New Roman',Times,serif;">12.</td>
              <td style="width: auto; vertical-align: top; text-align: justify;">
                <div>Notwithstanding the foregoing, no refund of excess tax withholding shall be affected by the Agent with respect to any Shareholder holding more than 5% of the issued share capital of the Company, or whose entitlement to dividend from
                  the Company pursuant to the Dividend exceeds $500,000, other than in accordance with a specific approval issued by the ITA.</div>
              </td>
            </tr>

        </table>
        <table cellspacing="0" cellpadding="0" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;" class="DSPFListTable" id="z888c2e2f01f14cbf82e63c23421fae80">

            <tr>
              <td style="width: 18pt;"><br>
              </td>
              <td style="width: 18pt; vertical-align: top; font-family: 'Times New Roman',Times,serif;">13.</td>
              <td style="width: auto; vertical-align: top; text-align: justify;">
                <div>The transfer of the amounts withheld, excluding the amounts returned to the Shareholders, as aforementioned, shall be conducted by the Agent. Subject to receipt by the Agent of your required documentation, the Agent will return the
                  amounts withheld to the Shareholders as detailed above to the account at which the dividend payment was made within 30 days from the date the amounts withheld are paid to the ITA.</div>
              </td>
            </tr>

        </table>
        <table cellspacing="0" cellpadding="0" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;" class="DSPFListTable" id="z1b53cf91212d4f1facca7f0825b64269">

            <tr>
              <td style="width: 18pt;"><br>
              </td>
              <td style="width: 18pt; vertical-align: top; font-family: 'Times New Roman',Times,serif;">14.</td>
              <td style="width: auto; vertical-align: top; text-align: justify;">
                <div>The Ruling is aimed to address solely the issue of tax withholding procedures and should not be construed as setting the actual tax liability of any Shareholder with respect to the Dividend or otherwise.</div>
              </td>
            </tr>

        </table>
        <div style="line-height: 1.25;">&#160;</div>
        <div style="line-height: 1.25; font-weight: bold;">Appointment of Israeli Tax Withholding Agent</div>
        <div style="line-height: 1.25;">&#160;</div>
        <div style="line-height: 1.25;">In order to facilitate the implementation of the procedures set forth in the Ruling for the benefit of its Shareholders, the Company appointed <font style="font-weight: bold;">ESOP Management &amp; Trust Services
            Ltd</font> to serve as a processing agent for the benefit of the Shareholders in connection with the distribution of the Dividend (the &#8220;Agent&#8221;). Shareholders are asked to note that the Agent will not provide tax advice to any Shareholders, who
          are encouraged to consult their own tax and financial advisors. Contact information of the Agent is provided at the bottom of this announcement. <font style="font-weight: bold;">We encourage you to contact the Agent if you need any
            clarifications in filling-in the forms required under the Ruling to obtain a Reduced Withholding Tax Rate, or if you have any questions concerning the process. Please note that the Agent (as defined below) will not provide any tax advice to any
            Shareholder, who should consult their own tax and financial advisors.</font></div>
        <div style="line-height: 1.25;"><br style="line-height: 1.25;">
        </div>
        <div id="DSPFPageBreakArea" style="clear: both; margin-top: 10pt; margin-bottom: 10pt;">
          <div id="DSPFPageBreak" style="page-break-after: always;">
            <hr noshade="noshade" style="border-width: 0px; clear: both; margin: 4px 0px; width: 100%; height: 2px; color: #000000; background-color: #000000;"></div>
        </div>
        <div style="line-height: 1.25; text-align: center;">
          <div style="line-height: 1.25;"><img src="image00004.jpg"></div>
          <div style="line-height: 1.25;"><br style="line-height: 1.25;">
          </div>
        </div>
        <div style="line-height: 1.25;"><br style="line-height: 1.25;">
        </div>
        <div style="line-height: 1.25;">In order to be eligible to benefit from a Reduced Withholding Tax Rate, Shareholders must provide the Agent with all documentation required under the Ruling not later than <font style="font-weight: bold;">May 5,
            2022</font>. The relevant forms included in the Ruling are and attached as exhibits 99.2, 99.3 and 99.4 to the Company&#8217;s Current Report on form 6-K filed on March 23, 2022, with the SEC.</div>
        <div style="line-height: 1.25;"><br style="line-height: 1.25;">
        </div>
        <div style="line-height: 1.25; font-weight: bold;"><u>If a Shareholder fails to provide the Agent with all the documentation required by May 5, 2022, the Agent will not be able to attend to such Shareholder's application and will not be able to
            return any amounts originally remitted on behalf of such Shareholder nor provide any confirmation of tax withholding to such a Shareholder, either in connection with the Ruling or in connection with any other tax filing by such Shareholder.</u></div>
        <div style="line-height: 1.25;"><br style="line-height: 1.25;">
        </div>
        <div style="line-height: 1.25;"><u>ZIM's Agent Contact Information</u>:</div>
        <div style="line-height: 1.25;"><br style="line-height: 1.25;">
        </div>
        <div style="line-height: 1.25; font-style: italic; font-weight: bold;">ESOP Management &amp; Trust Services Ltd.</div>
        <div style="line-height: 1.25;"><br style="line-height: 1.25;">
        </div>
        <div style="line-height: 1.25;">Tel No: +972-3-753-6823</div>
        <div style="line-height: 1.25;">Fax No: +972-3-760-2636</div>
        <div style="line-height: 1.25;">Email: <u>esop-helpdesk@esop.co.il</u></div>
        <div style="line-height: 1.25;"><br style="line-height: 1.25;">
        </div>
        <div style="text-align: left; line-height: 1.25; font-weight: bold;"><u>About ZIM</u></div>
        <div style="line-height: 1.25;"> <br>
        </div>
        <div style="line-height: 1.25;">ZIM (NYSE: ZIM) is a global container liner shipping company with leadership positions in the markets where it operates. Founded in Israel in 1945, ZIM is a veteran shipping liner, with decades of experience
          providing customers with innovative seaborne transportation and logistics services and a reputation for industry leading transit times, schedule reliability and service excellence.</div>
        <div style="line-height: 1.25;"><br style="line-height: 1.25;">
        </div>
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        </div>
        <div style="line-height: 1.25;">
          <div style="line-height: 1.25; text-align: center;"><img src="image00004.jpg"></div>
          <div style="line-height: 1.25;"><br style="line-height: 1.25;">
          </div>
        </div>
        <div style="line-height: 1.25;"><br style="line-height: 1.25;">
        </div>
        <div style="text-align: left; line-height: 1.25; font-weight: bold;"><u>ZIM Contacts</u></div>
        <div style="text-align: left; line-height: 1.25; font-weight: bold;"><u> <br>
          </u></div>
        <div style="text-align: left; line-height: 1.25;"><u>Media:</u></div>
        <div style="text-align: left; line-height: 1.25;"><u> <br>
          </u></div>
        <div style="text-align: left; line-height: 1.25;">Avner Shats<br>
          ZIM Integrated Shipping Services Ltd.<br>
          +972-4-865-2520<br>
          <u>shats.avner@zim.com</u>&#160;</div>
        <div style="line-height: 1.25;"><br style="line-height: 1.25;">
        </div>
        <div style="text-align: left; line-height: 1.25;"><u>Investor Relations:</u></div>
        <div style="text-align: left; line-height: 1.25;"><u> <br>
          </u></div>
        <div style="text-align: left; line-height: 1.25;">Elana Holzman<br>
          ZIM Integrated Shipping Services Ltd.<br>
          +972-4-865-2300<br>
          <u>holzman.elana@zim.com</u></div>
        <div style="line-height: 1.25;"><br style="line-height: 1.25;">
        </div>
        <div style="text-align: left; line-height: 1.25;">Leon Berman<br>
          The IGB Group<br>
          212-477-8438<br>
          <u>lberman@igbir.com</u></div>
        <div style="line-height: 1.25">&#160;</div>
      </div>
      <div style="text-align: justify; line-height: 1.25;">
        <hr align="center" style="border: none; border-bottom: 4px solid black; border-top: 1px solid black; height: 10px; color: #ffffff; background-color: #ffffff; text-align: center; margin-left: auto; margin-right: auto;"></div>
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<DOCUMENT>
<TYPE>EX-99.2
<SEQUENCE>3
<FILENAME>exhibit_99-2.htm
<DESCRIPTION>EXHIBIT 99.2
<TEXT>
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    <div>
      <div style="text-align: right; line-height: 1.25; font-weight: bold;"><u>Exhibit 99.2</u></div>
      <div style="line-height: 1.25;">
        <div id="DSPFPageHeader">
          <div style="line-height: 1.25;"><br style="line-height: 1.25;">
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        <div style="text-align: center; line-height: 1.25; font-weight: bold;">ZIM Integrated Shipping Services Ltd.</div>
        <div style="text-align: center; line-height: 1.25; font-weight: bold;">dividends distribution</div>
        <div style="text-align: center; line-height: 1.25; font-weight: bold;">CLAIM FOR REDUCED RATE OF WITHHOLDING TAX</div>
        <div style="text-align: center; line-height: 1.25; font-weight: bold;">IN ISRAEL ON DIVIDEND PAYMENTS TO A NON-ISRAELI TAX RESIDENT</div>
        <div style="line-height: 1.25;"><br style="line-height: 1.25;">
        </div>
        <div style="text-align: justify; line-height: 1.25;">You are receiving this form "Declaration of Status for Israeli Income Tax Purposes" as a holder of shares of ZIM Integrated Shipping Services Ltd. ("<font style="font-weight: bold;">Shares</font>"
          and &#8220;<font style="font-weight: bold;">ZIM</font>&#8221;), in connection with the payment of dividends to the shareholders of ZIM on April 4, 2022.</div>
        <div style="line-height: 1.25;"><br style="line-height: 1.25;">
        </div>
        <div style="text-align: justify; line-height: 1.25;">By completing this form in a manner that would substantiate your eligibility for a reduced rate of Israeli withholding tax with respect to this dividend distribution, you will allow ZIM and its
          Israeli tax agent, to withhold tax in Israel from the dividend distribution made to you at a reduced tax rate.</div>
        <div style="line-height: 1.25;"><br style="line-height: 1.25;">
        </div>
        <div style="text-align: justify; line-height: 1.25;">This form shall be completed and signed by the recipient of the dividend or by an authorized officer or representative of the recipient.</div>
        <div style="line-height: 1.25;"><br style="line-height: 1.25;">
        </div>
        <div style="text-align: justify; line-height: 1.25;">This claim is made pursuant to the Double Tax Convention between Israel and the country of residence of the recipient of the dividend.</div>
        <div style="line-height: 1.25;"><br style="line-height: 1.25;">
        </div>
        <div style="text-align: justify; line-height: 1.25; font-family: 'Times New Roman',Times,serif; font-weight: bold;"><u>PART A: RECIPIENT DECLARATION</u></div>
        <div style="line-height: 1.25">&#160;</div>
        <div style="line-height: 1.25; font-family: 'Times New Roman',Times,serif; font-weight: bold;">RECIPIENT INFORMATION</div>
        <div style="margin-left: 10.9pt; line-height: 1.25; font-weight: bold;"> <br>
        </div>
        <table cellspacing="0" cellpadding="3" border="0" style="font-family: 'Times New Roman',Times,serif; font-size: 10pt; width: 100%; text-align: left; color: rgb(0, 0, 0);" id="z47e04f84ca80443ba40bdd954c3f284e">

            <tr>
              <td style="width: 30.98%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.4pt; line-height: 1.25; font-family: 'Times New Roman', Times, serif;">Full name of the recipient:</div>
              </td>
              <td style="width: 31.71%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.35pt; line-height: 1.25; font-family: 'Times New Roman', Times, serif; font-weight: bold;">For Individuals:</div>
                <div style="margin-right: 4.7pt; margin-left: 5.35pt; line-height: 1.25;"><font style="font-family: 'Times New Roman', Times, serif;">Identity</font>&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;<font style="font-family: 'Times New Roman', Times, serif;">Number,&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;Social


                    Security No., or Passport No./ <font style="font-weight: bold;"></font></font></div>
                <div style="margin-right: 4.7pt; margin-left: 5.35pt; line-height: 1.25;"><font style="font-family: 'Times New Roman', Times, serif;"><font style="font-weight: bold;">For Legal Entities</font>: </font></div>
                <div style="margin-right: 4.7pt; margin-left: 5.35pt; line-height: 1.25;"><font style="font-family: 'Times New Roman', Times, serif;">Registration No. /Corporation No.</font></div>
              </td>
              <td style="width: 37.31%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0); border-right: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.4pt; line-height: 1.25; font-family: 'Times New Roman', Times, serif;">Type of Investor:</div>
                <div style="margin-left: 5.4pt; line-height: 1.25; font-family: 'Times New Roman', Times, serif;">Legal Entity &#9744; Individual &#9744;</div>
                <div style="margin-left: 5.4pt; line-height: 1.25; font-family: 'Times New Roman', Times, serif;">Trust Beneficiary &#9744;</div>
              </td>
            </tr>
            <tr>
              <td colspan="2" style="width: 62.69%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.4pt; line-height: 1.25; font-family: 'Times New Roman', Times, serif; font-weight: bold;">With respect to an individual</div>
              </td>
              <td style="width: 37.31%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0); border-right: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.4pt; line-height: 1.25; font-family: 'Times New Roman', Times, serif; font-weight: bold;">With respect to a legal entity</div>
              </td>
            </tr>
            <tr>
              <td colspan="2" style="width: 62.69%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.4pt; line-height: 1.25; font-family: 'Times New Roman', Times, serif;">Date of birth:</div>
              </td>
              <td rowspan="5" style="width: 37.31%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0); border-right: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.4pt; line-height: 1.25; font-family: 'Times New Roman', Times, serif;">The country in which it was incorporated:</div>
                <div style="line-height: 1.25;"><font style="line-height: 1.25;">&#160;</font></div>
                <div style="margin-left: 5.4pt; line-height: 1.25; font-family: 'Times New Roman', Times, serif;">The country in which control and management are conducted:</div>
              </td>
            </tr>
            <tr>
              <td colspan="2" style="width: 62.69%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.4pt; line-height: 1.25; font-family: 'Times New Roman', Times, serif;">Country of residence:</div>
              </td>
            </tr>
            <tr>
              <td colspan="2" style="width: 62.69%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.4pt; line-height: 1.25; font-family: 'Times New Roman', Times, serif;">Country of citizenship:</div>
              </td>
            </tr>
            <tr>
              <td colspan="2" style="width: 62.69%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.4pt; line-height: 1.25; font-family: 'Times New Roman', Times, serif;">Country issuing passport:</div>
              </td>
            </tr>
            <tr>
              <td colspan="2" style="width: 62.69%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0);">&#160;</td>
            </tr>
            <tr>
              <td colspan="3" style="width: 100%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0); border-right: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.4pt; line-height: 1.25;"><font style="font-family: 'Times New Roman', Times, serif;">Income Tax File number of recipient in place of residence: </font>______________________________________________________</div>
              </td>
            </tr>
            <tr>
              <td colspan="3" style="width: 100%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0); border-right: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.4pt; line-height: 1.25;"><font style="font-family: 'Times New Roman', Times, serif;">Address of local income tax assessing office in recipient&#8217;s place of residence: ____________________________</font></div>
              </td>
            </tr>
            <tr>
              <td colspan="3" style="width: 100%; vertical-align: top; border-width: 1px; border-style: solid; border-color: rgb(0, 0, 0);">
                <div style="margin-left: 5.4pt; line-height: 1.25;"><font style="font-family: 'Times New Roman', Times, serif;">The recipient is a fiscal resident of (insert country)</font>______________<font style="font-family: 'Times New Roman', Times, serif;">since (insert date)._________.__</font></div>
              </td>
            </tr>

        </table>
        <table cellspacing="0" cellpadding="3" border="0" style="font-family: 'Times New Roman',Times,serif; font-size: 10pt; width: 100%; text-align: left; color: rgb(0, 0, 0);" id="ze5a62a996aa74084ae6a40093846a418">

            <tr>
              <td colspan="2" style="width: 100%; vertical-align: top; border-left: 1px solid rgb(0, 0, 0); border-right: 1px solid rgb(0, 0, 0);">&#160;</td>
            </tr>
            <tr>
              <td colspan="2" style="width: 100%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0); border-right: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.4pt; line-height: 1.25; font-family: 'Times New Roman', Times, serif;">Permanent Address (country, city, street, house or apartment number):</div>
              </td>
            </tr>
            <tr>
              <td rowspan="2" style="width: 62.69%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0); border-bottom: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.4pt; line-height: 1.25; font-family: 'Times New Roman', Times, serif;">Mailing Address:</div>
              </td>
              <td style="width: 37.31%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0); border-right: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.4pt; line-height: 1.25; font-family: 'Times New Roman', Times, serif;">Investor's Telephone number:</div>
              </td>
            </tr>
            <tr>
              <td style="width: 37.31%; vertical-align: top; border-width: 1px; border-style: solid; border-color: rgb(0, 0, 0);">
                <div style="margin-right: 5pt; margin-left: 5.4pt; line-height: 1.25;"><font style="font-family: 'Times New Roman', Times, serif;">Telephone</font>&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;<font style="font-family: 'Times New Roman', Times, serif;">number&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;of&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;authorized



                    signatory:</font></div>
              </td>
            </tr>

        </table>
        <div style="line-height: 1.25">&#160;</div>
        <div id="DSPFPageBreakArea" style="clear: both; margin-top: 10pt; margin-bottom: 10pt;">
          <div id="DSPFPageBreak" style="page-break-after: always;">
            <hr noshade="noshade" style="border-width: 0px; clear: both; margin: 4px 0px; width: 100%; height: 2px; color: #000000; background-color: #000000;"></div>
        </div>
        <!--PROfilePageNumberReset%Num%2%%%-->
        <div style="line-height: 1.25">&#160;</div>
        <div style="line-height: 1.25; font-family: 'Times New Roman',Times,serif; font-weight: bold;">With regard to an Individual:</div>
        <div style="line-height: 1.25; font-family: 'Times New Roman',Times,serif; font-weight: bold;"> <br>
        </div>
        <div style="line-height: 1.25; font-family: 'Times New Roman',Times,serif; font-weight: bold;">I declare that I am not an Israeli resident because (please mark all applicable boxes):</div>
        <div style="line-height: 1.25">&#160;</div>
        <table cellspacing="0" cellpadding="3" border="0" style="font-family: 'Times New Roman',Times,serif; font-size: 10pt; width: 100%; text-align: left; color: rgb(0, 0, 0);" id="z74a6ecf64bcd47fb82b28a1d33e9918c">

            <tr>
              <td style="width: 4%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0);">&#9744;</td>
              <td style="width: 4%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.4pt; line-height: 1.25;">1.</div>
              </td>
              <td style="width: 92%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0); border-right: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.45pt; line-height: 1.25;">The State of Israel is not my permanent place of residence.</div>
              </td>
            </tr>
            <tr>
              <td style="width: 4%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0);">&#9744;</td>
              <td style="width: 4%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.4pt; line-height: 1.25;">2.</div>
              </td>
              <td style="width: 92%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0); border-right: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.45pt; line-height: 1.25;">The State of Israel is neither my place of residence nor my family's place of residence.</div>
              </td>
            </tr>
            <tr>
              <td style="width: 4%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0);">&#9744;</td>
              <td style="width: 4%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.4pt; line-height: 1.25;">3.</div>
              </td>
              <td style="width: 92%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0); border-right: 1px solid rgb(0, 0, 0);">
                <div style="margin-right: 2.55pt; margin-left: 5.45pt; line-height: 1.25;">My ordinary or permanent place of activity is not within the State of Israel, and I do not have a permanent establishment in the State of Israel.</div>
              </td>
            </tr>
            <tr>
              <td style="width: 4%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0);">&#9744;</td>
              <td style="width: 4%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.4pt; line-height: 1.25;">4.</div>
              </td>
              <td style="width: 92%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0); border-right: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.45pt; line-height: 1.25;">I do not engage in any occupation within the State of Israel.</div>
              </td>
            </tr>
            <tr>
              <td style="width: 4%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0);">&#9744;</td>
              <td style="width: 4%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.4pt; line-height: 1.25;">5.</div>
              </td>
              <td style="width: 92%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0); border-right: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.45pt; line-height: 1.25;">I do not own a business or part of a business within the State of Israel.</div>
              </td>
            </tr>
            <tr>
              <td style="width: 4%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0);">&#9744;</td>
              <td style="width: 4%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.4pt; line-height: 1.25;">6.</div>
              </td>
              <td style="width: 92%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0); border-right: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.45pt; line-height: 1.25;">This year, I did not stay and I do not intend to stay in Israel for 183 days or more.</div>
              </td>
            </tr>
            <tr>
              <td style="width: 4%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0);">&#9744;</td>
              <td style="width: 4%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.4pt; line-height: 1.25;">7.</div>
              </td>
              <td style="width: 92%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0); border-right: 1px solid rgb(0, 0, 0);">
                <div style="margin-right: 2.55pt; margin-left: 5.45pt; line-height: 1.25;">This year, I did not stay in Israel and I also do not intend to stay in Israel for 30 days or more and my total stay in Israel this year and in the two preceding
                  years will not reach 425 days.</div>
              </td>
            </tr>
            <tr>
              <td style="width: 4%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0);">&#9744;</td>
              <td style="width: 4%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.4pt; line-height: 1.25;">8.</div>
              </td>
              <td style="width: 92%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0); border-right: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.45pt; line-height: 1.25;">I am not insured with the National Insurance Institute in the State of Israel.</div>
              </td>
            </tr>
            <tr>
              <td style="width: 4%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0); border-bottom: 1px solid rgb(0, 0, 0);">&#9744;</td>
              <td style="width: 4%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0); border-bottom: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.4pt; line-height: 1.25;">9.</div>
              </td>
              <td style="width: 92%; vertical-align: top; border-width: 1px; border-style: solid; border-color: rgb(0, 0, 0);">
                <div style="margin-left: 5.45pt; line-height: 1.25;">I am the sole beneficial owner of the dividend income.</div>
              </td>
            </tr>

        </table>
        <div style="line-height: 1.25">&#160;</div>
        <div style="line-height: 1.25; font-family: 'Times New Roman',Times,serif; font-weight: bold;">With regard to a Legal Entity:</div>
        <div style="line-height: 1.25;">&#160;</div>
        <div style="line-height: 1.25; font-family: 'Times New Roman',Times,serif;"><font style="font-weight: bold;">I declare that the Legal Entity is a non - Israeli resident because (please mark all applicable boxes</font>):</div>
        <div style="line-height: 1.25;">&#160;</div>
        <table cellspacing="0" cellpadding="3" border="0" style="font-family: 'Times New Roman',Times,serif; font-size: 10pt; width: 100%; text-align: left; color: rgb(0, 0, 0);" id="z70d765ecd8014679931e16488e80f85e">

            <tr>
              <td style="width: 4%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0);">&#9744;</td>
              <td style="width: 4%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.4pt; line-height: 1.25;">1.</div>
              </td>
              <td style="width: 92%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0); border-right: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.45pt; line-height: 1.25;">Over 75% of the shareholders are individuals with the same residency as the Legal Entity (attached declaration of shareholders)</div>
              </td>
            </tr>
            <tr>
              <td style="width: 4%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0);">&#9744;</td>
              <td style="width: 4%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.4pt; line-height: 1.25;">2.</div>
              </td>
              <td style="width: 92%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0); border-right: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.45pt; line-height: 1.25;">It is not registered /incorporated with the Registrar of Companies in Israel.</div>
              </td>
            </tr>
            <tr>
              <td style="width: 4%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0);">&#9744;</td>
              <td style="width: 4%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.4pt; line-height: 1.25;">3.</div>
              </td>
              <td style="width: 92%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0); border-right: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.45pt; line-height: 1.25;">It is not registered with the Registrar of non profit organizations in Israel. (Amutot)</div>
              </td>
            </tr>
            <tr>
              <td style="width: 4%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0);">&#9744;</td>
              <td style="width: 4%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.4pt; line-height: 1.25;">4.</div>
              </td>
              <td style="width: 92%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0); border-right: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.45pt; line-height: 1.25;">The control of the legal entity is not executed in Israel.</div>
              </td>
            </tr>
            <tr>
              <td style="width: 4%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0);">&#9744;</td>
              <td style="width: 4%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.4pt; line-height: 1.25;">5.</div>
              </td>
              <td style="width: 92%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0); border-right: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.45pt; line-height: 1.25;">The management of the legal entity is not in Israel.</div>
              </td>
            </tr>
            <tr>
              <td style="width: 4%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0);">&#9744;</td>
              <td style="width: 4%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.4pt; line-height: 1.25;">6.</div>
              </td>
              <td style="width: 92%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0); border-right: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.45pt; line-height: 1.25;">The legal entity does not have a permanent enterprise in Israel and the entity does not have</div>
                <div style="margin-left: 5.45pt; line-height: 1.25;">a permanent establishment in the State of Israel</div>
              </td>
            </tr>
            <tr>
              <td style="width: 4%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0); border-bottom: 1px solid rgb(0, 0, 0);">&#9744;</td>
              <td style="width: 4%; vertical-align: top; border-top: 1px solid rgb(0, 0, 0); border-left: 1px solid rgb(0, 0, 0); border-bottom: 1px solid rgb(0, 0, 0);">
                <div style="margin-left: 5.4pt; line-height: 1.25;">7.</div>
              </td>
              <td style="width: 92%; vertical-align: top; border-width: 1px; border-style: solid; border-color: rgb(0, 0, 0);">
                <div style="text-align: justify; margin-right: 4.85pt; margin-left: 5.45pt; line-height: 1.25;">No Israeli resident holds, directly or indirectly via shares or through a trust or in any other manner, alone or with another who is an Israeli
                  resident, one or more of the "means of control" of the legal entity, as specified below, at a rate exceeding 25%. The term "means of control" refers to the following:</div>
                <div style="text-indent: -25.5pt; margin-left: 36.65pt; line-height: 1.25;">(a)&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;the right to participate in profits;</div>
                <div style="text-indent: -25.75pt; margin-left: 36.65pt; line-height: 1.25;">(b)&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;the right to appoint a director;</div>
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                <div style="margin-left: 5.45pt; line-height: 1.25;">The legal entity is the sole beneficial owner of the dividend income.</div>
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        <div style="line-height: 1.25; font-weight: bold;">DETAILS OF INCOME RECEIVED</div>
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        <div style="line-height: 1.25;">Place of receipt (country, city, bank account number, Amount)</div>
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            <div> <br>
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            <div> <br>
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                <div>the recipient regularly reports his income as required, the most recent income tax return filed being for the year_____________;</div>
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                      <div>Name of Income Tax Authority official making this certification: ____________________</div>
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        <div style="margin-left: 9pt; line-height: 1.25; text-indent: -9pt;"><font style="font-weight: bold;">With regard to an Individual </font>- List all documents attached &#8211;:</div>
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                <div>Bank statement from the date of entitlement to the dividend including bank account details of the account holder, bank name and account number and the number of listed shares held by the shareholder.</div>
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                <div>Bank statement from the date of payment of the dividend, including bank account details of the account holder, bank account number and the amount of the dividend received.</div>
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                <div>Required Details Form &#8211; attached.</div>
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                <div>List of shareholders of the Legal Entity and declarations regarding their state of residency for tax purposes.</div>
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            </tr>

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                <div>Bank statement from the date of entitlement to the dividend including bank account details of the account holder, bank name and account number and the number of listed shares held by the shareholder.</div>
                <div> <br>
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              </td>
            </tr>

        </table>
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                <div>Bank statement from the date of payment of the dividend, including bank account details of the account holder, bank account number and the amount of the dividend received.</div>
                <div> <br>
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            </tr>

        </table>
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                <div>Required Details Form &#8211; attached.</div>
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                <div>Controlling Person Required Details Form &#8211; attached.</div>
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<DOCUMENT>
<TYPE>EX-99.3
<SEQUENCE>4
<FILENAME>exhibit_99-3.htm
<DESCRIPTION>EXHIBIT 99.3
<TEXT>
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    <p style="font: 14pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt; text-align: center"><b> <br>
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    <p style="font: 14pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt; text-align: center"><b>Beneficiary's Details &#8211; ESOP</b></p>
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    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.25in; text-indent: -0.25in"><font style="font-family: Times New Roman, Times, Serif;"><b>Name of the company:</b></font> __________________________</p>
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    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.25in; text-indent: -0.25in"><b>Dear Beneficiary,</b></p>
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    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0.25in 0pt 0;">ESOP would like to thank you to for joining us and welcome you onboard.<br>
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    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&#160;</p>
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        <tr style="vertical-align: bottom">
          <td style="font: 10pt Times New Roman, Times, Serif">&#160;</td>
          <td style="font: 10pt Times New Roman, Times, Serif">&#160;</td>
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        <tr style="vertical-align: bottom">
          <td style="border-bottom: Black 1pt solid; font: 10pt Times New Roman, Times, Serif">&#160;</td>
          <td style="border-bottom: Black 1pt solid; font: 10pt Times New Roman, Times, Serif">&#160;</td>
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    </table>
    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&#160;</p>
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          <td style="border-bottom: Black 1pt solid; font: 10pt Times New Roman, Times, Serif; width: 72%">&#160;</td>
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        <tr style="vertical-align: bottom">
          <td style="font: 10pt Times New Roman, Times, Serif">&#160;</td>
          <td style="font: 10pt Times New Roman, Times, Serif">&#160;</td>
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    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&#160;</p>
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    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&#160;</p>
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    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&#160;</p>
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    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&#160;</p>
    <table cellspacing="0" cellpadding="0" style="border-collapse: collapse; width: 100%">

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          <td style="border-bottom: Black 1pt solid; font: 10pt Times New Roman, Times, Serif; width: 55%">&#160;</td>
        </tr>

    </table>
    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&#160;</p>
    <table cellspacing="0" cellpadding="0" style="border-collapse: collapse; width: 100%">

        <tr style="vertical-align: bottom">
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          <td style="border-bottom: Black 1pt solid; font: 10pt Times New Roman, Times, Serif; width: 95%">&#160;</td>
        </tr>

    </table>
    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&#160;</p>
    <table cellspacing="0" cellpadding="0" style="border-collapse: collapse; width: 100%">

        <tr style="vertical-align: bottom">
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          <td style="font: bold 10pt Times New Roman,Times,serif; width: 12%; text-align: center;">&#160;&#160;Telephone #2:</td>
          <td style="border-bottom: Black 1pt solid; font: bold 10pt Times New Roman, Times, Serif; width: 38%">&#160;</td>
        </tr>

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    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.25in; text-indent: -0.25in"><b>Please attach:</b></p>
    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&#160;</p>
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        <tr style="vertical-align: top">
          <td style="width: 0"><br>
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          <td><font style="font-size: 10pt"><b>A copy of your identification card or your passport or your incorporation certificate.<br>
              </b>* Israeli Citizen is requested to provide a copy of the identification card</font></td>
        </tr>

    </table>
    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&#160;</p>
    <table width="100%" cellspacing="0" cellpadding="0" style="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt">

        <tr style="vertical-align: top">
          <td style="width: 0"><br>
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          <td style="width: 0.25in">&#10003;</td>
          <td><font style="font-size: 10pt"><b>A proof of ownership of your bank account (void check or any other statement).</b></font></td>
        </tr>

    </table>
    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&#160;</p>
    <table width="100%" cellspacing="0" cellpadding="0" style="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt">

        <tr style="vertical-align: top">
          <td style="width: 0"><br>
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            <div style="text-align: justify; line-height: 1.25; font-family: 'Times New Roman', Times, serif; font-size: 10pt;"><b>Please attach</b>: W-9 / W-8BEN / W-8BEN-E / W-8IMY / W-8EXP / W-8ECI</div>
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    </table>
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    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&#160;</p>
    <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px; text-align: center;"> <img src="img03.jpg"></p>
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    <p style="font: 10pt Times New Roman, Times, Serif; text-align: center; margin-top: 0pt; margin-bottom: 0pt"><br>
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    <p style="text-align: center; margin-top: 0; margin-bottom: 0"><img src="img02.jpg"></p>
    <p style="font: 10pt Times New Roman, Times, Serif; text-align: center; margin-top: 0pt; margin-bottom: 0pt">&#160;</p>
    <p style="font: 10pt Times New Roman, Times, Serif; text-align: center; margin-top: 0pt; margin-bottom: 0pt"> <br>
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    <div style="line-height: 1.25">&#160;</div>
    <div style="line-height: 1.25;">Please complete the following table indicating<font style="font-style: italic;">&#160;</font>(i) what is the Beneficiary tax residence and (ii) the Beneficiary's TIN for each country/jurisdiction indicated<font style="font-weight: bold;">.</font></div>
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    <div style="line-height: 1.25;">* If a TIN is unavailable please provide the appropriate reason <font style="font-weight: bold;">A, B</font> or <font style="font-weight: bold;">C where indicated below</font>:</div>
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    <div style="line-height: 1.25">&#160;</div>
    <table cellspacing="0" cellpadding="0" style="font: 10pt Times New Roman, Times, Serif; width: 100%; border-collapse: collapse">

        <tr style="vertical-align: top">
          <td style="width: 4%; border-top: black 1pt solid; border-bottom: black 1pt solid; border-left: black 1pt solid; padding-top: 2.35pt; padding-right: 2.55pt; padding-left: 1.45pt"><font style="font-size: 10pt">&#160;</font></td>
          <td style="width: 35%; border-top: black 1pt solid; border-right: black 1pt solid; border-bottom: black 1pt solid; padding-top: 2.35pt; padding-right: 2.55pt; padding-left: 1.45pt; text-align: center"><font style="font-family: Times New Roman, Times, Serif; font-size: 10pt"><b>Country/Jurisdiction of tax residence</b></font></td>
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        </tr>
        <tr>
          <td style="border-right: black 1pt solid; border-bottom: black 1pt solid; border-left: black 1pt solid; padding-top: 2.35pt; padding-right: 2.55pt; padding-left: 3.95pt"><font style="font-family: Times New Roman, Times, Serif; font-size: 10pt"><b>1
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          <td style="border-right: black 1pt solid; border-bottom: black 1pt solid; padding-top: 2.35pt; padding-right: 2.55pt; padding-left: 4pt"><font style="font-size: 10pt">&#160;</font></td>
          <td style="border-right: black 1pt solid; border-bottom: black 1pt solid; padding-top: 2.35pt; padding-right: 2.55pt; padding-left: 3.4pt"><font style="font-size: 10pt">&#160;</font></td>
          <td style="border-right: black 1pt solid; border-bottom: black 1pt solid; padding-top: 2.35pt; padding-right: 2.55pt; padding-left: 3.25pt"><font style="font-size: 10pt">&#160;</font></td>
        </tr>
        <tr>
          <td style="border-right: black 1pt solid; border-bottom: black 1pt solid; border-left: black 1pt solid; padding-top: 2.35pt; padding-right: 2.55pt; padding-left: 3.95pt"><font style="font-family: Times New Roman, Times, Serif; font-size: 10pt"><b>2
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          <td style="border-right: black 1pt solid; border-bottom: black 1pt solid; padding-top: 2.35pt; padding-right: 2.55pt; padding-left: 4pt"><font style="font-size: 10pt">&#160;</font></td>
          <td style="border-right: black 1pt solid; border-bottom: black 1pt solid; padding-top: 2.35pt; padding-right: 2.55pt; padding-left: 3.4pt"><font style="font-size: 10pt">&#160;</font></td>
          <td style="border-right: black 1pt solid; border-bottom: black 1pt solid; padding-top: 2.35pt; padding-right: 2.55pt; padding-left: 3.25pt"><font style="font-size: 10pt">&#160;</font></td>
        </tr>
        <tr>
          <td style="border-right: black 1pt solid; border-bottom: black 1pt solid; border-left: black 1pt solid; padding-top: 2.35pt; padding-right: 2.55pt; padding-left: 3.95pt"><font style="font-family: Times New Roman, Times, Serif; font-size: 10pt"><b>3
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          <td style="border-right: black 1pt solid; border-bottom: black 1pt solid; padding-top: 2.35pt; padding-right: 2.55pt; padding-left: 4pt"><font style="font-size: 10pt">&#160;</font></td>
          <td style="border-right: black 1pt solid; border-bottom: black 1pt solid; padding-top: 2.35pt; padding-right: 2.55pt; padding-left: 3.4pt"><font style="font-size: 10pt">&#160;</font></td>
          <td style="border-right: black 1pt solid; border-bottom: black 1pt solid; padding-top: 2.35pt; padding-right: 2.55pt; padding-left: 3.25pt"><font style="font-size: 10pt">&#160;</font></td>
        </tr>

    </table>
    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&#160;</p>
    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.25in; text-indent: -0.25in"><font style="font-family: Times New Roman, Times, Serif;"><i>Please explain why you are unable to obtain a TIN if you selected Reason <b>B </b>above</i></font>:</p>
    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&#160;</p>
    <table cellspacing="0" cellpadding="0" style="font: 10pt Times New Roman, Times, Serif; width: 100%; border-collapse: collapse">

        <tr>
          <td style="width: 4%; border: black 1pt solid; padding-top: 3.95pt; padding-right: 5.75pt; padding-left: 5.4pt"><font style="font-family: Times New Roman, Times, Serif; font-size: 10pt"><b>1 </b></font></td>
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        </tr>
        <tr>
          <td style="border-right: black 1pt solid; border-bottom: black 1pt solid; border-left: black 1pt solid; padding-top: 3.95pt; padding-right: 5.75pt; padding-left: 5.4pt"><font style="font-family: Times New Roman, Times, Serif; font-size: 10pt"><b>2
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          <td style="border-right: black 1pt solid; border-bottom: black 1pt solid; padding-top: 3.95pt; padding-right: 5.75pt; padding-left: 5.4pt"><font style="font-size: 10pt">&#160;</font></td>
        </tr>
        <tr>
          <td style="border-right: black 1pt solid; border-bottom: black 1pt solid; border-left: black 1pt solid; padding-top: 3.95pt; padding-right: 5.75pt; padding-left: 5.4pt"><font style="font-family: Times New Roman, Times, Serif; font-size: 10pt"><b>3
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          <td style="vertical-align: top; border-right: black 1pt solid; border-bottom: black 1pt solid; padding-top: 3.95pt; padding-right: 5.75pt; padding-left: 5.4pt"><font style="font-size: 10pt">&#160;</font></td>
        </tr>

    </table>
    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.25in; text-indent: -0.25in">&#160;</p>
    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.25in; text-indent: -0.25in"> </p>
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        <tr>
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            <div style="font-weight: bold;">Please note, additional information may be needed in accordance with the Beneficiary's self-certification above.</div>
          </td>
        </tr>

    </table>
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        <tr>
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            <div>For more information please consult your tax adviser or the information at the OECD automatic exchange of information portal&#160;<font style="font-weight: bold;">www.oecd.org/tax/automatic-exchange</font></div>
          </td>
        </tr>

    </table>
    &#160; </div>
  <div style="text-align: center;">
    <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px;"> <img src="img03.jpg"></p>
  </div>
  <div id="DSPFPageBreakArea" style="clear: both; margin-top: 10pt; margin-bottom: 10pt;">
    <div id="DSPFPageBreak" style="page-break-after: always;">
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  <div><br>
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    <p style="font: 10pt Times New Roman, Times, Serif; text-align: center; margin-top: 0pt; margin-bottom: 0pt">&#160;</p>
    <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px;"><b>Part&#160;3 &#8211; Wire information</b></p>
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    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify"><b>Currency of choice:</b></p>
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    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify">Attention: you should choose whether you wish to receive the net proceed in NIS or in US dollar. Please note that the wire commission for USD will be charged in
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    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify"><b>Please mark only one alternative:</b></p>
    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&#160;</p>
    <table cellspacing="0" cellpadding="0" style="border-collapse: collapse; width: 100%">

        <tr style="vertical-align: bottom">
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            <p style="margin-top: 0; margin-bottom: 0">&#9744;<font style="font-size: 10pt">&#160;&#160;&#160; I would like to receive the</font></p>
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          <td style="width: 49%; font: 10pt Times New Roman, Times, Serif; text-align: left">
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    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&#160;</p>
    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><font style="font-family: Times New Roman, Times, Serif;">*</font>Additional charges may apply by the receiving bank in case of USD wires such as intermediary bank fee</p>
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    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&#160;</p>
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    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&#160;</p>
    <table cellspacing="0" cellpadding="0" style="width: 100%; font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt">

        <tr style="vertical-align: top">
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        </tr>

    </table>
    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&#160;</p>
    <table cellspacing="0" cellpadding="0" style="width: 100%; font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt">

        <tr style="vertical-align: top">
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        </tr>

    </table>
    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&#160;</p>
    <table cellspacing="0" cellpadding="0" style="width: 100%; font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt">

        <tr style="vertical-align: top">
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        </tr>

    </table>
    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&#160;</p>
    <table cellspacing="0" cellpadding="0" style="width: 100%; font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt">

        <tr style="vertical-align: top">
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    </table>
    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&#160;</p>
    <table cellspacing="0" cellpadding="0" style="width: 100%; font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt">

        <tr style="vertical-align: top">
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        <tr style="vertical-align: top">
          <td><font style="font-size: 10pt">&#160;</font></td>
          <td><font style="font-size: 10pt">&#160;</font></td>
          <td><font style="font-size: 10pt">&#160;</font></td>
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        <tr style="vertical-align: top">
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        </tr>

    </table>
    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in; text-indent: -0.25in">&#160;</p>
    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in; text-indent: -0.25in"> </p>
    <table cellspacing="0" cellpadding="0" style="width: 100%; font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt">

        <tr style="vertical-align: top">
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          <td style="width: 82%;"><font style="font-size: 10pt">&#160;</font></td>
        </tr>

    </table>
    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&#160;</p>
    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in; text-indent: -0.25in"> </p>
    <table cellspacing="0" cellpadding="0" border="0" style="width: 100%; font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt">

        <tr style="vertical-align: top">
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          <td style="width: 77%;"><font style="font-size: 10pt">&#160;</font></td>
        </tr>

    </table>
    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&#160;</p>
    <table cellspacing="0" cellpadding="0" style="width: 100%; font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt">

        <tr style="vertical-align: top">
          <td style="width: 3%;"><font style="font-family: Times New Roman, Times, Serif; font-size: 10pt">8.</font></td>
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        </tr>

    </table>
    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&#160;</p>
    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.25in; text-indent: -0.25in"><b>Mandatory details &#8211; domestic wire:</b></p>
    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&#160;</p>
    <table cellspacing="0" cellpadding="0" style="width: 100%; font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt">

        <tr style="vertical-align: top">
          <td style="width: 3%"><font style="font-family: Times New Roman, Times, Serif; font-size: 10pt">1.</font></td>
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          <td style="border-bottom: Black 1pt solid; width: 82%"><font style="font-size: 10pt">&#160;</font></td>
        </tr>

    </table>
    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&#160;</p>
    <table cellspacing="0" cellpadding="0" style="width: 100%; font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt">

        <tr style="vertical-align: top">
          <td style="width: 3%"><font style="font-size: 10pt">2.</font></td>
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          <td style="border-bottom: Black 1pt solid; width: 82%"><font style="font-size: 10pt">&#160;</font></td>
        </tr>

    </table>
    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&#160;</p>
    <table cellspacing="0" cellpadding="0" style="width: 100%; font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt">

        <tr style="vertical-align: top">
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          <td style="border-bottom: Black 1pt solid; width: 82%"><font style="font-size: 10pt">&#160;</font></td>
        </tr>

    </table>
    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&#160;</p>
    <table cellspacing="0" cellpadding="0" style="width: 100%; font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt">

        <tr style="vertical-align: top">
          <td style="width: 3%"><font style="font-size: 10pt">4.</font></td>
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          <td style="border-bottom: Black 1pt solid; width: 82%"><font style="font-size: 10pt">&#160;</font></td>
        </tr>

    </table>
    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&#160;</p>
    <table cellspacing="0" cellpadding="0" style="width: 100%; font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt">

        <tr style="vertical-align: top">
          <td style="width: 3%"><font style="font-size: 10pt">5.</font></td>
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          <td style="border-bottom: Black 1pt solid; width: 82%"><font style="font-size: 10pt">&#160;</font></td>
        </tr>

    </table>
    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&#160;</p>
    <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px; text-align: center;"> <img src="img03.jpg"></p>
    <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px; text-align: center;"> </p>
  </div>
  <div id="DSPFPageBreakArea" style="clear: both; margin-top: 10pt; margin-bottom: 10pt;">
    <div id="DSPFPageBreak" style="page-break-after: always;">
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  <div><br>
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    <p style="text-align: center; font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt">&#160;</p>
    <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px;"><b>Part&#160;4 &#8211; Declarations and Signature</b></p>
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    <div style="text-align: justify; line-height: 1.25;">I understand that the information supplied by me is covered by the full provisions of the terms and conditions governing my relationship with ESOP Management &amp; Trust Services Ltd. (&#8220;ESOP&#8221;).</div>
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    <div style="text-align: justify; line-height: 1.25;">I acknowledge that the information contained in this form may be provided to the tax authorities of the country/jurisdiction described in this form above and exchanged with tax authorities of another
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    <div style="line-height: 1.25;">I certify that I am the Beneficiary) of all the account(s) to which this form relates to.</div>
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    <div style="line-height: 1.25;">For natural person only - I declare that I am not holding Senior Public Position<sup style="vertical-align: text-top; line-height: 1; font-size: smaller;">1</sup> and I am not a Politically Exposed Person<sup style="vertical-align: text-top; line-height: 1; font-size: smaller;"> 2</sup>and I will update you if the above will change in the future.</div>
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    <table cellspacing="0" cellpadding="0" style="border-collapse: collapse; width: 100%">

        <tr style="vertical-align: bottom">
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        <tr style="vertical-align: bottom">
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        <tr style="vertical-align: bottom">
          <td style="border-right: Black 1pt solid; border-left: Black 1pt solid; font: 10pt Times New Roman, Times, Serif; padding-right: 2pt; padding-left: 2pt" colspan="3"><font style="font-size: 10pt">&#160;</font></td>
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        <tr style="vertical-align: bottom">
          <td style="border-right: Black 1pt solid; border-left: Black 1pt solid; font: 10pt Times New Roman, Times, Serif; padding-right: 2pt; padding-left: 2pt" colspan="3"><font style="font-size: 10pt">&#160;</font></td>
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        <tr style="vertical-align: bottom">
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          <td style="border-right: Black 1pt solid; padding-right: 2pt; font: 10pt Times New Roman, Times, Serif; width: 50%; padding-left: 2pt"><font style="font-size: 10pt">&#160;</font></td>
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        <tr style="vertical-align: bottom">
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        <tr style="vertical-align: bottom">
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          <td style="border-bottom: Black 1pt solid; padding-right: 2pt; font: 10pt Times New Roman, Times, Serif; padding-left: 2pt"><font style="font-size: 10pt">&#160;</font></td>
          <td style="border-right: Black 1pt solid; padding-right: 2pt; font: 10pt Times New Roman, Times, Serif; padding-left: 2pt"><font style="font-size: 10pt">&#160;</font></td>
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        <tr style="vertical-align: bottom">
          <td style="border-right: Black 1pt solid; border-left: Black 1pt solid; font: 10pt Times New Roman, Times, Serif; padding-right: 2pt; padding-left: 2pt" colspan="3"><font style="font-size: 10pt">&#160;</font></td>
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        <tr style="vertical-align: bottom">
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          <td style="border-right: Black 1pt solid; padding-right: 2pt; font: 10pt Times New Roman, Times, Serif; padding-left: 2pt"><font style="font-size: 10pt">&#160;</font></td>
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        <tr style="vertical-align: bottom">
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        <tr style="vertical-align: bottom">
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        </tr>
        <tr style="vertical-align: bottom">
          <td style="border-right: Black 1pt solid; border-left: Black 1pt solid; font: 10pt Times New Roman, Times, Serif; padding-right: 2pt; padding-left: 2pt" colspan="3"><font style="font-size: 10pt">&#160;</font></td>
        </tr>
        <tr style="vertical-align: bottom">
          <td style="border-left: Black 1pt solid; padding-right: 2pt; font: 10pt Times New Roman, Times, Serif; padding-left: 2pt"><font style="font-size: 10pt">Capacity:</font></td>
          <td style="border-bottom: Black 1pt solid; padding-right: 2pt; font: 10pt Times New Roman, Times, Serif; padding-left: 2pt"><font style="font-size: 10pt">&#160;</font></td>
          <td style="border-right: Black 1pt solid; padding-right: 2pt; font: 10pt Times New Roman, Times, Serif; padding-left: 2pt"><font style="font-size: 10pt">&#160;</font></td>
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        <tr style="vertical-align: bottom">
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        </tr>

    </table>
    <p style="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt">&#160;</p>
    <p style="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt;"><font style="font-family: Times New Roman, Times, Serif;">For additional info, please contact us at: </font><b>esop-heldesk@esop.co.il</b><br>
      972-3-7536823 &#8239;&#8239;&#8239;&#8239;&#8239;&#8239;&#8239;&#8239;&#8239;&#8239;&#8239;&#8239;&#8239;&#8239;&#8239;&#8239;&#8239;&#8239;&#8239;&#8239;Domestic calls: 1700-70-37-67</p>
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    <div style="text-align: justify; line-height: 1.25;"><sup style="vertical-align: text-top; line-height: 1; font-size: smaller;">1</sup>&#160;"Senior public position"- Including head of state, president, city mayor, judge, member of parliament, senior party member, member of the government, senior officer in the army or
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    <div style="text-align: justify; line-height: 1.25;">"foreign Politically Exposed Person"- Politically Exposed Person who is a foreign resident.</div>
  </div>
  <div> <br>
  </div>
  <div>
    <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px; text-align: center;"> <img src="img03.jpg"></p>
    <div style="text-align: center;">&#160;</div>
    <div id="DSPFPageBreakArea" style="clear: both; margin-top: 10pt; margin-bottom: 10pt;">
      <div id="DSPFPageBreak" style="page-break-after: always;">
        <hr noshade="noshade" style="border-width: 0px; clear: both; margin: 4px 0px; width: 100%; height: 2px; color: #000000; background-color: #000000;"></div>
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    <p style="text-align: center; margin-top: 0; margin-bottom: 0"><img src="img02.jpg"></p>
    <p style="text-align: center; font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt">&#160;</p>
    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: center">Annex I &#8211; Legal Entity</p>
    <p style="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&#160;</p>
    <p style="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-right: 0; margin-bottom: 0pt; text-align: justify">Please provide the Legal Entity's (not applicable to individual account holders) Status by ticking <b>one</b> of the
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    <p style="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-right: 0; margin-bottom: 0pt">&#160;</p>
    <table cellspacing="0" cellpadding="0" style="width: 100%; font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt">

        <tr style="vertical-align: top">
          <td><font style="font-size: 10pt"><b>1.</b></font></td>
          <td><font style="font-size: 10pt"><b>(a)</b></font></td>
          <td><font style="font-size: 10pt">Financial Institution &#8211; Investment Entity</font></td>
          <td style="text-align: right"><br>
          </td>
        </tr>
        <tr style="vertical-align: top">
          <td><font style="font-size: 10pt">&#160;</font></td>
          <td><font style="font-size: 10pt">&#160;</font></td>
          <td><font style="font-size: 10pt">&#160;</font></td>
          <td style="text-align: right"><br>
          </td>
        </tr>
        <tr style="vertical-align: top">
          <td><font style="font-size: 10pt">&#160;</font></td>
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        </tr>
        <tr style="vertical-align: top">
          <td><font style="font-size: 10pt">&#160;</font></td>
          <td><font style="font-size: 10pt">&#160;</font></td>
          <td><font style="font-size: 10pt">&#160;</font></td>
          <td style="text-align: right"><br>
          </td>
        </tr>
        <tr style="vertical-align: top">
          <td><font style="font-size: 10pt">&#160;</font></td>
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        </tr>
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<DOCUMENT>
<TYPE>EX-99.4
<SEQUENCE>5
<FILENAME>exhibit_99-4.htm
<DESCRIPTION>EXHIBIT 99.4
<TEXT>
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      <div style="text-align: right; text-indent: 432pt; line-height: 1.25; font-weight: bold;"><u>Exhibit 99.4</u></div>
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        <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px 0pt 0.25in; text-indent: -0.25in;"><b>Full Name of the legal entity which I am a Controlling Person<sup style="vertical-align: text-top; line-height: 1; font-size: smaller;">1</sup> in:</b></p>
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              <td style="border-bottom: 1pt solid Black; font: 10pt Times New Roman,Times,serif;">&#160;</td>
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        <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px;">&#160;</p>
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        <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px;">&#160;</p>
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        <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px;">&#160;</p>
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        <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px;">&#160;</p>
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          <div><br>
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        </div>
        <p style="text-align: center; font: 10pt Times New Roman,Times,serif; margin-top: 0pt; margin-bottom: 0pt;"> </p>
        <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px;"><b><u>Please attach:</u></b></p>
        <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px;"><br>
        </p>
        <table width="100%" cellspacing="0" cellpadding="0" style="font: 10pt Times New Roman,Times,serif; margin-top: 0pt; margin-bottom: 0pt;">

            <tr style="vertical-align: top;">
              <td style="width: 0px;"><br>
              </td>
              <td style="width: 0.25in;">&#10003;</td>
              <td><b><u>A copy of your identification card or your passport or your incorporation certificate.<br>
                  </u></b>* Israeli Citizen is requested to provide a copy of the identification card</td>
            </tr>

        </table>
        <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px;">&#160;</p>
        <table width="100%" cellspacing="0" cellpadding="0" style="font: 10pt Times New Roman,Times,serif; margin-top: 0pt; margin-bottom: 0pt;">

            <tr style="vertical-align: top;">
              <td style="width: 0px;"><br>
              </td>
              <td style="width: 0.25in;">&#10003;</td>
              <td><b><u>Please attach</u></b>:W-9 / W-8BEN / W-8BEN-E / W-8IMY / W-8EXP / W-8ECI</td>
            </tr>

        </table>
        <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px; text-indent: 0.25in;"><font style="font-family: Times New Roman,Times,serif;">*</font>such forms can be downloaded from <b><u>www.irs.gov</u></b></p>
        <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px;">&#160;</p>
        <div style="line-height: 1.25; font-weight: bold;">Part 2 &#8211; Country/Jurisdiction of Residence for Tax Purposes and related Taxpayer Identification Number or equivalent number* (&#8220;TIN&#8221;)</div>
        <div style="line-height: 1.25;">&#160;</div>
        <div style="line-height: 1.25;">Please complete the following table indicating<font style="font-style: italic;">&#160;</font>(i) what is the Beneficiary tax residence and (ii) the Beneficiary's</div>
        <div style="line-height: 1.25;">&#160;</div>
        <div style="line-height: 1.25;">TIN for each country/jurisdiction indicated<font style="font-weight: bold;">.</font></div>
        <div style="line-height: 1.25;">&#160;</div>
        <div style="line-height: 1.25;">* If a TIN is unavailable please provide the appropriate reason <font style="font-weight: bold;">A, B</font> or <font style="font-weight: bold;">C where indicated below</font>:</div>
        <div style="line-height: 1.25;"> <br>
        </div>
        <div style="text-align: justify; margin-right: 17.2pt; line-height: 1.25;"><font style="font-weight: bold; font-style: italic;">Reason A - </font>The country/jurisdiction where the Beneficiary is resident does not issue TINs to its residents.</div>
        <div style="text-align: justify; margin-right: 17.2pt; line-height: 1.25;"><font style="font-weight: bold; font-style: italic;">Reason B - </font>The Beneficiary is otherwise unable to obtain a TIN<font style="font-style: italic;"> or equivalent
            number</font></div>
        <div style="text-align: justify; margin-right: 17.2pt; line-height: 1.25; font-style: italic;">(Please explain why you are unable to obtain a TIN in the below table if you have selected this reason)</div>
        <div style="text-align: justify; line-height: 1.25; font-style: italic;"><font style="font-weight: bold; font-style: italic;">Reason C</font><font style="font-style: italic;"> - </font><font style="font-style: normal;">No TIN is required.&#160;</font>(<font style="font-style: italic;">Note. Only select this reason if the domestic law of the relevant jurisdiction</font> does not require the collection of the TIN issued by such jurisdiction)</div>
        <div style="line-height: 1.25;">&#160;</div>
        <table cellspacing="0" cellpadding="0" style="font: 10pt Times New Roman,Times,serif; width: 100%; border-collapse: collapse;">

            <tr style="vertical-align: top;">
              <td style="width: 4%; border-top: 1pt solid black; border-bottom: 1pt solid black; border-left: 1pt solid black; padding-top: 2.35pt; padding-right: 2.55pt; padding-left: 1.45pt;">&#160;</td>
              <td style="width: 29%; border-top: 1pt solid black; border-right: 1pt solid black; border-bottom: 1pt solid black; padding-top: 2.35pt; padding-right: 2.55pt; padding-left: 1.45pt; text-align: center;"><font style="font-family: Times New Roman,Times,serif; font-size: 10pt;"><b>Country/Jurisdiction of tax residence</b></font></td>
              <td style="width: 15%; border-top: 1pt solid black; border-right: 1pt solid black; border-bottom: 1pt solid black; padding-top: 2.35pt; padding-right: 2.55pt; padding-left: 1.45pt; text-align: center;"><font style="font-family: Times New Roman,Times,serif; font-size: 10pt;"><b>TIN</b></font></td>
              <td style="width: 52%; border-top: 1pt solid black; border-right: 1pt solid black; border-bottom: 1pt solid black; padding-top: 2.35pt; padding-right: 2.55pt; padding-left: 1.45pt; text-align: center;"><font style="font-family: Times New Roman,Times,serif; font-size: 10pt;"><b>If no TIN available enter Reason <i>A, B or C</i></b></font></td>
            </tr>
            <tr>
              <td style="border-right: 1pt solid black; border-bottom: 1pt solid black; border-left: 1pt solid black; padding-top: 2.35pt; padding-right: 2.55pt; padding-left: 3.95pt;"><font style="font-family: Times New Roman,Times,serif; font-size: 10pt;"><b>1 </b></font></td>
              <td style="border-right: 1pt solid black; border-bottom: 1pt solid black; padding-top: 2.35pt; padding-right: 2.55pt; padding-left: 4pt;"><font style="font-family: Times New Roman,Times,serif; font-size: 10pt;">&#160;</font></td>
              <td style="border-right: 1pt solid black; border-bottom: 1pt solid black; padding-top: 2.35pt; padding-right: 2.55pt; padding-left: 3.4pt;"><font style="font-family: Times New Roman,Times,serif; font-size: 10pt;">&#160;</font></td>
              <td style="border-right: 1pt solid black; border-bottom: 1pt solid black; padding-top: 2.35pt; padding-right: 2.55pt; padding-left: 3.25pt;"><font style="font-family: Times New Roman,Times,serif; font-size: 10pt;">&#160;</font></td>
            </tr>
            <tr>
              <td style="border-right: 1pt solid black; border-bottom: 1pt solid black; border-left: 1pt solid black; padding-top: 2.35pt; padding-right: 2.55pt; padding-left: 3.95pt;"><font style="font-family: Times New Roman,Times,serif; font-size: 10pt;"><b>2 </b></font></td>
              <td style="border-right: 1pt solid black; border-bottom: 1pt solid black; padding-top: 2.35pt; padding-right: 2.55pt; padding-left: 4pt;"><font style="font-family: Times New Roman,Times,serif; font-size: 10pt;">&#160;</font></td>
              <td style="border-right: 1pt solid black; border-bottom: 1pt solid black; padding-top: 2.35pt; padding-right: 2.55pt; padding-left: 3.4pt;"><font style="font-family: Times New Roman,Times,serif; font-size: 10pt;">&#160;</font></td>
              <td style="border-right: 1pt solid black; border-bottom: 1pt solid black; padding-top: 2.35pt; padding-right: 2.55pt; padding-left: 3.25pt;"><font style="font-family: Times New Roman,Times,serif; font-size: 10pt;">&#160;</font></td>
            </tr>
            <tr>
              <td style="border-right: 1pt solid black; border-bottom: 1pt solid black; border-left: 1pt solid black; padding-top: 2.35pt; padding-right: 2.55pt; padding-left: 3.95pt;"><font style="font-family: Times New Roman,Times,serif; font-size: 10pt;"><b>3 </b></font></td>
              <td style="border-right: 1pt solid black; border-bottom: 1pt solid black; padding-top: 2.35pt; padding-right: 2.55pt; padding-left: 4pt;">&#160;</td>
              <td style="border-right: 1pt solid black; border-bottom: 1pt solid black; padding-top: 2.35pt; padding-right: 2.55pt; padding-left: 3.4pt;">&#160;</td>
              <td style="border-right: 1pt solid black; border-bottom: 1pt solid black; padding-top: 2.35pt; padding-right: 2.55pt; padding-left: 3.25pt;">&#160;</td>
            </tr>

        </table>
        <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px;">&#160;</p>
        <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px 0pt 0.25in; text-indent: -0.25in;"><font style="font-family: Times New Roman,Times,serif;"><i>Please explain why you are unable to obtain a TIN if you selected Reason <b>B </b>above</i></font>:</p>
        <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px;">&#160;</p>
        <table cellspacing="0" cellpadding="0" style="font: 10pt Times New Roman,Times,serif; width: 100%; border-collapse: collapse;">

            <tr>
              <td style="width: 4%; border: 1pt solid black; padding-top: 3.95pt; padding-right: 5.75pt; padding-left: 5.4pt;"><font style="font-family: Times New Roman,Times,serif; font-size: 10pt;"><b>1 </b></font></td>
              <td style="width: 96%; border-top: 1pt solid black; border-right: 1pt solid black; border-bottom: 1pt solid black; padding-top: 3.95pt; padding-right: 5.75pt; padding-left: 5.4pt;">&#160;</td>
            </tr>
            <tr>
              <td style="border-right: 1pt solid black; border-bottom: 1pt solid black; border-left: 1pt solid black; padding-top: 3.95pt; padding-right: 5.75pt; padding-left: 5.4pt;"><font style="font-family: Times New Roman,Times,serif; font-size: 10pt;"><b>2
                  </b></font></td>
              <td style="border-right: 1pt solid black; border-bottom: 1pt solid black; padding-top: 3.95pt; padding-right: 5.75pt; padding-left: 5.4pt;">&#160;</td>
            </tr>
            <tr>
              <td style="border-right: 1pt solid black; border-bottom: 1pt solid black; border-left: 1pt solid black; padding-top: 3.95pt; padding-right: 5.75pt; padding-left: 5.4pt;"><font style="font-family: Times New Roman,Times,serif; font-size: 10pt;"><b>3
                  </b></font></td>
              <td style="vertical-align: top; border-right: 1pt solid black; border-bottom: 1pt solid black; padding-top: 3.95pt; padding-right: 5.75pt; padding-left: 5.4pt;">&#160;</td>
            </tr>

        </table>
        <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px 0pt 0.25in; text-indent: -0.25in;">&#160;</p>
        <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px 0pt 0.25in; text-indent: -0.25in;"> </p>
        <table cellspacing="0" cellpadding="0" style="font-family: 'Times New Roman',Times,serif; font-size: 10pt; width: 100%; text-align: left; color: rgb(0, 0, 0);" class="DSPFListTable" id="z957a47ec4ef34ff0a7f6d641dfbbf053">

            <tr>
              <td style="width: 18pt; vertical-align: top;">&#8226;</td>
              <td style="width: auto; vertical-align: top; text-align: justify;">
                <div style="font-weight: bold;">Please note, additional information may be needed in accordance with the Beneficiary's self-certification above.</div>
              </td>
            </tr>

        </table>
        <div style="line-height: 1.25;"><br style="line-height: 1.25;">
        </div>
        <table cellspacing="0" cellpadding="0" style="font-family: 'Times New Roman',Times,serif; font-size: 10pt; width: 100%; text-align: left; color: rgb(0, 0, 0);" class="DSPFListTable" id="z21eebb1bf2f54f9ca2621d987dd32c5f">

            <tr>
              <td style="width: 18pt; vertical-align: top;">&#8226;</td>
              <td style="width: auto; vertical-align: top; text-align: justify;">
                <div>For more information please consult your tax adviser or the information at the <u>OECD automatic exchange of information portal</u>&#160;<font style="font-weight: bold;"><u>www.oecd.org/tax/automatic-exchange</u></font></div>
              </td>
            </tr>

        </table>
        <div> <br>
        </div>
        <div style="text-align: center;"><img src="img03.jpg"> </div>
      </div>
      <div id="DSPFPageBreakArea" style="clear: both; margin-top: 10pt; margin-bottom: 10pt;">
        <div id="DSPFPageBreak" style="page-break-after: always;">
          <hr noshade="noshade" style="border-width: 0px; clear: both; margin: 4px 0px; width: 100%; height: 2px; color: rgb(0, 0, 0); background-color: rgb(0, 0, 0);"></div>
      </div>
      <div style="line-height: 1.25;">
        <div style="text-align: center;"><img src="img02.jpg"></div>
        <br>
        <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px; text-align: justify;"><b><u>Part&#160;3 &#8211; Type of Controlling Person</u></b></p>
        <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px; text-align: justify;"><b><u>(Please only complete this section if you are tax resident in one or more Reportable Jurisdictions according to the CRS)</u></b></p>
        <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px;">&#160;</p>
        <table cellspacing="0" cellpadding="3" border="0" align="CENTER" style="font: 10pt Times New Roman,Times,serif; width: 75%; border-collapse: collapse;">

            <tr style="vertical-align: bottom;">
              <td style="padding: 1pt 5.4pt; width: 83%; border: 1pt solid Black;"><font style="font-family: Times New Roman,Times,serif; font-size: 10pt;"><b>Please provide the Controlling Person&#8217;s Status by ticking the appropriate box.</b></font></td>
              <td style="padding: 1pt 5.4pt; white-space: nowrap; width: 17%; border-top: 1pt solid Black; border-right: 1pt solid Black; border-bottom: 1pt solid Black;">&#160;</td>
            </tr>
            <tr style="vertical-align: bottom;">
              <td style="padding: 1pt 5.4pt; white-space: nowrap; border-right: 1pt solid Black; border-bottom: 1pt solid Black; border-left: 1pt solid Black;"><font style="font-family: Times New Roman,Times,serif; font-size: 10pt;"><b>a</b></font><font style="font-family: Times New Roman,Times,serif;">. Controlling Person of a legal person &#8211; <b>control by ownership</b></font></td>
              <td style="padding: 1pt 5.4pt; white-space: nowrap; border-right: 1pt solid Black; border-bottom: 1pt solid Black;">&#160;</td>
            </tr>
            <tr style="vertical-align: bottom;">
              <td style="padding: 1pt 5.4pt; white-space: nowrap; border-right: 1pt solid Black; border-bottom: 1pt solid Black; border-left: 1pt solid Black;"><font style="font-family: Times New Roman,Times,serif; font-size: 10pt;"><b>b</b></font><font style="font-family: Times New Roman,Times,serif;">. Controlling Person of a legal person &#8211; <b>control by other means</b></font></td>
              <td style="padding: 1pt 5.4pt; white-space: nowrap; border-right: 1pt solid Black; border-bottom: 1pt solid Black;">&#160;</td>
            </tr>
            <tr style="vertical-align: bottom;">
              <td style="padding: 1pt 5.4pt; white-space: nowrap; border-right: 1pt solid Black; border-bottom: 1pt solid Black; border-left: 1pt solid Black;"><font style="font-family: Times New Roman,Times,serif; font-size: 10pt;"><b>c</b></font><font style="font-family: Times New Roman,Times,serif;">. Controlling Person of a legal person &#8211; <b>senior managing official</b></font></td>
              <td style="padding: 1pt 5.4pt; white-space: nowrap; border-right: 1pt solid Black; border-bottom: 1pt solid Black;">&#160;</td>
            </tr>
            <tr style="vertical-align: bottom;">
              <td style="padding: 1pt 5.4pt; white-space: nowrap; border-right: 1pt solid Black; border-bottom: 1pt solid Black; border-left: 1pt solid Black;"><font style="font-family: Times New Roman,Times,serif; font-size: 10pt;"><b>d</b></font><font style="font-family: Times New Roman,Times,serif;">. Controlling Person of a trust - <b>settlor</b></font></td>
              <td style="padding: 1pt 5.4pt; white-space: nowrap; border-right: 1pt solid Black; border-bottom: 1pt solid Black;">&#160;</td>
            </tr>
            <tr style="vertical-align: bottom;">
              <td style="padding: 1pt 5.4pt; white-space: nowrap; border-right: 1pt solid Black; border-bottom: 1pt solid Black; border-left: 1pt solid Black;"><font style="font-family: Times New Roman,Times,serif; font-size: 10pt;"><b>e</b></font><font style="font-family: Times New Roman,Times,serif;">. Controlling Person of a trust &#8211; <b>trustee</b></font></td>
              <td style="padding: 1pt 5.4pt; white-space: nowrap; border-right: 1pt solid Black; border-bottom: 1pt solid Black;">&#160;</td>
            </tr>
            <tr style="vertical-align: bottom;">
              <td style="padding: 1pt 5.4pt; white-space: nowrap; border-right: 1pt solid Black; border-bottom: 1pt solid Black; border-left: 1pt solid Black;"><font style="font-family: Times New Roman,Times,serif; font-size: 10pt;"><b>f</b></font><font style="font-family: Times New Roman,Times,serif;">.&#160; Controlling Person of a trust &#8211; <b>protector</b></font></td>
              <td style="padding: 1pt 5.4pt; white-space: nowrap; border-right: 1pt solid Black; border-bottom: 1pt solid Black;">&#160;</td>
            </tr>
            <tr style="vertical-align: bottom;">
              <td style="padding: 1pt 5.4pt; white-space: nowrap; border-right: 1pt solid Black; border-bottom: 1pt solid Black; border-left: 1pt solid Black;"><font style="font-family: Times New Roman,Times,serif; font-size: 10pt;"><b>g</b></font><font style="font-family: Times New Roman,Times,serif;">. Controlling Person of a trust &#8211; <b>beneficiary</b></font></td>
              <td style="padding: 1pt 5.4pt; white-space: nowrap; border-right: 1pt solid Black; border-bottom: 1pt solid Black;">&#160;</td>
            </tr>
            <tr style="vertical-align: bottom;">
              <td style="padding: 1pt 5.4pt; white-space: nowrap; border-right: 1pt solid Black; border-bottom: 1pt solid Black; border-left: 1pt solid Black;"><font style="font-family: Times New Roman,Times,serif; font-size: 10pt;"><b>h</b></font><font style="font-family: Times New Roman,Times,serif;">. Controlling Person of a trust &#8211; <b>other</b></font></td>
              <td style="padding: 1pt 5.4pt; white-space: nowrap; border-right: 1pt solid Black; border-bottom: 1pt solid Black;">&#160;</td>
            </tr>
            <tr style="vertical-align: bottom;">
              <td style="padding: 1pt 5.4pt; white-space: nowrap; border-right: 1pt solid Black; border-bottom: 1pt solid Black; border-left: 1pt solid Black;"><font style="font-family: Times New Roman,Times,serif; font-size: 10pt;"><b>i</b></font><font style="font-family: Times New Roman,Times,serif;">.&#160; Controlling Person of a legal arrangement (non-trust) &#8211; <b>settlor-equivalent</b></font></td>
              <td style="padding: 1pt 5.4pt; white-space: nowrap; border-right: 1pt solid Black; border-bottom: 1pt solid Black;">&#160;</td>
            </tr>
            <tr style="vertical-align: bottom;">
              <td style="padding: 1pt 5.4pt; white-space: nowrap; border-right: 1pt solid Black; border-bottom: 1pt solid Black; border-left: 1pt solid Black;"><font style="font-family: Times New Roman,Times,serif; font-size: 10pt;"><b>j</b></font><font style="font-family: Times New Roman,Times,serif;">.&#160; Controlling Person of a legal arrangement (non-trust) &#8211; <b>trustee-equivalent</b></font></td>
              <td style="padding: 1pt 5.4pt; white-space: nowrap; border-right: 1pt solid Black; border-bottom: 1pt solid Black;">&#160;</td>
            </tr>
            <tr style="vertical-align: bottom;">
              <td style="padding: 1pt 5.4pt; white-space: nowrap; border-right: 1pt solid Black; border-bottom: 1pt solid Black; border-left: 1pt solid Black;"><font style="font-family: Times New Roman,Times,serif; font-size: 10pt;"><b>k</b></font><font style="font-family: Times New Roman,Times,serif;">. Controlling Person of a legal arrangement (non-trust) &#8211; <b>protector-equivalent</b></font></td>
              <td style="padding: 1pt 5.4pt; white-space: nowrap; border-right: 1pt solid Black; border-bottom: 1pt solid Black;">&#160;</td>
            </tr>
            <tr style="vertical-align: bottom;">
              <td style="padding: 1pt 5.4pt; white-space: nowrap; border-right: 1pt solid Black; border-bottom: 1pt solid Black; border-left: 1pt solid Black;"><font style="font-family: Times New Roman,Times,serif; font-size: 10pt;"><b>l</b></font><font style="font-family: Times New Roman,Times,serif;">.&#160; Controlling Person of a legal arrangement (non-trust) &#8211; <b>beneficiary-equivalent</b></font></td>
              <td style="padding: 1pt 5.4pt; white-space: nowrap; border-right: 1pt solid Black; border-bottom: 1pt solid Black;">&#160;</td>
            </tr>
            <tr style="vertical-align: bottom;">
              <td style="padding: 1pt 5.4pt; white-space: nowrap; border-right: 1pt solid Black; border-bottom: 1pt solid Black; border-left: 1pt solid Black;"><font style="font-family: Times New Roman,Times,serif; font-size: 10pt;"><b>m</b></font><font style="font-family: Times New Roman,Times,serif;">.Controlling Person of a legal arrangement (non-trust) &#8211; <b>other-equivalent</b></font></td>
              <td style="padding: 1pt 5.4pt; white-space: nowrap; border-right: 1pt solid Black; border-bottom: 1pt solid Black;">&#160;</td>
            </tr>

        </table>
        <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px; text-align: justify;">&#160;</p>
        <div style="text-align: center;"><img src="img03.jpg"> </div>
        <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px; text-align: center;"> </p>
        <div id="DSPFPageBreakArea" style="clear: both; margin-top: 10pt; margin-bottom: 10pt;">
          <div id="DSPFPageBreak" style="page-break-after: always;">
            <hr noshade="noshade" style="border-width: 0px; clear: both; margin: 4px 0px; width: 100%; height: 2px; color: rgb(0, 0, 0); background-color: rgb(0, 0, 0);"></div>
        </div>
        <p style="font: 10pt Times New Roman,Times,serif; margin-top: 0pt; margin-bottom: 0pt; text-align: center;"><img src="img02.jpg"> </p>
        <p style="font: 10pt Times New Roman,Times,serif; margin-top: 0pt; margin-bottom: 0pt; text-align: center;"><br>
        </p>
        <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px; text-align: justify;"></p>
        <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px;"><b>Part&#160;4 &#8211; Declarations and Signature</b></p>
        <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px;">&#160;</p>
        <div style="text-align: justify; line-height: 1.25;">I understand that the information supplied by me is covered by the full provisions of the terms and conditions governing my relationship with ESOP Management &amp; Trust Services Ltd. (&#8220;ESOP&#8221;).</div>
        <div style="line-height: 1.25;">&#160;</div>
        <div style="text-align: justify; line-height: 1.25;">I acknowledge that the information contained in this form may be provided to the tax authorities of the country/jurisdiction described in this form above and exchanged with tax authorities of
          another country/jurisdiction or countries/jurisdictions in which I may be tax resident pursuant to intergovernmental agreements to exchange financial account information.</div>
        <div style="line-height: 1.25;">&#160;</div>
        <div style="line-height: 1.25;">I certify that I am the Beneficiary of all the account(s) to which this form relates to.</div>
        <div style="line-height: 1.25;">&#160;</div>
        <div style="line-height: 1.25;">I declare that I am not holding Senior Public Position<sup style="vertical-align: text-top; line-height: 1; font-size: smaller;">2</sup> and I am not a Politically Exposed Person<sup style="vertical-align: text-top; line-height: 1; font-size: smaller;"> 3</sup> and I will update you if the above will change in the future.</div>
        <div style="line-height: 1.25;">&#160;&#160; </div>
        <div style="border: 1pt solid Black; padding-right: 5pt; padding-left: 5pt; width: 98%;">
          <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px;">&#160;</p>
          <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px;"><b>I declare that all statements made in this declaration are, to the best of my knowledge and belief, correct and complete.</b></p>
          <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px;">&#160;</p>
          <p style="font: 10pt Times New Roman,Times,serif; margin-top: 0pt; margin-right: 0px; margin-bottom: 0pt; text-align: justify;">I undertake to advise ESOP of any change in circumstances which affects the tax residency status of the individual
            identified in this form and to provide with an updated form.</p>
          <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px;">&#160;</p>
          <table cellspacing="0" cellpadding="0" style="font: 10pt Times New Roman,Times,serif; margin-top: 0px; margin-bottom: 0px; width: 100%;">

              <tr style="vertical-align: top; text-align: justify;">
                <td style="width: 20%; text-align: left;">Signature:</td>
                <td style="border-bottom: 1pt solid Black; width: 60%;"><br>
                </td>
                <td style="width: 20%;">&#160;</td>
              </tr>

          </table>
          <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px;">&#160;</p>
          <table cellspacing="0" cellpadding="0" style="font: 10pt Times New Roman,Times,serif; margin-top: 0px; margin-bottom: 0px; width: 100%;">

              <tr style="vertical-align: top; text-align: justify;">
                <td style="width: 20%; text-align: left;">Print name:</td>
                <td style="border-bottom: 1pt solid Black; width: 60%;"><br>
                </td>
                <td style="width: 20%;">&#160;</td>
              </tr>

          </table>
          <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px;">&#160;</p>
          <table cellspacing="0" cellpadding="0" style="font: 10pt Times New Roman,Times,serif; margin-top: 0px; margin-bottom: 0px; width: 100%;">

              <tr style="vertical-align: top; text-align: justify;">
                <td style="width: 20%; text-align: left;">Date:</td>
                <td style="border-bottom: 1pt solid Black; width: 60%;"><br>
                </td>
                <td style="width: 20%;">&#160;</td>
              </tr>

          </table>
          <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px;">&#160;</p>
          <p style="font: 10pt Times New Roman,Times,serif; text-align: justify; margin-top: 0pt; margin-right: 0px; margin-bottom: 0pt;"><font style="font-family: Times New Roman,Times,serif;"><b>Note</b></font>: If you are not the Beneficiary please
            indicate the capacity in which you are signing the form. If signing under a power of attorney please also attach a certified copy of the power of attorney.</p>
          <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px;">&#160;</p>
          <table cellspacing="0" cellpadding="0" style="font: 10pt Times New Roman,Times,serif; margin-top: 0px; margin-bottom: 0px; width: 100%;">

              <tr style="vertical-align: top; text-align: justify;">
                <td style="width: 20%; text-align: left;">Capacity:</td>
                <td style="border-bottom: 1pt solid Black; width: 60%;"><br>
                </td>
                <td style="width: 20%;">&#160;</td>
              </tr>

          </table>
          <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px;">&#160;</p>
        </div>
        <p style="font: 10pt Times New Roman,Times,serif; margin: 0pt 0px;">&#160;</p>
        <p style="font: 10pt Times New Roman,Times,serif; margin-top: 0pt; margin-bottom: 0pt; margin-left: 0px;"><font style="font-family: Times New Roman,Times,serif;">For additional info, please contact us at: </font><b><u>esop-heldesk@esop.co.il </u></b><br>
          972-3-7536823 &#8239;&#8239;&#8239;&#8239;&#8239;&#8239;&#8239;&#8239;&#8239;&#8239;&#8239;&#8239;&#8239;&#8239;&#8239;&#8239;&#8239;&#8239;&#8239;&#8239;&#8239;&#8239;&#8239;&#8239;&#8239;&#8239;&#8239;Domestic calls: 1700-70-37-67</p>
        <div><br>
        </div>
        <hr noshade="noshade" align="left" style="background-color: rgb(0, 0, 0); border: 0px none; height: 1px; width: 2in; margin-left: 0pt; margin-right: auto; color: rgb(0, 0, 0);">
        <div style="text-align: justify; line-height: 1.25;"><sup style="vertical-align: text-top; line-height: 1; font-size: smaller;">2</sup> "Senior public position"- Including head of state, president, city mayor, judge, member of parliament, senior party member, member of the government, senior officer in the army or
          police, senior official in government companies, senior position in international organizations or anyone who performs such a role even if the title is different.</div>
        <div style="text-align: justify; line-height: 1.25;"><sup style="vertical-align: text-top; line-height: 1; font-size: smaller;"> <br>
          </sup></div>
        <div style="text-align: justify; line-height: 1.25;"><sup style="vertical-align: text-top; line-height: 1; font-size: smaller;">3</sup><sup style="font-family: David,sans-serif; vertical-align: text-top; line-height: 1; font-size: smaller;"> </sup><sup style="vertical-align: text-top; line-height: 1; font-size: smaller;">"</sup>Politically Exposed Person"- Holds a senior public position for the past five years, including a family member of such
          a person or a corporation under his control or a business partner of any of the above.</div>
        <div style="line-height: 1.25;"><br style="line-height: 1.25;">
        </div>
        <div style="text-align: justify; line-height: 1.25;">"foreign Politically Exposed Person"- Politically Exposed Person who is a foreign resident</div>
        <br>
      </div>
      <div style="text-align: center;"> <img src="img03.jpg"></div>
      <div><br>
      </div>
      <br>
      <hr align="center" style="border: none; border-bottom: 4px solid black; border-top: 1px solid black; height: 10px; color: #ffffff; background-color: #ffffff; text-align: center; margin-left: auto; margin-right: auto;"></div>
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end
</TEXT>
</DOCUMENT>
</SEC-DOCUMENT>
