<SEC-DOCUMENT>0001178913-22-004130.txt : 20221123
<SEC-HEADER>0001178913-22-004130.hdr.sgml : 20221123
<ACCEPTANCE-DATETIME>20221123080721
ACCESSION NUMBER:		0001178913-22-004130
CONFORMED SUBMISSION TYPE:	6-K
PUBLIC DOCUMENT COUNT:		11
CONFORMED PERIOD OF REPORT:	20221123
FILED AS OF DATE:		20221123
DATE AS OF CHANGE:		20221123

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:		221412304

	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>zk2228798.htm
<DESCRIPTION>6-K
<TEXT>
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    <div style="text-align: center; line-height: 1.25; font-family: 'Times New Roman',Times,serif; font-weight: bold;">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;">SECURITIES AND EXCHANGE COMMISSION</div>
    <div style="text-align: center; line-height: 1.25; font-family: 'Times New Roman',Times,serif; font-weight: bold;">Washington, D.C. 20549</div>
    <div style="text-align: center; line-height: 1.25; font-family: 'Times New Roman',Times,serif; 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;">FORM 6-K</div>
    <div style="text-align: center; line-height: 1.25; font-family: 'Times New Roman',Times,serif; font-weight: bold;">&#160;</div>
    <div style="text-align: center; line-height: 1.25; font-family: 'Times New Roman',Times,serif; font-weight: bold;">REPORT OF FOREIGN PRIVATE ISSUER</div>
    <div style="text-align: center; line-height: 1.25; font-family: 'Times New Roman',Times,serif; font-weight: bold;">PURSUANT TO RULE 13a-16 OR 15d-16 OF THE</div>
    <div style="text-align: center; line-height: 1.25; font-family: 'Times New Roman',Times,serif; font-weight: bold;">SECURITIES EXCHANGE ACT OF 1934</div>
    <div style="text-align: center; line-height: 1.25; font-family: 'Times New Roman',Times,serif;">&#160;</div>
    <div style="text-align: center; line-height: 1.25; font-family: 'Times New Roman',Times,serif;">For the month of November, 2022</div>
    <div style="text-align: center; line-height: 1.25; font-family: 'Times New Roman',Times,serif;"><img width="246" height="1" src="image0.jpg">&#160;</div>
    <div style="text-align: center; line-height: 1.25; font-family: 'Times New Roman',Times,serif; font-weight: bold;">Commission File Number: 001-39937</div>
    <div style="text-align: center; line-height: 1.25; font-family: 'Times New Roman',Times,serif; 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;">ZIM Integrated Shipping Services Ltd.</div>
    <div style="text-align: center; line-height: 1.25; font-family: 'Times New Roman',Times,serif;">(<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-family: 'Times New Roman',Times,serif; font-weight: bold;">&#160;</div>
    <div style="text-align: center; line-height: 1.25; font-family: 'Times New Roman',Times,serif; font-weight: bold;">9 Andrei Sakharov Street</div>
    <div style="text-align: center; line-height: 1.25; font-family: 'Times New Roman',Times,serif; font-weight: bold;">P.O. Box 15067</div>
    <div style="text-align: center; line-height: 1.25; font-family: 'Times New Roman',Times,serif; font-weight: bold;">Matam, Haifa 3190500, Israel</div>
    <div style="text-align: center; line-height: 1.25; font-family: 'Times New Roman',Times,serif; font-weight: bold;">+972 (4) 865-2000</div>
    <div style="text-align: center; line-height: 1.25; font-family: 'Times New Roman',Times,serif; font-style: italic;">(Address of principal executive office)</div>
    <div style="text-align: center; line-height: 1.25; font-family: 'Times New Roman',Times,serif;">&#160; <br>
    </div>
    <div style="text-align: center; line-height: 1.25; font-family: 'Times New Roman',Times,serif;">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; font-family: 'Times New Roman',Times,serif;">&#160;</div>
    <div style="text-align: center; line-height: 1.25; font-family: 'Times New Roman',Times,serif;">
      <div style="line-height: 1.25;">Form 20-F &#9746;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160; Form 40-F &#9744;</div>
    </div>
    <div style="text-align: center; line-height: 1.25; font-family: 'Times New Roman',Times,serif;"> <br>
    </div>
    <div style="text-align: center; line-height: 1.25; font-family: 'Times New Roman',Times,serif;">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; font-family: 'Times New Roman',Times,serif;">&#160;</div>
    <div style="text-align: center; line-height: 1.25; font-family: 'Times New Roman',Times,serif;">
      <div style="line-height: 1.25;">
        <div style="line-height: 1.25;">
          <div style="line-height: 1.25;">Yes &#9744;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160; No &#9746;</div>
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    <div style="text-align: center; line-height: 1.25; font-family: 'Times New Roman',Times,serif;"> <br>
    </div>
    <div style="text-align: center; line-height: 1.25; font-family: 'Times New Roman',Times,serif;">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; font-family: 'Times New Roman',Times,serif;"> <br>
    </div>
    <div style="text-align: center; line-height: 1.25; font-family: 'Times New Roman',Times,serif;">
      <div style="line-height: 1.25;">
        <div style="line-height: 1.25;">Yes &#9744;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160; No &#9746;</div>
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      &#160; <br>
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    <div style="line-height: 1.25; font-family: 'Times New Roman',Times,serif;">&#160;</div>
    <div style="text-align: justify; line-height: 1.25; color: rgb(0, 0, 0); font-family: 'Times New Roman',Times,serif;">On November 16, 2022, and in connection with the payment of a dividend previously announced by the Company, that is expected to be
      distributed on December 7, 2022, to the Company&#8217;s shareholders of record on November 29, 2022, (the &#8220;Dividend&#8221;), the Company has issued a press release announcing that certain shareholders of the Company may be eligible to a reduced Israeli
      withholding tax with respect to their share of the Dividend, in accordance with a previously obtained tax ruling (the &#8220;Ruling&#8221;) from the Israeli Tax Authority (&#8220;ITA&#8221;). A copy of this press release is attached herewith as Exhibit 99.1.</div>
    <div style="line-height: 1.25; font-family: 'Times New Roman',Times,serif;"><br style="line-height: 1.25;">
    </div>
    <div style="text-align: justify; line-height: 1.25; color: rgb(0, 0, 0); font-family: 'Times New Roman',Times,serif;">In addition, and in accordance with the Ruling and the Company&#8217;s press release, A copy of the following forms: (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 distribution of the Dividend are attached herewith as Exhibits 99.2, 99.3 and 99.4,
      respectively.</div>
    <div style="line-height: 1.25; font-family: 'Times New Roman',Times,serif;"><br style="line-height: 1.25;">
    </div>
    <div style="text-align: justify; line-height: 1.25; font-family: 'Times New Roman',Times,serif;">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="text-align: justify; line-height: 1.25; font-family: 'Times New Roman',Times,serif;"> <br>
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    <div style="text-align: center; line-height: 1.25; font-family: 'Times New Roman',Times,serif; font-weight: bold;"> <br>
      SIGNATURES</div>
    <div style="text-align: center; line-height: 1.25; font-family: 'Times New Roman',Times,serif;">&#160;</div>
    <div style="text-align: justify; line-height: 1.25; font-family: 'Times New Roman',Times,serif;">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; font-family: 'Times New Roman',Times,serif;">&#160;</div>
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            <div style="line-height: 1.25;">&#160;</div>
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          <td colspan="2" style="width: 50.44%; vertical-align: top; font-family: 'Times New Roman',Times,serif;">
            <div style="line-height: 1.25;">ZIM INTEGRATED SHIPPING SERVICES LTD.</div>
          </td>
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            <div style="line-height: 1.25;">&#160;</div>
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            <div style="line-height: 1.25;">&#160;</div>
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            <div style="line-height: 1.25;">&#160;</div>
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            <div style="line-height: 1.25;">&#160;</div>
          </td>
          <td nowrap="nowrap" style="width: 3.86%; vertical-align: top; font-family: 'Times New Roman',Times,serif;">
            <div style="line-height: 1.25;">By:&#160;&#160;</div>
          </td>
          <td nowrap="nowrap" style="width: 46.58%; vertical-align: top; border-bottom: 2px solid rgb(0, 0, 0); font-family: 'Times New Roman',Times,serif;">
            <div style="line-height: 1.25;">/s/ Noam Nativ</div>
          </td>
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            <div style="line-height: 1.25;">&#160;</div>
          </td>
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            <div style="line-height: 1.25;">&#160;</div>
          </td>
          <td style="width: 46.58%; vertical-align: bottom; font-family: 'Times New Roman',Times,serif;">
            <div style="line-height: 1.25;">Noam Nativ</div>
          </td>
        </tr>
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          <td style="width: 49.56%; vertical-align: middle; font-family: 'Times New Roman',Times,serif;">
            <div style="line-height: 1.25;">&#160;</div>
          </td>
          <td style="width: 3.86%; vertical-align: top; font-family: 'Times New Roman',Times,serif;">
            <div style="line-height: 1.25;">&#160;</div>
          </td>
          <td style="width: 46.58%; vertical-align: bottom; font-family: 'Times New Roman',Times,serif;">
            <div style="line-height: 1.25;">EVP General Counsel and Corporate Secretary</div>
          </td>
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    <div style="line-height: 1.25; font-family: 'Times New Roman',Times,serif;">&#160;</div>
    <div style="line-height: 1.25; font-family: 'Times New Roman',Times,serif;">Date: November 23, 2022</div>
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      <div><br>
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      EXHIBIT INDEX</div>
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            <div style="text-align: center; line-height: 1.25;">EXHIBIT NO.</div>
          </td>
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            <div style="line-height: 1.25;">&#160;</div>
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          <td style="width: 86.04%; vertical-align: bottom; border-bottom: 2px solid rgb(0, 0, 0); font-family: 'Times New Roman',Times,serif;">
            <div style="line-height: 1.25;">DESCRIPTION</div>
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          <td style="width: 11.99%; vertical-align: bottom; font-family: 'Times New Roman',Times,serif;">
            <div style="text-align: center; line-height: 1.25;"><a href="exhibit_99-1.htm">99.1</a></div>
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          <td style="width: 1.96%; vertical-align: bottom; font-family: 'Times New Roman',Times,serif;"><br>
          </td>
          <td style="width: 86.04%; vertical-align: bottom; font-family: 'Times New Roman',Times,serif;">
            <div style="line-height: 1.25;"><a href="exhibit_99-1.htm">Press Release dated November 23, 2022</a></div>
          </td>
        </tr>
        <tr>
          <td style="width: 11.99%; vertical-align: bottom; font-family: 'Times New Roman',Times,serif;">
            <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; font-family: 'Times New Roman',Times,serif;"><br>
          </td>
          <td style="width: 86.04%; vertical-align: bottom; font-family: 'Times New Roman',Times,serif;">
            <div style="line-height: 1.25; color: rgb(0, 0, 0);"><a href="exhibit_99-2.htm">Form of Declaration of Status For Israeli Income Tax Purposes</a></div>
          </td>
        </tr>
        <tr>
          <td style="width: 11.99%; vertical-align: bottom; font-family: 'Times New Roman',Times,serif;">
            <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; font-family: 'Times New Roman',Times,serif;"><br>
          </td>
          <td style="width: 86.04%; vertical-align: bottom; font-family: 'Times New Roman',Times,serif;">
            <div style="line-height: 1.25; color: rgb(0, 0, 0);"><a href="exhibit_99-3.htm">Form of Beneficiary&#8217;s Details</a></div>
          </td>
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        <tr>
          <td style="width: 11.99%; vertical-align: bottom; font-family: 'Times New Roman',Times,serif;">
            <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; font-family: 'Times New Roman',Times,serif;"><br>
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          <td style="width: 86.04%; vertical-align: bottom; font-family: 'Times New Roman',Times,serif;">
            <div style="line-height: 1.25; color: rgb(0, 0, 0);"><a href="exhibit_99-4.htm">Additional Beneficiary&#8217;s Details &#8211; Controlling Person</a></div>
          </td>
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    <div style="line-height: 1.25; font-family: 'Times New Roman',Times,serif;">&#160;</div>
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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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    <!-- Licensed to: company
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    <div style="text-align: right; line-height: 1.25; font-family: 'Times New Roman',Times,serif;">
      <hr align="center" style="border: none; border-bottom: 1px solid black; border-top: 4px solid black; height: 10px; color: #ffffff; background-color: #ffffff; text-align: center; margin-left: auto; margin-right: auto;"><u><font style="font-weight: bold;">Exhibit 99.1</font></u><br>
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    <div style="line-height: 1.25; font-family: 'Times New Roman',Times,serif;"><br>
    </div>
    <div style="line-height: 1.25; font-family: 'Times New Roman',Times,serif; text-align: center;">&#160;<img src="image00002.jpg"></div>
    <div style="line-height: 1.25; font-family: 'Times New Roman',Times,serif;"> <br>
    </div>
    <div style="line-height: 1.25; font-family: 'Times New Roman',Times,serif;"> <br>
    </div>
    <div style="text-align: center; line-height: 1.25; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif; font-weight: bold; background-color: rgb(255, 255, 255); font-size: 12pt; font-style: normal; font-variant: normal; text-transform: none;">ZIM Updates on Withholding Tax Procedures on December 2022 Cash Dividend</div>
    <div style="text-align: center; line-height: 1.25; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif; font-weight: bold;"> <br>
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    <div style="text-align: justify; line-height: 1.25; font-family: Tahoma, sans-serif; font-size: 11pt;"><font style="font-family: 'Times New Roman',Times,serif; font-size: 10pt; color: rgb(0, 32, 96);">Haifa, Israel, November 23, 2022 &#8211; </font><font style="font-family: 'Times New Roman',Times,serif; font-size: 10pt; color: rgb(5, 99, 193);"><u>ZIM Integrated Shipping Services Ltd.</u></font><font style="font-family: 'Times New Roman',Times,serif; font-size: 10pt; color: rgb(0, 32, 96);">
        (NYSE: ZIM), a global container liner shipping company, hereby updates that in connection with the dividend distribution expected to take place on December 7, 2022, as previously announced by the Company on November 16, 2022 (the &#8220;Dividend&#8221;), and
        in accordance with its previously obtained tax ruling (the &#8220;Ruling&#8221;) from the Israeli Tax Authority (&#8220;ITA&#8221;), certain shareholders of the Company (&#8220;Shareholders&#8221;) may be eligible to a reduced Israeli withholding tax rate with respect to their share
        of this Dividend, 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. The Ruling applies to any dividend distributions made by the Company on or
        before December 31, 2022.</font></div>
    <div style="line-height: 1.25; font-family: 'Times New Roman',Times,serif;">&#160;</div>
    <div style="text-align: justify; line-height: 1.25; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif; 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 of the Shareholders, 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 December 7, 2022, there is no guarantee the Company will declare additional dividends in the future.</div>
    <div style="line-height: 1.25; font-family: 'Times New Roman',Times,serif;">&#160;</div>
    <div style="text-align: justify; line-height: 1.25; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif; 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 of
      coordinating certain procedures relating to the Ruling, and it is NOT intended that the Agent will provide any tax advice to any of the Shareholders, who are encouraged to consult their own tax and financial advisors.</div>
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    </div>
    <div style="text-align: justify; line-height: 1.25; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif; font-weight: bold;">Forms required to be submitted to the Agent in connection with the Ruling as described below are attached as
      exhibits 99.2, 99.3 and 99.4 to Company&#8217;s Current Report on Form 6-K filed with the Securities and Exchange Commission (SEC) on November 23, 2022, (<u>www.sec.gov</u>) and can also be found on the Company&#8217;s website <u>here</u>.</div>
    <div style="line-height: 1.25; font-family: 'Times New Roman',Times,serif;">&#160;</div>
    <div style="text-align: justify; line-height: 1.25; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif; font-weight: bold;">Background</div>
    <div style="text-align: justify; line-height: 1.25; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif;">On November 16, 2022, ZIM announced a dividend payment of $2.95 per ordinary share (approximately $354 million), to holders of the
      ordinary shares as of November 29, 2022. Payment of the Dividend is expected to be made on December 7, 2022 (the "Payment Date").</div>
    <div style="line-height: 1.25; font-family: 'Times New Roman',Times,serif;">&#160;</div>
    <div style="text-align: justify; line-height: 1.25; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif; font-weight: bold;">General Withholding Tax Treatment under Israeli Law</div>
    <div style="text-align: justify; line-height: 1.25; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif;">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; font-family: 'Times New Roman',Times,serif;">&#160;</div>
    <div style="text-align: justify; line-height: 1.25; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif; font-weight: bold;">Summary of the Main Terms of the Ruling</div>
    <div style="text-align: justify; line-height: 1.25; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif;">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>
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    </div>
    <table cellspacing="0" cellpadding="0" id="z0276bee5b2a84d52bc6e4262be8a61a6" class="DSPFListTable" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;">

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          <td style="width: 18pt; vertical-align: top; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif;">1.</td>
          <td style="width: auto; vertical-align: top; text-align: justify; font-family: 'Times New Roman',Times,serif;">
            <div style="color: rgb(0, 32, 96);">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>
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    </table>
    <table cellspacing="0" cellpadding="0" id="zdc85559343ed46f4ba5cdf146faf9efa" class="DSPFListTable" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;">

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          </td>
          <td style="width: 18pt; vertical-align: top; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif;">2.</td>
          <td style="width: auto; vertical-align: top; text-align: justify; font-family: 'Times New Roman',Times,serif;">
            <div style="color: rgb(0, 32, 96);">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>
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    </table>
    <table cellspacing="0" cellpadding="0" id="z28c59494883f4335bab2182614598cc2" class="DSPFListTable" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;">

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          <td style="width: 18pt; vertical-align: top; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif;">3.</td>
          <td style="width: auto; vertical-align: top; text-align: justify; font-family: 'Times New Roman',Times,serif;">
            <div style="color: rgb(0, 32, 96);">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;">January 5, 2023</font> ("Change of Rate Period").</div>
          </td>
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    </table>
    <table cellspacing="0" cellpadding="0" id="z7c70c7672ea141648bfb237cec81fb5e" class="DSPFListTable" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;">

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          </td>
          <td style="width: 18pt; vertical-align: top; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif;">4.</td>
          <td style="width: auto; vertical-align: top; text-align: justify; font-family: 'Times New Roman',Times,serif;">
            <div style="color: rgb(0, 32, 96);">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>
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    </table>
    <table cellspacing="0" cellpadding="0" id="z8eff190cb4094bbab4fb27b3679281f8" class="DSPFListTable" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;">

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          </td>
          <td style="width: 18pt; vertical-align: top; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif;">5.</td>
          <td style="width: auto; vertical-align: top; text-align: justify; font-family: 'Times New Roman',Times,serif;">
            <div style="color: rgb(0, 32, 96);">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 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>
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    </table>
    <div> <br>
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          <td style="width: 18pt; vertical-align: top; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif;">6.</td>
          <td style="width: auto; vertical-align: top; text-align: justify;">
            <div style="color: #002060; font-family: Tahoma, sans-serif; font-size: 11pt;"><font style="font-family: 'Times New Roman',Times,serif; font-size: 10pt; 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
                November 23, 2022 with the Securities and Exchange Commission (SEC) on no later than January 5, 2023 (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><font style="font-family: 'Times New Roman',Times,serif; font-size: 10pt;">.</font></div>
          </td>
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    </table>
    <table cellspacing="0" cellpadding="0" id="zd5efd879736a4a6696dfff16ea04e953" class="DSPFListTable" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;">

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          <td style="width: 18pt; vertical-align: top; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif;">7.</td>
          <td style="width: auto; vertical-align: top; text-align: justify; font-family: 'Times New Roman',Times,serif;">
            <div style="color: rgb(0, 32, 96);">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)&#160; 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>
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    </table>
    <table cellspacing="0" cellpadding="0" id="zb5be799f3aed4d54ba37f784d36ebced" class="DSPFListTable" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;">

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          <td style="width: 18pt; vertical-align: top; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif;">8.</td>
          <td style="width: auto; vertical-align: top; text-align: justify; font-family: 'Times New Roman',Times,serif;">
            <div style="color: rgb(0, 32, 96);">
              <div style="font-family: 'Times New Roman', Times, serif;">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 November 30, 2022, and a statement confirming that more than 75% of its shareholders, directly or indirectly, are individuals of its state of residence.</div>
            </div>
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    <table cellspacing="0" cellpadding="0" id="zb60a0c6dd5c64994be79c50f85c2dc7d" class="DSPFListTable" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;">

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          <td style="width: 18pt; vertical-align: top; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif;">9.</td>
          <td style="width: auto; vertical-align: top; text-align: justify; font-family: 'Times New Roman',Times,serif;">
            <div style="color: rgb(0, 32, 96);">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>
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    </table>
    <table cellspacing="0" cellpadding="0" id="z1822986d6c794f2e9d8891f10b91ad7d" class="DSPFListTable" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;">

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          </td>
          <td style="width: 18pt; vertical-align: top; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif;">10.</td>
          <td style="width: auto; vertical-align: top; text-align: justify; font-family: 'Times New Roman',Times,serif;">
            <div style="color: rgb(0, 32, 96);">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 January 5, 2023
              (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>
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    </table>
    <br>
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    <table cellspacing="0" cellpadding="0" id="z4589bc206241423c92fee289837ab0c8" class="DSPFListTable" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;">

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          <td style="width: 18pt; vertical-align: top; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif;">11.</td>
          <td style="width: auto; vertical-align: top; text-align: justify; font-family: 'Times New Roman',Times,serif;">
            <div style="color: rgb(0, 32, 96);">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>
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    </table>
    <table cellspacing="0" cellpadding="0" id="z184a78da00dc418d91f80c6c93c331c2" class="DSPFListTable" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;">

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          <td style="width: 18pt; vertical-align: top; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif;">12.</td>
          <td style="width: auto; vertical-align: top; text-align: justify; font-family: 'Times New Roman',Times,serif;">
            <div style="color: rgb(0, 32, 96);">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>
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    </table>
    <table cellspacing="0" cellpadding="0" id="z11d22752e1924a699901efe514df7a69" class="DSPFListTable" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;">

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          <td style="width: 18pt; vertical-align: top; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif;">13.</td>
          <td style="width: auto; vertical-align: top; text-align: justify; font-family: 'Times New Roman',Times,serif;">
            <div style="color: rgb(0, 32, 96);">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>
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    </table>
    <table cellspacing="0" cellpadding="0" id="zbec34f9911a841a687c7ad53fdc49878" class="DSPFListTable" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;">

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          <td style="width: 18pt; vertical-align: top; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif;">14.</td>
          <td style="width: auto; vertical-align: top; text-align: justify; font-family: 'Times New Roman',Times,serif;">
            <div style="color: rgb(0, 32, 96);">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>
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    </table>
    <div style="line-height: 1.25; font-family: 'Times New Roman',Times,serif;">&#160;</div>
    <div style="text-align: justify; line-height: 1.25; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif; font-weight: bold;">Appointment of Israeli Tax Withholding Agent</div>
    <div style="text-align: justify; line-height: 1.25; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif;">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>
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    </div>
    <div style="line-height: 1.25; font-family: 'Times New Roman',Times,serif;"><br style="line-height: 1.25;">
    </div>
    <div style="text-align: justify; line-height: 1.25; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif;">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;">January 5, 2023</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
      November 23, 2022 with the SEC.</div>
    <div style="line-height: 1.25; font-family: 'Times New Roman',Times,serif;"><br style="line-height: 1.25;">
    </div>
    <div style="text-align: justify; line-height: 1.25; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif; font-weight: bold;"><u>If a Shareholder fails to provide the Agent with all the documentation required by January 5, 2023, 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; font-family: 'Times New Roman',Times,serif;"><br style="line-height: 1.25;">
    </div>
    <div style="text-align: justify; line-height: 1.25; color: #002060; font-family: Tahoma, sans-serif; font-size: 11pt;"><font style="font-family: 'Times New Roman',Times,serif; font-size: 10pt;"><u>ZIM's Agent Contact Information</u>:</font></div>
    <div style="line-height: 1.25; font-family: 'Times New Roman',Times,serif;"><br style="line-height: 1.25;">
    </div>
    <div style="text-align: justify; line-height: 1.25; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif; font-style: italic; font-weight: bold;">ESOP Management &amp; Trust Services Ltd.</div>
    <div style="line-height: 1.25; font-family: 'Times New Roman',Times,serif;"><br style="line-height: 1.25;">
    </div>
    <div style="text-align: justify; line-height: 1.25; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif;">Tel No: +972-3-7536823</div>
    <div style="text-align: justify; line-height: 1.25; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif;">Fax No: +972-3-7602636</div>
    <div style="text-align: justify; line-height: 1.25; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif;">Email: <u>esop-sp@esop.co.il</u></div>
    <div style="line-height: 1.25; font-family: 'Times New Roman',Times,serif;"><br style="line-height: 1.25;">
    </div>
    <div style="line-height: 1.25; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif; font-weight: bold;"><u>About ZIM</u></div>
    <div style="text-align: justify; line-height: 1.25; color: #002060; font-family: Tahoma, sans-serif; font-size: 11pt;"><font style="font-family: 'Times New Roman',Times,serif; font-size: 10pt;">Founded in Israel in 1945, ZIM (NYSE: ZIM) is a leading
        global container liner shipping company with established operations in approximately 100 countries serving approximately 30,000 customers in over 350 ports worldwide. ZIM leverages digital strategies and a commitment to ESG values to provide
        customers innovative seaborne transportation and logistics services and exceptional customer experience. ZIM's differentiated global-niche strategy, based on agile fleet management and deployment, covers major trade routes with a focus on select
        markets where the company holds competitive advantages. Additional information about ZIM is available at&#160;<u>www.ZIM.com</u>.</font></div>
    <div style="line-height: 1.25; font-family: 'Times New Roman',Times,serif;"><br style="line-height: 1.25;">
    </div>
    <div style="line-height: 1.25; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif; font-weight: bold;"><u>ZIM Contacts</u></div>
    <div style="line-height: 1.25; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif;"><u>Media:</u></div>
    <div style="line-height: 1.25; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif;">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; font-family: 'Times New Roman',Times,serif;"><br style="line-height: 1.25;">
    </div>
    <div style="line-height: 1.25; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif;"><u>Investor Relations:</u></div>
    <div style="line-height: 1.25; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif;">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; font-family: 'Times New Roman',Times,serif;"><br style="line-height: 1.25;">
    </div>
    <div style="line-height: 1.25; color: rgb(0, 32, 96); font-family: 'Times New Roman',Times,serif;">Leon Berman<br>
      The IGB Group<br>
      212-477-8438<br>
      <u>lberman@igbir.com</u></div>
    <div style="line-height: 1.25; font-family: 'Times New Roman',Times,serif;">&#160;</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="line-height: 1.25;"><br style="line-height: 1.25;">
      </div>
    </div>
    <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; font-family: 'Times New Roman',Times,serif;">
      <div style="line-height: 1.25;">You are receiving this form "Declaration of Status for Israeli Income Tax Purposes" as a holder of shares of <font style="color: rgb(35, 31, 32);">ZIM Integrated Shipping Services Ltd.</font> ("<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 December 7, 2022.</div>
    </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;"><u>ZIM's Israeli tax agent contact information:</u></div>
    <div style="line-height: 1.25;"><br style="line-height: 1.25;">
    </div>
    <div style="text-align: justify; line-height: 1.25; 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="text-align: justify; line-height: 1.25; font-weight: bold;">Tel No: +972-3-7536823</div>
    <div style="text-align: justify; line-height: 1.25; font-weight: bold;">Fax No: +972-3-7602636</div>
    <div style="text-align: justify; line-height: 1.25; font-weight: bold;">Email: esop-sp@esop.co.il</div>
    <div style="line-height: 1.25;"><br style="line-height: 1.25;">
    </div>
    <div style="text-align: justify; margin-left: 10.9pt; line-height: 1.25; font-weight: bold;"><u>PART A: RECIPIENT DECLARATION</u></div>
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    <div style="margin-left: 10.9pt; line-height: 1.25; font-weight: bold;">RECIPIENT INFORMATION</div>
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            <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 </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;">Security No., or Passport No./ </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>
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            <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>
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            <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>
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            <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>
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            <div style="margin-left: 5.4pt; line-height: 1.25; font-family: 'Times New Roman', Times, serif;">Date of birth:</div>
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            <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>
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            <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>
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            <div style="margin-left: 5.4pt; line-height: 1.25; font-family: 'Times New Roman', Times, serif;">Country of residence:</div>
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            <div style="margin-left: 5.4pt; line-height: 1.25; font-family: 'Times New Roman', Times, serif;">Country of citizenship:</div>
          </td>
        </tr>
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          <td style="width: 62.69%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);" colspan="2">
            <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 style="width: 62.69%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);" colspan="2">&#160;</td>
        </tr>
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          <td style="width: 100%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px solid rgb(0, 0, 0);" colspan="3">
            <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>
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          <td style="width: 100%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px solid rgb(0, 0, 0);" colspan="3">
            <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>
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          <td style="width: 100%; vertical-align: top; border-width: 2px; border-style: solid; border-color: rgb(0, 0, 0);" colspan="3">
            <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>
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          <td style="width: 100%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px solid rgb(0, 0, 0);" colspan="2">&#160;</td>
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            <div style="margin-left: 5.4pt; line-height: 1.25;">Permanent Address (country, city, street, house or apartment number):</div>
          </td>
        </tr>
        <tr>
          <td style="width: 62.69%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-bottom: 2px solid rgb(0, 0, 0);" rowspan="2">
            <div style="margin-left: 5.4pt; line-height: 1.25;">Mailing Address:</div>
          </td>
          <td style="width: 37.31%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px solid rgb(0, 0, 0);">
            <div style="margin-left: 5.4pt; line-height: 1.25;">Investor's Telephone number:</div>
          </td>
        </tr>
        <tr>
          <td style="width: 37.31%; vertical-align: top; border-width: 2px; border-style: solid; border-color: rgb(0, 0, 0);">
            <div style="margin-right: 5pt; margin-left: 5.4pt; line-height: 1.25;">Telephone number of authorized signatory:</div>
          </td>
        </tr>

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    <div style="line-height: 1.25">&#160;</div>
    <div style="line-height: 1.25;"></div>
    <div style="margin-left: 10.9pt; line-height: 1.25; font-weight: bold;">With regard to an Individual:</div>
    <div style="margin-left: 10.9pt; line-height: 1.25; font-weight: bold;"> <br>
    </div>
    <div style="margin-left: 10.9pt; line-height: 1.25; 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" id="z6bd8248743434f908afe730efe8233d2" style="font-family: 'Times New Roman',Times,serif; font-size: 10pt; width: 100%; text-align: left; color: rgb(0, 0, 0);">

        <tr>
          <td style="width: 6.09%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
            <div style="margin-left: 5.4pt; line-height: 1.25;">&#9744;</div>
          </td>
          <td style="width: 4.96%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
            <div style="margin-left: 5.4pt; line-height: 1.25;">1.</div>
          </td>
          <td style="width: 88.94%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px 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: 6.09%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
            <div style="margin-left: 5.4pt; line-height: 1.25;">&#9744;</div>
          </td>
          <td style="width: 4.96%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
            <div style="margin-left: 5.4pt; line-height: 1.25;">2.</div>
          </td>
          <td style="width: 88.94%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px 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: 6.09%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
            <div style="margin-left: 5.4pt; line-height: 1.25;">&#9744;</div>
          </td>
          <td style="width: 4.96%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
            <div style="margin-left: 5.4pt; line-height: 1.25;">3.</div>
          </td>
          <td style="width: 88.94%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px 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: 6.09%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
            <div style="margin-left: 5.4pt; line-height: 1.25;">&#9744;</div>
          </td>
          <td style="width: 4.96%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
            <div style="margin-left: 5.4pt; line-height: 1.25;">4.</div>
          </td>
          <td style="width: 88.94%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px 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: 6.09%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
            <div style="margin-left: 5.4pt; line-height: 1.25;">&#9744;</div>
          </td>
          <td style="width: 4.96%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
            <div style="margin-left: 5.4pt; line-height: 1.25;">5.</div>
          </td>
          <td style="width: 88.94%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px 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: 6.09%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
            <div style="margin-left: 5.4pt; line-height: 1.25;">&#9744;</div>
          </td>
          <td style="width: 4.96%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
            <div style="margin-left: 5.4pt; line-height: 1.25;">6.</div>
          </td>
          <td style="width: 88.94%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px 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: 6.09%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
            <div style="margin-left: 5.4pt; line-height: 1.25;">&#9744;</div>
          </td>
          <td style="width: 4.96%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
            <div style="margin-left: 5.4pt; line-height: 1.25;">7.</div>
          </td>
          <td style="width: 88.94%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px 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: 6.09%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
            <div style="margin-left: 5.4pt; line-height: 1.25;">&#9744;</div>
          </td>
          <td style="width: 4.96%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
            <div style="margin-left: 5.4pt; line-height: 1.25;">8.</div>
          </td>
          <td style="width: 88.94%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px 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: 6.09%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-bottom: 2px solid rgb(0, 0, 0);">
            <div style="margin-left: 5.4pt; line-height: 1.25;">&#9744;</div>
          </td>
          <td style="width: 4.96%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-bottom: 2px solid rgb(0, 0, 0);">
            <div style="margin-left: 5.4pt; line-height: 1.25;">9.</div>
          </td>
          <td style="width: 88.94%; vertical-align: top; border-width: 2px; 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="margin-left: 10.9pt; line-height: 1.25; font-weight: bold;">With regard to a Legal Entity:</div>
    <div style="line-height: 1.25">&#160;</div>
    <div style="line-height: 1.25;"></div>
    <div style="margin-left: 10.9pt; line-height: 1.25;"><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="2" border="0" align="left" id="z5918e6f3ec0d46d7a1c8b2b4432c0aee" style="font-family: 'Times New Roman',Times,serif; font-size: 10pt; width: 100%; text-align: left; color: rgb(0, 0, 0);">

        <tr>
          <td style="width: 6.09%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
            <div style="margin-left: 5.4pt; line-height: 1.25;">&#9744;</div>
          </td>
          <td style="width: 4.96%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
            <div style="margin-left: 5.4pt; line-height: 1.25;">1.</div>
          </td>
          <td style="width: 88.94%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px 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: 6.09%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
            <div style="margin-left: 5.4pt; line-height: 1.25;">&#9744;</div>
          </td>
          <td style="width: 4.96%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
            <div style="margin-left: 5.4pt; line-height: 1.25;">2.</div>
          </td>
          <td style="width: 88.94%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px 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: 6.09%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
            <div style="margin-left: 5.4pt; line-height: 1.25;">&#9744;</div>
          </td>
          <td style="width: 4.96%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
            <div style="margin-left: 5.4pt; line-height: 1.25;">3.</div>
          </td>
          <td style="width: 88.94%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px 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: 6.09%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
            <div style="margin-left: 5.4pt; line-height: 1.25;">&#9744;</div>
          </td>
          <td style="width: 4.96%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
            <div style="margin-left: 5.4pt; line-height: 1.25;">4.</div>
          </td>
          <td style="width: 88.94%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px 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: 6.09%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
            <div style="margin-left: 5.4pt; line-height: 1.25;">&#9744;</div>
          </td>
          <td style="width: 4.96%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
            <div style="margin-left: 5.4pt; line-height: 1.25;">5.</div>
          </td>
          <td style="width: 88.94%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px 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: 6.09%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
            <div style="margin-left: 5.4pt; line-height: 1.25;">&#9744;</div>
          </td>
          <td style="width: 4.96%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
            <div style="margin-left: 5.4pt; line-height: 1.25;">6.</div>
          </td>
          <td style="width: 88.94%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px 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 a permanent establishment in the State of Israel</div>
          </td>
        </tr>
        <tr>
          <td style="width: 6.09%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
            <div style="margin-left: 5.4pt; line-height: 1.25;">&#9744;</div>
          </td>
          <td style="width: 4.96%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
            <div style="margin-left: 5.4pt; line-height: 1.25;">7.</div>
          </td>
          <td style="width: 88.94%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-right: 2px solid rgb(0, 0, 0); border-left: 2px solid 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>
            <div style="text-indent: -25.5pt; margin-left: 36.65pt; line-height: 1.25;">(c)&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;the right to vote;</div>
            <div style="text-indent: -25.75pt; margin-left: 36.65pt; line-height: 1.25;">(d)&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;the right to share in the assets of the entity at the time of its liquidation;</div>
            <div style="text-indent: -25.5pt; margin-left: 36.65pt; line-height: 1.25;">(e)&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;the right to direct the manner of exercising one of the rights specified above.</div>
          </td>
        </tr>
        <tr>
          <td rowspan="1" style="width: 6.09%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-bottom: 2px solid rgb(0, 0, 0);">
            <div style="margin-left: 5.4pt; line-height: 1.25;">&#9744;</div>
          </td>
          <td rowspan="1" style="width: 4.96%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-bottom: 2px solid rgb(0, 0, 0);">
            <div style="margin-left: 5.4pt; line-height: 1.25;">8.</div>
          </td>
          <td rowspan="1" style="width: 88.94%; vertical-align: top; border-width: 2px; border-style: solid; border-color: rgb(0, 0, 0);">
            <div style="margin-left: 5.45pt; line-height: 1.25;">The legal entity is the sole beneficial owner of the dividend income.</div>
          </td>
        </tr>

    </table>
    <div> <br>
    </div>
    <div style="line-height: 1.25">&#160;</div>
    <div class="BRPFPageBreakArea" style="clear: both; margin-top: 10pt; margin-bottom: 10pt;">
      <div class="BRPFPageNumberArea" style="text-align: center;"><font class="BRPFPageNumber" style="color: #000000; font-weight: normal; font-style: normal;">2</font></div>
      <div class="BRPFPageBreak" 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;"><br style="line-height: 1.25;">
    </div>
    <div style="line-height: 1.25">
      <div style="line-height: 1.25; font-weight: bold;">DETAILS OF INCOME RECEIVED</div>
      <div style="line-height: 1.25;">Place of receipt (country, city, bank account number, Amount)</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);">

          <tr>
            <td style="width: 25.01%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
              <div style="margin-left: 5.4pt; line-height: 1.25; font-family: 'Times New Roman', Times, serif;">Country</div>
            </td>
            <td style="width: 24.98%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
              <div style="margin-left: 5.25pt; line-height: 1.25; font-family: 'Times New Roman', Times, serif;">City</div>
            </td>
            <td style="width: 25.01%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
              <div style="margin-left: 5.3pt; line-height: 1.25;"><font style="font-family: 'Times New Roman', Times, serif;">Bank</font>&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;<font style="font-family: 'Times New Roman', Times, serif;">name&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;and</font></div>
              <div style="margin-left: 5.3pt; line-height: 1.25; font-family: 'Times New Roman', Times, serif;">account number</div>
            </td>
            <td style="width: 25.01%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px solid rgb(0, 0, 0);">
              <div style="margin-left: 5.3pt; line-height: 1.25; font-family: 'Times New Roman', Times, serif;">Amount</div>
            </td>
          </tr>
          <tr>
            <td style="width: 25.01%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-bottom: 2px solid rgb(0, 0, 0);">&#160;</td>
            <td style="width: 24.98%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-bottom: 2px solid rgb(0, 0, 0);">&#160;</td>
            <td style="width: 25.01%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-bottom: 2px solid rgb(0, 0, 0);">&#160;</td>
            <td style="width: 25.01%; vertical-align: top; border-width: 2px; border-style: solid; border-color: rgb(0, 0, 0);">&#160;</td>
          </tr>

      </table>
      <div style="line-height: 1.25;"><br style="line-height: 1.25;">
      </div>
      <div style="line-height: 1.25;">The recipient declares that all the information provided above is accurate and complete.</div>
      <div style="line-height: 1.25;"><br style="line-height: 1.25;">
      </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;">

          <tr>
            <td rowspan="1" style="width: 33.33%; vertical-align: top; text-align: center; border-bottom: 2px solid rgb(0, 0, 0);">&#160;</td>
            <td rowspan="1" style="width: 33.35%; vertical-align: top; padding-bottom: 2px;">&#160;</td>
            <td rowspan="1" style="width: 33.33%; vertical-align: top; text-align: center; border-bottom: 2px solid rgb(0, 0, 0);">&#160;</td>
          </tr>
          <tr>
            <td style="width: 33.33%; vertical-align: top; text-align: center;">
              <div style="line-height: 1.25; font-family: 'Times New Roman',Times,serif;">Date of Signature</div>
            </td>
            <td style="width: 33.35%; vertical-align: top;">&#160;</td>
            <td style="width: 33.33%; vertical-align: top; text-align: center;">
              <div style="line-height: 1.25; font-family: 'Times New Roman',Times,serif;">Signature of Recipient</div>
            </td>
          </tr>

      </table>
      <div style="line-height: 1.25;"><br style="line-height: 1.25;">
      </div>
      <div style="line-height: 1.25;"><font style="font-weight: bold;"><u>PART</u></font><u>&#160;</u><font style="font-weight: bold;"><font style="font-weight: bold;"><u>B:</u><u> CERTIFICATION</u><u> OF</u><u> FOREIGN </u><u>INCOME </u></font><u>TAX</u>&#160;<u>AUTHORITY</u></font></div>
      <div style="line-height: 1.25;"><font style="font-weight: bold;"><u> <br>
          </u></font></div>
      <div style="line-height: 1.25;">This part shall be completed and signed by the income tax authorities of the recipient&#8217;s place of residence</div>
      <div style="line-height: 1.25">&#160;</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">

          <tr>
            <td style="width: 11.1pt; vertical-align: top; align: right;">1.</td>
            <td style="width: auto; vertical-align: top;">
              <div>I certify that:</div>
            </td>
          </tr>

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

          <tr>
            <td style="width: 15.05pt;"><br>
            </td>
            <td style="width: 11.45pt; vertical-align: top; align: right;">a.</td>
            <td style="width: auto; vertical-align: top;">the recipient of the income is a fiscal resident of (insert country)<u>&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160; </u>;</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">

          <tr>
            <td style="width: 15.05pt;"><br>
            </td>
            <td style="width: 11.45pt; vertical-align: top; align: right;">b.</td>
            <td style="width: auto; vertical-align: top;">
              <div>the recipient regularly reports his income as required, the most recent income tax return filed being for the year<u>&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160; </u>;</div>
            </td>
          </tr>

      </table>
      <div style="line-height: 1.25;">
        <div>
          <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">

                <tr>
                  <td style="width: 15.05pt;"><br>
                  </td>
                  <td style="width: 11.45pt; vertical-align: top; align: right;">c.</td>
                  <td style="width: auto; vertical-align: top;">
                    <div>the income concerned &#9744; is/ &#9744; is not subject to tax in (insert the recipient&#8217;s country of residence)<u>&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160; </u>.</div>
                  </td>
                </tr>

            </table>
            <div style="line-height: 1.25;">
              <div>
                <div>&#160;</div>
              </div>
            </div>
          </div>
        </div>
      </div>
      <table cellspacing="0" cellpadding="0" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;">

          <tr>
            <td rowspan="1" style="width: 20%; vertical-align: top; text-align: center; border-bottom: 2px solid rgb(0, 0, 0);">&#160;</td>
            <td rowspan="1" style="width: 20%; vertical-align: top; text-align: center; padding-bottom: 2px;">&#160;</td>
            <td rowspan="1" style="width: 20%; vertical-align: top; text-align: center; border-bottom: 2px solid rgb(0, 0, 0);">&#160;</td>
            <td rowspan="1" style="width: 20.02%; vertical-align: top; text-align: center; padding-bottom: 2px;">&#160;</td>
            <td rowspan="1" style="width: 20%; vertical-align: top; text-align: center; border-bottom: 2px solid rgb(0, 0, 0);">&#160;</td>
          </tr>
          <tr>
            <td style="width: 20%; vertical-align: top; text-align: center;">
              <div style="line-height: 1.25; font-family: 'Times New Roman',Times,serif;">Date of Signature</div>
            </td>
            <td style="width: 20%; vertical-align: top; text-align: center;">&#160;</td>
            <td style="width: 20%; vertical-align: top; text-align: center;">
              <div style="line-height: 1.25; font-family: 'Times New Roman',Times,serif;">Signature</div>
            </td>
            <td style="width: 20.02%; vertical-align: top; text-align: center;">&#160;</td>
            <td style="width: 20%; vertical-align: top; text-align: center;">
              <div style="line-height: 1.25; font-family: 'Times New Roman',Times,serif;">Official Stamp</div>
            </td>
          </tr>

      </table>
      <div style="line-height: 1.25;"><br style="line-height: 1.25;">
      </div>
      <table cellspacing="0" cellpadding="0" class="DSPFListTable" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;">

          <tr>
            <td style="width: 11.1pt; vertical-align: top; align: right;">2.</td>
            <td style="width: auto; vertical-align: top;">Address of certifying official:<u> &#160; &#160; &#160; &#160; &#160; &#160;&#160; &#160; &#160; &#160;&#160;&#160;&#160;&#160;&#160;&#160; </u><br>
            </td>
          </tr>

      </table>
      <div style="line-height: 1.25;"><br style="line-height: 1.25;">
      </div>
      <table cellspacing="0" cellpadding="0" class="DSPFListTable" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;">

          <tr>
            <td style="width: 11.1pt; vertical-align: top; align: right;">3.</td>
            <td style="width: auto; vertical-align: top;">
              <div>Position or Title of certifying official:<u> &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160;&#160;&#160;&#160;&#160;&#160;&#160; </u></div>
            </td>
          </tr>

      </table>
      <div style="line-height: 1.25;"><br style="line-height: 1.25;">
      </div>
      <table cellspacing="0" cellpadding="0" class="DSPFListTable" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;">

          <tr>
            <td style="width: 11.1pt; vertical-align: top; align: right;">4.</td>
            <td style="width: auto; vertical-align: top;">
              <div>Name of Income Tax Authority official making this certification:<u> &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160;&#160;&#160;&#160;&#160;&#160;&#160; </u></div>
            </td>
          </tr>

      </table>
    </div>
    <div style="line-height: 1.25">&#160;</div>
    <div class="BRPFPageBreakArea" style="clear: both; margin-top: 10pt; margin-bottom: 10pt;">
      <div class="BRPFPageNumberArea" style="text-align: center;"><font class="BRPFPageNumber" style="color: #000000; font-weight: normal; font-style: normal;">3</font></div>
      <div class="BRPFPageBreak" 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><u> </u><br>
      <div style="line-height: 1.25;"> <img src="image00004.jpg"></div>
      <div style="margin-left: 10.9pt; line-height: 1.25; font-weight: bold;"><u> <br>
        </u></div>
      <div style="margin-left: 10.9pt; line-height: 1.25; font-weight: bold;"><u>PART C: DOCUMENTATION</u></div>
      <div style="line-height: 1.25">&#160;</div>
      <div style="line-height: 1.25;"></div>
      <div style="margin-left: 10.9pt; line-height: 1.25;"><font style="font-weight: bold;">With regard to an Individual </font>- List all documents attached &#8211;:</div>
      <table cellspacing="0" cellpadding="0" id="z3fd533b595ec4d5bb67230c94faf0159" class="DSPFListTable" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;">

          <tr>
            <td style="width: 10.85pt;"><br>
            </td>
            <td style="width: 18.05pt; vertical-align: top; align: right;">1.</td>
            <td style="width: auto; vertical-align: top; text-align: justify;">
              <div>Copy of passport</div>
            </td>
          </tr>

      </table>
      <table cellspacing="0" cellpadding="0" id="zc206cb9538f54d4f8bce3abe178279a9" class="DSPFListTable" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;">

          <tr>
            <td style="width: 10.9pt;"><br>
            </td>
            <td style="width: 18pt; vertical-align: top; align: right;">2.</td>
            <td style="width: auto; vertical-align: top; text-align: justify;">
              <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>
            </td>
          </tr>

      </table>
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          <tr>
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            <td style="width: 18pt; vertical-align: top; align: right;">3.</td>
            <td style="width: auto; vertical-align: top; text-align: justify;">
              <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>
            </td>
          </tr>

      </table>
      <table cellspacing="0" cellpadding="0" id="zfaa5eeb6c7bb4a2a9f32a36724f8f6b9" class="DSPFListTable" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;">

          <tr>
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            </td>
            <td style="width: 18pt; vertical-align: top; align: right;">4.</td>
            <td style="width: auto; vertical-align: top; text-align: justify;">
              <div>Required Details Form &#8211; attached.</div>
            </td>
          </tr>

      </table>
      <table cellspacing="0" cellpadding="0" id="z25f3e358d0194a29ab3fae7ac06f1a32" class="DSPFListTable" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;">

          <tr>
            <td style="width: 10.9pt;"><br>
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            <td style="width: 18pt; vertical-align: top; align: right;">5.</td>
            <td style="width: auto; vertical-align: top; text-align: justify;">
              <div>US tax form (W8/w9)</div>
            </td>
          </tr>

      </table>
      <div style="line-height: 1.25">&#160;</div>
      <div style="margin-left: 10.9pt; line-height: 1.25;"><font style="font-weight: bold;">With regard to a Legal Entity </font>- List all documents attached:</div>
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          <tr>
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            <td style="width: 18.05pt; vertical-align: top; align: right;">1.</td>
            <td style="width: auto; vertical-align: top; text-align: justify;">
              <div>Copy of Certificate of Incorporation</div>
            </td>
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      <table cellspacing="0" cellpadding="0" id="zd8cce4ca7ec941588e4cff73882d6e92" class="DSPFListTable" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;">

          <tr>
            <td style="width: 10.9pt;"><br>
            </td>
            <td style="width: 18pt; vertical-align: top; align: right;">2.</td>
            <td style="width: auto; vertical-align: top; text-align: justify;">
              <div>List of shareholders of the Legal Entity and declarations regarding their state of residency for tax purposes.</div>
            </td>
          </tr>

      </table>
      <table cellspacing="0" cellpadding="0" id="z047bc676f602466fb954e92616e3c11d" class="DSPFListTable" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;">

          <tr>
            <td style="width: 10.9pt;"><br>
            </td>
            <td style="width: 18pt; vertical-align: top; align: right;">3.</td>
            <td style="width: auto; vertical-align: top; text-align: justify;">
              <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>
            </td>
          </tr>

      </table>
      <table cellspacing="0" cellpadding="0" id="z3c7221c86c08435ea327de2b7d22cf8e" class="DSPFListTable" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;">

          <tr>
            <td style="width: 10.9pt;"><br>
            </td>
            <td style="width: 18pt; vertical-align: top; align: right;">4.</td>
            <td style="width: auto; vertical-align: top; text-align: justify;">
              <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>
            </td>
          </tr>

      </table>
      <table cellspacing="0" cellpadding="0" id="z0f967de55ffd4dd0886d4474796c4a3f" class="DSPFListTable" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;">

          <tr>
            <td style="width: 10.9pt;"><br>
            </td>
            <td style="width: 18pt; vertical-align: top; align: right;">5.</td>
            <td style="width: auto; vertical-align: top;">
              <div>Required Details Form &#8211; attached.</div>
            </td>
          </tr>

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          <tr>
            <td style="width: 10.9pt;"><br>
            </td>
            <td style="width: 18pt; vertical-align: top; align: right;">6.</td>
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              <div>US tax form (W8/w9) of the entity</div>
            </td>
          </tr>

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      <table cellspacing="0" cellpadding="0" id="z356b0734ccac4b5294c285175829668d" class="DSPFListTable" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;">

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            </td>
            <td style="width: 18pt; vertical-align: top; align: right;">7.</td>
            <td style="width: auto; vertical-align: top; text-align: justify;">
              <div>Controlling Person Required Details Form &#8211; attached.</div>
            </td>
          </tr>

      </table>
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          <tr>
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            <td style="width: 18pt; vertical-align: top; align: right;">8.</td>
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              <div>Copy of passport of the Controlling Person</div>
            </td>
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      <table cellspacing="0" cellpadding="0" id="zad77c59385f94fd4a019b77b2100ee72" class="DSPFListTable" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;">

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            </td>
            <td style="width: 18pt; vertical-align: top; align: right;">9.</td>
            <td style="width: auto; vertical-align: top; text-align: justify;">
              <div>US tax form (W8/w9) of the Controlling person</div>
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          </tr>

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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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    <div>
      <div style="text-align: right; line-height: 1.25; font-weight: bold;"><u>Exhibit 99.3</u></div>
    </div>
    <div> <br>
      <div style="line-height: 1.25;">
        <div style="text-align: center;"><img src="image00007.jpg"></div>
        <br style="line-height: 1.25;">
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      <div style="text-align: center; line-height: 1.25; font-weight: bold;">Beneficiary's Details &#8211; ESOP</div>
      <div style="line-height: 1.25">&#160;</div>
      <div style="text-align: center; text-indent: -7.1pt; margin-left: 7.1pt; line-height: 1.25; font-weight: bold;">ZIM</div>
      <div style="line-height: 1.25;"><br style="line-height: 1.25;">
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      <div style="text-indent: -7.1pt; margin-left: 7.1pt; line-height: 1.25; font-weight: bold;">Dear Beneficiary,</div>
      <div style="margin-right: 18.6pt; line-height: 1.25;">ESOP would like to thank you to for joining us and welcome you onboard.<br>
        In order to set up an account on your behalf, please fill out the information requested within the form and send to &#8211; <font style="font-weight: bold;"><u>esop-sp@esop.co.il</u></font></div>
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      <div style="text-indent: -0.5pt; margin-left: 0.5pt; line-height: 1.25;"><font style="font-weight: bold;">Part 1 &#8211; Identification of Beneficiary </font>(in case of Legal Entity, please fill Annex I)</div>
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      <div style="text-indent: -21.3pt; margin-left: 21.3pt; line-height: 1.25; font-weight: bold;">Beneficiary Information:</div>
      <div style="text-indent: -21.3pt; margin-left: 21.3pt; line-height: 1.25; font-weight: bold;"> <br>
      </div>
      <div style="text-indent: -21.3pt; margin-left: 21.3pt; line-height: 1.25;">Full Name of Beneficiary<font style="font-weight: bold;">: </font><font style="font-weight: bold; font-style: italic;">(</font><font style="font-style: italic;">First and
          Last Name/Legal name of the corporation):</font>___________________________</div>
      <div style="text-indent: -21.3pt; margin-left: 21.3pt; line-height: 1.25;">____________________________________________________________<font style="font-weight: bold;">_____________________________</font></div>
      <div style="text-indent: -21.3pt; margin-left: 21.3pt; line-height: 1.25;"><font style="font-weight: bold;"> <br>
        </font></div>
      <div style="text-indent: -21.3pt; margin-left: 21.3pt; line-height: 1.25;">ID/Passport No. /Incorporation No.: ____________________________________________________________</div>
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      </div>
      <div style="text-indent: -21.3pt; margin-left: 21.3pt; line-height: 1.25;">Date of Birth/Incorporation Date: ______________________________________________________________</div>
      <div style="text-indent: -21.3pt; margin-left: 21.3pt; line-height: 1.25;"> <br>
      </div>
      <div style="text-indent: -21.3pt; margin-left: 21.3pt; line-height: 1.25;">Place of Birth/Incorporation place: <font style="font-weight: bold;">Town:</font> ______________________<font style="font-weight: bold;"> Country:</font>
        __________________________</div>
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      <div style="text-indent: -21.3pt; margin-left: 21.3pt; line-height: 1.25;">Current Residence:<font style="font-weight: bold;">&#160;Address:</font> _________________________________________________________________</div>
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      <div style="text-indent: -21.3pt; margin-left: 21.3pt; line-height: 1.25;"><font style="font-weight: bold;">Town:______________________&#160; country:____________________ Postal code/zip code:</font> ________________</div>
      <div style="text-indent: -21.3pt; margin-left: 21.3pt; line-height: 1.25;"> <br>
      </div>
      <div style="text-indent: -21.3pt; margin-left: 21.3pt; line-height: 1.25;"><font style="font-weight: bold;">Mailing Address</font>: (please only complete if different from above) ______________________________________</div>
      <div style="text-indent: -21.3pt; margin-left: 21.3pt; line-height: 1.25;"> <br>
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      <div style="text-indent: -21.3pt; margin-left: 21.3pt; line-height: 1.25;"><font style="font-weight: bold;">Email:</font> ___________________________________________________________________________________</div>
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      </div>
      <div style="text-indent: -21.3pt; margin-left: 21.3pt; line-height: 1.25; font-weight: bold;">Telephone #1: ____________________________ Telephone #2: _____________________________________</div>
      <div style="line-height: 1.25;"><br style="line-height: 1.25;">
      </div>
      <div style="text-indent: -21.3pt; margin-left: 21.3pt; line-height: 1.25; font-weight: bold;">Please attach:</div>
      <div style="line-height: 1.25">&#160;</div>
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            <td style="width: 21.3pt; vertical-align: top; align: right;">&#10004;</td>
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              <div><font style="font-weight: bold;">A copy of your identification card or your passport or your incorporation certificate.</font><br>
                * Israeli Citizen is requested to provide a copy of the identification card</div>
            </td>
          </tr>

      </table>
      <div style="line-height: 1.25">&#160;</div>
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            <td style="width: 21.3pt; vertical-align: top; align: right;">&#10004;</td>
            <td style="width: auto; vertical-align: top;">
              <div style="font-weight: bold;">A proof of ownership of your bank account (void check or any other statement).</div>
            </td>
          </tr>

      </table>
      <div style="line-height: 1.25">&#160;</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="z8f336c4f9e284bb2ba0838dd2a5d6469">

          <tr>
            <td style="width: 21.3pt; vertical-align: top; align: right;">&#10004;</td>
            <td style="width: auto; vertical-align: top;">
              <div><font style="font-weight: bold;">Please attach</font>:W-9 / W-8BEN / W-8BEN-E / W-8IMY / W-8EXP / W-8ECI</div>
            </td>
          </tr>

      </table>
      <div style="margin-left: 5.4pt; line-height: 1.25;">&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;*such forms can be downloaded from&#160;<font style="font-weight: bold;"><u>www.irs.gov</u></font></div>
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      <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 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>
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      <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.<font style="font-style: italic;">&#160; </font><font style="font-weight: bold; font-style: italic;"></font></div>
      <div style="text-align: justify; margin-right: 17.2pt; line-height: 1.25;"><font style="font-weight: bold; font-style: italic;"> <br>
        </font></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 (Please explain why you are unable to obtain a TIN in the below table if you have selected this reason)</font></div>
      <div style="text-align: justify; margin-right: 17.2pt; line-height: 1.25;"><font style="font-style: italic;"> <br>
        </font></div>
      <div style="text-align: justify; line-height: 1.25;"><font style="font-weight: bold; font-style: italic;">Reason C</font><font style="font-style: italic;"> - </font>No TIN is required.<font style="font-style: italic;">&#160;</font>(<font style="font-style: italic;">Note. Only select this reason if the domestic law of the relevant jurisdiction does not require the collection of the TIN issued by such jurisdiction)</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="zbe11e9d0e9344a76a295d9f8d76ba21d">

          <tr>
            <td style="width: 4.22%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">&#160;</td>
            <td style="width: 35.23%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
              <div style="text-align: center; line-height: 1.25; font-family: 'Times New Roman', Times, serif; font-weight: bold;">Country/Jurisdiction of tax residence</div>
            </td>
            <td style="width: 21.06%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
              <div style="text-align: center; margin-left: 1.1pt; line-height: 1.25; font-family: 'Times New Roman', Times, serif; font-weight: bold;">TIN</div>
            </td>
            <td style="width: 39.48%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px solid rgb(0, 0, 0);">
              <div style="text-align: center; margin-left: 2.95pt; line-height: 1.25; font-family: 'Times New Roman', Times, serif; font-weight: bold;">If no TIN available enter Reason <font style="font-style: italic;">A, B or C</font></div>
            </td>
          </tr>
          <tr>
            <td style="width: 4.22%; vertical-align: middle; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
              <div style="margin-left: 3.95pt; line-height: 1.25; font-family: 'Times New Roman', Times, serif; font-weight: bold;">1</div>
            </td>
            <td style="width: 35.23%; vertical-align: middle; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">&#160;</td>
            <td style="width: 21.06%; vertical-align: middle; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">&#160;</td>
            <td style="width: 39.48%; vertical-align: middle; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px solid rgb(0, 0, 0);">&#160;</td>
          </tr>
          <tr>
            <td style="width: 4.22%; vertical-align: middle; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
              <div style="margin-left: 3.95pt; line-height: 1.25; font-family: 'Times New Roman', Times, serif; font-weight: bold;">2</div>
            </td>
            <td style="width: 35.23%; vertical-align: middle; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">&#160;</td>
            <td style="width: 21.06%; vertical-align: middle; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">&#160;</td>
            <td style="width: 39.48%; vertical-align: middle; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px solid rgb(0, 0, 0);">&#160;</td>
          </tr>
          <tr>
            <td style="width: 4.22%; vertical-align: middle; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-bottom: 2px solid rgb(0, 0, 0);">
              <div style="margin-left: 3.95pt; line-height: 1.25; font-family: 'Times New Roman', Times, serif; font-weight: bold;">3</div>
            </td>
            <td style="width: 35.23%; vertical-align: middle; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-bottom: 2px solid rgb(0, 0, 0);">&#160;</td>
            <td style="width: 21.06%; vertical-align: middle; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-bottom: 2px solid rgb(0, 0, 0);">&#160;</td>
            <td style="width: 39.48%; vertical-align: middle; border-width: 2px; border-style: solid; border-color: rgb(0, 0, 0);">&#160;</td>
          </tr>

      </table>
      <div style="line-height: 1.25">&#160;</div>
      <div style="line-height: 1.25;"><font style="font-style: italic;">Please explain why you are unable to obtain a TIN if you selected Reason</font><font style="font-weight: bold; font-style: italic;"> B </font><font style="font-style: italic;">above</font>:</div>
      <div style="line-height: 1.25">&#160;</div>
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              <div style="line-height: 1.25; font-family: 'Times New Roman', Times, serif; font-weight: bold;">1</div>
            </td>
            <td style="width: 95.78%; vertical-align: middle; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px solid rgb(0, 0, 0);">&#160;</td>
          </tr>
          <tr>
            <td style="width: 4.22%; vertical-align: middle; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
              <div style="line-height: 1.25; font-family: 'Times New Roman', Times, serif; font-weight: bold;">2</div>
            </td>
            <td style="width: 95.78%; vertical-align: middle; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px solid rgb(0, 0, 0);">&#160;</td>
          </tr>
          <tr>
            <td style="width: 4.22%; vertical-align: middle; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-bottom: 2px solid rgb(0, 0, 0);">
              <div style="line-height: 1.25; font-family: 'Times New Roman', Times, serif; font-weight: bold;">3</div>
            </td>
            <td style="width: 95.78%; vertical-align: top; border-width: 2px; border-style: solid; border-color: rgb(0, 0, 0);">&#160;</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: #000000;" class="DSPFListTable" id="z8572285b85ca46e481d3299636f1145e">

          <tr>
            <td style="width: -3.8pt;"><br>
            </td>
            <td style="width: 18pt; vertical-align: top; align: right;">&#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: #000000;" class="DSPFListTable" id="ze36f1972bc5b42f7a34bd92734794e0a">

          <tr>
            <td style="width: -3.8pt;"><br>
            </td>
            <td style="width: 18pt; vertical-align: top; align: right;">&#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 OECD automatic exchange of information portal&#160;<font style="font-weight: bold;">www.oecd.org/tax/automatic-exchange</font></div>
            </td>
          </tr>

      </table>
      <div style="line-height: 1.25;"><br style="line-height: 1.25;">
      </div>
      <div class="BRPFPageBreakArea" style="clear: both; margin-top: 10pt; margin-bottom: 10pt;">
        <div class="BRPFPageBreak" 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; font-weight: bold;">Part 3 &#8211; Wire information</div>
      <div style="line-height: 1.25">&#160;</div>
      <div style="text-align: justify; line-height: 1.25; font-weight: bold;">Currency of choice:</div>
      <div style="line-height: 1.25;"><br style="line-height: 1.25;">
      </div>
      <div style="text-align: justify; line-height: 1.25;">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 USD.</div>
      <div style="line-height: 1.25;"><br style="line-height: 1.25;">
      </div>
      <div style="text-align: justify; line-height: 1.25; font-weight: bold;">Please mark only one alternative:</div>
      <div style="line-height: 1.25;"><br style="line-height: 1.25;">
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      <div style="line-height: 1.25;">
        <table cellspacing="0" cellpadding="0" border="0" id="zdddb3775b761489fafc01239afeb648d" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; color: #000000; width: 100%;">

            <tr>
              <td style="width: 2.2%;">
                <div><font style="font-family: 'Segoe UI Symbol', sans-serif;">&#9744;</font></div>
              </td>
              <td style="width: 23%;">
                <div>I would like to receive the</div>
              </td>
              <td style="width: 2.2%;">
                <div><font style="font-family: 'Segoe UI Symbol', sans-serif;">&#9744;</font></div>
              </td>
              <td style="width: 73.35%;">
                <div>I would like to receive the</div>
              </td>
            </tr>
            <tr>
              <td style="width: 2.2%;">
                <div>&#160;</div>
              </td>
              <td style="width: 23%;">
                <div>Payment in <font style="font-weight: bold;">NIS</font> <br>
                </div>
              </td>
              <td style="width: 2.2%;">
                <div>&#160;</div>
              </td>
              <td style="width: 73.35%;">
                <div>payment in <font style="font-weight: bold;">US dollar</font></div>
              </td>
            </tr>
            <tr>
              <td style="width: 2.2%;">
                <div>&#160;</div>
              </td>
              <td style="width: 23%;">
                <div>&#160;</div>
              </td>
              <td style="width: 2.2%;">
                <div>&#160;</div>
              </td>
              <td style="width: 73.35%;">
                <div>&#160;</div>
              </td>
            </tr>

        </table>
      </div>
      <div style="line-height: 1.25;">&#160;&#160;&#160; <br>
        <font style="font-weight: bold;"></font></div>
      <div style="line-height: 1.25;">*Additional charges may apply by the receiving bank in case of USD wires such as intermediary bank fee</div>
      <div style="text-indent: -21.3pt; margin-left: 21.3pt; line-height: 1.25;">&#160; (Please contact your bank for additional info)</div>
      <div style="line-height: 1.25;"><br style="line-height: 1.25;">
      </div>
      <div style="text-indent: -21.3pt; margin-left: 21.3pt; line-height: 1.25; font-weight: bold;">Mandatory details &#8211; international wire:</div>
      <div style="line-height: 1.25">&#160;</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="z3067dc8c7e3948dd9a546a8bc6934a45">

          <tr>
            <td style="width: 21.3pt; vertical-align: top; align: right;">1.</td>
            <td style="width: auto; vertical-align: top;">
              <div>Bank Name : _________________________________________________________________________</div>
            </td>
          </tr>

      </table>
      <div style="line-height: 1.25">&#160;</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="z6b95f86e86dc4174bd486681d3e7f73f">

          <tr>
            <td style="width: 21.3pt; vertical-align: top; align: right;">2.</td>
            <td style="width: auto; vertical-align: top;">
              <div>Account Name : _______________________________________________________________________</div>
            </td>
          </tr>

      </table>
      <div style="line-height: 1.25">&#160;</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="z15362358f5b6482e82b4c4ff6eb0a9b6">

          <tr>
            <td style="width: 21.3pt; vertical-align: top; align: right;">3.</td>
            <td style="width: auto; vertical-align: top;">
              <div>Account Number : _____________________________________________________________________</div>
            </td>
          </tr>

      </table>
      <div style="line-height: 1.25">&#160;</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="zb6c30c77561f4d89b84efff6923d2c55">

          <tr>
            <td style="width: 21.3pt; vertical-align: top; align: right;">4.</td>
            <td style="width: auto; vertical-align: top;">
              <div>Swift code : __________________________________________________________________________</div>
            </td>
          </tr>

      </table>
      <div style="line-height: 1.25">&#160;</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="zbd5b5d4f4d1443c7a6a23554d03fcf6a">

          <tr>
            <td style="width: 21.3pt; vertical-align: top; align: right;">5.</td>
            <td style="width: auto; vertical-align: top;">
              <div>ABA (routing #) : _____________________________________________________________________</div>
            </td>
          </tr>

      </table>
      <div style="line-height: 1.25">&#160;</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="z7f67e9e47be04a3fbf4cdc81669e8c73">

          <tr>
            <td style="width: 21.3pt; vertical-align: top; align: right;">6.</td>
            <td style="width: auto; vertical-align: top;">
              <div> IBAN: ______________________________________________________________________________<br>
                <div><br>
                </div>
                <font style="font-weight: bold;">In case of a Sub-Account:</font></div>
            </td>
          </tr>

      </table>
      <div style="line-height: 1.25">&#160;</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="z499f5316afdd410e8347137130c7042f">

          <tr>
            <td style="width: 21.3pt; vertical-align: top; align: right;">7.</td>
            <td style="width: auto; vertical-align: top;">
              <div>For Further credit to (Account name) :</div>
            </td>
          </tr>

      </table>
      <div style="line-height: 1.25">&#160;</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="z8a92677caa414fbf910373d5c4ebb9ad">

          <tr>
            <td style="width: 21.3pt; vertical-align: top; align: right;">8.</td>
            <td style="width: auto; vertical-align: top;">
              <div>Sub-Account Number:__________________________________________________________________</div>
            </td>
          </tr>

      </table>
      <div style="line-height: 1.25">&#160;</div>
      <div style="text-indent: -21.3pt; margin-left: 21.3pt; line-height: 1.25; font-weight: bold;">Mandatory details &#8211; domestic wire:</div>
      <div style="line-height: 1.25">&#160;</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="z59d232857c6540329573b06a1434d478">

          <tr>
            <td style="width: 21.3pt; vertical-align: top; align: right;">1.</td>
            <td style="width: auto; vertical-align: top;">
              <div>Bank Name : __________________________________________________________________________</div>
            </td>
          </tr>

      </table>
      <div style="line-height: 1.25">&#160;</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="z2ffbbcfca6104dde8259ecc54f98c6d7">

          <tr>
            <td style="width: 21.3pt; vertical-align: top; align: right;">2.</td>
            <td style="width: auto; vertical-align: top;">
              <div>Account Name : ________________________________________________________________________</div>
            </td>
          </tr>

      </table>
      <div style="line-height: 1.25">&#160;</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="z39a1bdbcb7524516b21cbf66e20c46b8">

          <tr>
            <td style="width: 21.3pt; vertical-align: top; align: right;">3.</td>
            <td style="width: auto; vertical-align: top;">
              <div>Branch Number : _______________________________________________________________________</div>
            </td>
          </tr>

      </table>
      <div style="line-height: 1.25">&#160;</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="zc25f34def2c24043a16e303858283724">

          <tr>
            <td style="width: 21.3pt; vertical-align: top; align: right;">4.</td>
            <td style="width: auto; vertical-align: top;">
              <div>Account Number : ______________________________________________________________________</div>
            </td>
          </tr>

      </table>
      <div style="line-height: 1.25">&#160;</div>
      <table cellspacing="0" cellpadding="0" class="DSPFListTable" id="26c275765c1a4bb8bd023dd71d4b7028" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; width: 100%; text-align: left; color: #000000;">

          <tr>
            <td style="width: 21.3pt; vertical-align: top; align: right;">5.</td>
            <td style="width: auto; vertical-align: top;">
              <div style="text-indent: -21.3pt; margin-left: 21.3pt; line-height: 1.25;">IBAN: _______________________________________________________________________________</div>
            </td>
          </tr>

      </table>
      <div style="text-indent: -21.3pt; margin-left: 21.3pt; line-height: 1.25;"><br>
      </div>
      <div class="BRPFPageBreakArea" style="clear: both; margin-top: 10pt; margin-bottom: 10pt;">
        <div class="BRPFPageBreak" 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="text-align: center; line-height: 1.25; font-weight: bold;">Part 4 &#8211; Declarations and Signature</div>
      <div style="line-height: 1.25">&#160;</div>
      <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;"><br style="line-height: 1.25;">
      </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;">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>
      <div style="line-height: 1.25">&#160;</div>
      <div style="line-height: 1.25">
        <div style="border: #000000 2px solid; padding: 5px; width: 99%;">
          <div>&#160;</div>
          <div>
            <div style="line-height: 1.25;">
              <div style="margin-left: 0.95pt; line-height: 1.25; font-weight: bold;">I declare that all statements made in this declaration are, to the best of my knowledge and belief, correct and complete.</div>
              <div style="line-height: 1.25">&#160;</div>
            </div>
            <div style="line-height: 1.25;">
              <div style="text-indent: -0.5pt; margin-left: 1.45pt; line-height: 1.25;">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.</div>
              <div style="line-height: 1.25">&#160;</div>
            </div>
            <div style="line-height: 1.25;">
              <div style="text-indent: -0.5pt; margin-left: 1.45pt; line-height: 1.25;">Signature:&#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160;&#160; ________________________________________________&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;</div>
              <div style="line-height: 1.25">&#160;</div>
              <div style="text-indent: -0.5pt; margin-left: 1.45pt; line-height: 1.25;">Print name:&#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; ________________________________________________</div>
              <div style="line-height: 1.25">&#160;</div>
              <div style="text-indent: -0.5pt; margin-left: 1.45pt; line-height: 1.25;">Date:&#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; ________________________________________________</div>
              <div style="line-height: 1.25">&#160;</div>
            </div>
            <div style="line-height: 1.25;">
              <div style="text-indent: -0.5pt; margin-left: 1.45pt; line-height: 1.25;"><font style="font-weight: bold;">Note</font>: If you are not the Beneficiary please indicate the capacity in which you are signing the form.&#160; If signing under a power
                of attorney please also attach a certified copy of the power of attorney.</div>
              <div style="line-height: 1.25">&#160;</div>
            </div>
            <div style="line-height: 1.25;">
              <div style="text-indent: -0.5pt; margin-left: 1.45pt; line-height: 1.25;">Capacity:&#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; _________________________________________________</div>
              <div style="line-height: 1.25">&#160;</div>
            </div>
          </div>
        </div>
        <br>
      </div>
      <div style="margin-right: 21.3pt; line-height: 1.25;">For additional info, please contact us at: <font style="font-weight: bold;"><u>esop-sp@esop.co.il</u></font><br>
        972-3-7536823&#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; Domestic calls: 1700-70-37-67</div>
      <br>
      <hr noshade="noshade" align="left" style="background-color: #000000; border: 0px; height: 1px; width: 2in; margin-left: 0pt; margin-right: auto; color: #000000;">
      <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 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;">2</sup><sup style="font-family: David, David, sans-serif; vertical-align: text-top; line-height: 1; font-size: smaller;">&#160;</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>
      <div style="line-height: 1.25;"><br style="line-height: 1.25;">
      </div>
      <div class="BRPFPageBreakArea" style="clear: both; margin-top: 10pt; margin-bottom: 10pt;">
        <div class="BRPFPageBreak" 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="text-align: center; line-height: 1.25;">Annex I &#8211; Legal Entity</div>
      <div style="line-height: 1.25;"><br style="line-height: 1.25;">
      </div>
      <div style="text-align: justify; text-indent: -0.5pt; margin-left: 0.5pt; line-height: 1.25;">Please provide the Legal Entity's (not applicable to individual account holders) Status by ticking <font style="font-weight: bold;">one</font> of the
        following boxes (please consult with your tax adviser):&#160;&#160; </div>
      <div style="line-height: 1.25">&#160;</div>
      <div style="line-height: 1.25">
        <table cellspacing="0" cellpadding="0" border="0" id="z15e534778c704d03b17957db1b4ccd02" style="font-family: 'Times New Roman', Times, serif; font-size: 10pt; color: #000000; width: 100%;">

            <tr>
              <td style="width: 2%; text-align: left; vertical-align: top;">
                <div><font style="font-family: 'Times New Roman',Times,serif; font-weight: bold;">1.</font></div>
              </td>
              <td style="width: 2%; text-align: left; vertical-align: top;">
                <div><font style="font-family: 'Times New Roman',Times,serif; font-weight: bold;">(a)</font></div>
              </td>
              <td style="width: 93%; text-align: left; vertical-align: top;">
                <div><font style="font-family: 'Times New Roman',Times,serif;">Financial Institution &#8211; Investment Entity</font></div>
              </td>
              <td style="width: 3%; text-align: left; vertical-align: top;">
                <div>&#160;</div>
              </td>
            </tr>
            <tr>
              <td style="width: 2%; text-align: left; vertical-align: top;">
                <div>&#160;</div>
              </td>
              <td style="width: 2%; text-align: left; vertical-align: top;">
                <div>&#160;</div>
              </td>
              <td style="width: 93%; text-align: left; vertical-align: top;">
                <div>&#160;</div>
              </td>
              <td style="width: 3%; text-align: left; vertical-align: top;">
                <div>&#160;</div>
              </td>
            </tr>
            <tr>
              <td style="width: 2%; text-align: left; vertical-align: top;">
                <div>&#160;</div>
              </td>
              <td style="width: 2%; text-align: left; vertical-align: top;">
                <div style="font-weight: bold;">&#160;i.</div>
              </td>
              <td style="width: 93%; text-align: left; vertical-align: top;">
                <div>
                  <div style="font-family: 'Times New Roman',Times,serif;">An Investment Entity located in a Non-Participating Jurisdiction and managed by another Financial Institution<font style="font-family: 'Segoe UI Symbol',sans-serif;"><br>
                    </font></div>
                </div>
              </td>
              <td style="width: 3%; text-align: center; vertical-align: top;">
                <div><font style="font-family: 'Segoe UI Symbol',sans-serif;">&#9744;</font></div>
              </td>
            </tr>
            <tr>
              <td rowspan="1" style="width: 2%; text-align: left; vertical-align: top;">&#160;</td>
              <td rowspan="1" style="width: 2%; text-align: left; vertical-align: top;">&#160;</td>
              <td rowspan="1" style="width: 93%; text-align: left; vertical-align: top;">&#160;</td>
              <td rowspan="1" style="width: 3%; text-align: center; vertical-align: top;">&#160;</td>
            </tr>
            <tr>
              <td rowspan="1" style="width: 2%; text-align: left; vertical-align: top;">&#160;</td>
              <td rowspan="1" style="width: 2%; text-align: left; vertical-align: top; font-weight: bold;">ii.</td>
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              <td rowspan="1" style="width: 2%; text-align: left; vertical-align: top;">&#160;</td>
              <td rowspan="1" style="width: 2%; text-align: left; vertical-align: top;">&#160;</td>
              <td rowspan="1" style="width: 93%; text-align: left; vertical-align: top;">&#160;</td>
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              <td rowspan="1" style="width: 2%; text-align: left; vertical-align: top;">&#160;</td>
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              <td rowspan="1" style="width: 2%; text-align: left; vertical-align: top;">&#160;</td>
              <td rowspan="1" style="width: 2%; text-align: left; vertical-align: top;">&#160;</td>
              <td rowspan="1" style="width: 93%; text-align: left; vertical-align: top;">&#160;</td>
              <td rowspan="1" style="width: 3%; text-align: left; vertical-align: top;">&#160;</td>
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              <td rowspan="1" style="width: 2%; text-align: left; vertical-align: top;">&#160;</td>
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            <td style="width: 5.32%; vertical-align: top; padding-bottom: 2px; border-left: 2px solid rgb(0, 0, 0);">
              <div style="margin-left: 0.25pt; line-height: 1.25; font-size: 14pt;">.</div>
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            <td style="width: 2%; text-align: left; vertical-align: top; font-weight: bold;">(c)</td>
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              <div style="font-family: 'Times New Roman',Times,serif;">Active NFE &#8211; a corporation the stock of which is regularly traded on an established securities market or a corporation which is a related entity of such a corporation<br>
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            <td rowspan="1" style="width: 2%; text-align: left; vertical-align: top;">&#160;</td>
            <td rowspan="1" style="width: 93%; text-align: left; vertical-align: top;">&#160;</td>
            <td rowspan="1" style="width: 3%; text-align: left; vertical-align: top;">&#160;</td>
          </tr>
          <tr>
            <td rowspan="1" style="width: 2%; text-align: left; vertical-align: top;">&#160;</td>
            <td colspan="2" rowspan="1" style="width: 2%; text-align: left; vertical-align: top;">
              <div style="line-height: 1.25; font-family: 'Times New Roman',Times,serif;">If you have ticked (c), please provide the name of the established securities market on which the corporation is regularly Traded: ________________________________</div>
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            <td rowspan="1" style="width: 3%; text-align: left; vertical-align: top;">&#160;</td>
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          <tr>
            <td rowspan="1" style="width: 2%; text-align: left; vertical-align: top;">&#160;</td>
            <td colspan="2" rowspan="1" style="width: 2%; text-align: left; vertical-align: top;">&#160;</td>
            <td rowspan="1" style="width: 3%; text-align: left; vertical-align: top;">&#160;</td>
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          <tr>
            <td rowspan="1" style="width: 2%; text-align: left; vertical-align: top;">&#160;</td>
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              <div style="line-height: 1.25; font-family: 'Times New Roman',Times,serif;">If you are a Related Entity of a regularly traded corporation, please provide the name of the regularly traded corporation that the Entity in (c) is a Related Entity<font style="font-style: italic;">&#160;</font>of: ______________________________</div>
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            <td rowspan="1" style="width: 3%; text-align: left; vertical-align: top;">&#160;</td>
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            <td colspan="1" style="width: 2%; vertical-align: top;">&#160;</td>
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              <div style="margin-left: 13.3pt; line-height: 1.25; font-family: 'Segoe UI Symbol', sans-serif;">&#9744;</div>
            </td>
          </tr>
          <tr>
            <td colspan="1" style="width: 2%; vertical-align: top;">&#160;</td>
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              <div style="line-height: 1.25; font-family: 'Times New Roman',Times,serif;"><font style="font-weight: bold;">(e)</font>&#160; Active NFE &#8211; an International Organization</div>
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          <tr>
            <td colspan="1" style="width: 2%; vertical-align: top;">&#160;</td>
            <td style="width: 95%; vertical-align: top;">
              <div style="line-height: 1.25; font-family: 'Times New Roman',Times,serif;"><font style="font-weight: bold;">(f)</font>&#160; Active NFE &#8211; other than <font style="font-weight: bold;">(c)-(e)</font> (<font style="font-style: italic;">for example
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            <td style="width: 3%; vertical-align: top;">
              <div style="margin-left: 13.3pt; line-height: 1.25; font-family: 'Segoe UI Symbol', sans-serif;">&#9744;</div>
            </td>
          </tr>
          <tr>
            <td colspan="1" style="width: 2%; vertical-align: top;">&#160;</td>
            <td style="width: 95%; vertical-align: top;">
              <div style="line-height: 1.25; font-family: 'Times New Roman',Times,serif;"><font style="font-weight: bold;">(g)</font>&#160; Passive NFE</div>
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              <div style="margin-left: 13.3pt; line-height: 1.25; font-family: 'Segoe UI Symbol', sans-serif;">&#9744;</div>
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      <div style="margin-right: 4.4pt; line-height: 1.25;"><font style="font-weight: bold; font-style: italic;">2.</font><font style="font-style: italic;">&#160;&#160; </font>Please fill a separate form for each "Controlling Person"<sup style="vertical-align: text-top; line-height: 1; font-size: smaller;">3</sup>.</div>
      <div><br>
      </div>
      <hr noshade="noshade" align="left" style="background-color: #000000; border: 0px; height: 1px; width: 2in; margin-left: 0pt; margin-right: auto; color: #000000;">
      <div style="text-align: justify; line-height: 1.25;"><sup style="font-family: 'Times New Roman', serif; vertical-align: text-top; line-height: 1; font-size: smaller;">3</sup>&#160;"controlling person":</div>
      <div style="text-align: justify; line-height: 1.25;">(1) An individual with the ability to direct the actions of the corporation, whether alone or together with others or through them, whether directly or indirectly, including an ability arising from
        the articles of association of the corporation, by virtue of a contract in writing, verbally or otherwise, or an ability arising from any other source, except for the ability arising only from the fulfilling of the position of an office holder in
        the corporation:</div>
      <div style="text-align: justify; line-height: 1.25;">(2) Without derogating from the generality of the above said in paragraph (1), an individual will be deemed to be of controlling interest in the corporation if such person holds 25% or more of any
        type of means of control, and no other person holds the means of control of that type at a rate which is greater than his/her holdings: for this purpose, &#8216;holdings&#8217;- including holding together with others as defined in the Securities Law;</div>
      <div style="text-align: justify; line-height: 1.25;">(3) Without derogating from the generality of that stated in paragraphs (1) and- (2), in a corporation in which there is no individual as stated, the chairman of the board of directors in the
        company and a comparable office holder and the CEO, will be deemed to be as the controlling persons. If there are none of the above, the office holder who holds effective control in the corporation will be deemed the controlling person.</div>
      <div style="text-align: justify; line-height: 1.25;"> <br>
      </div>
      <div style="text-align: justify; line-height: 1.25;"> <br>
      </div>
      <div style="text-align: center; line-height: 1.25; font-family: 'Times New Roman',Times,serif;"> <img src="image00008.jpg"></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-99.4
<SEQUENCE>5
<FILENAME>exhibit_99-4.htm
<DESCRIPTION>EXHIBIT 99.4
<TEXT>
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    <div>
      <div style="text-align: right; line-height: 1.25; font-weight: bold;"><u>Exhibit 99.4</u></div>
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    <div> <br>
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    <div>
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      <div style="line-height: 1.25; font-weight: bold;">Beneficiary's Details &#8211; Controlling Person - ESOP</div>
      <div style="line-height: 1.25">&#160;</div>
      <div style="text-indent: -5.4pt; margin-left: 5.4pt; line-height: 1.25; font-weight: bold;">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:</div>
      <div style="text-indent: -5.4pt; margin-left: 5.4pt; line-height: 1.25; font-weight: bold;"> <br>
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      <div style="text-align: justify; text-indent: -7.1pt; margin-left: 7.1pt; line-height: 1.25;">________________________________________________________________________________________</div>
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      <div style="text-indent: -7.1pt; margin-left: 7.1pt; line-height: 1.25;">Dear Beneficiary,</div>
      <div style="text-indent: -7.1pt; margin-left: 7.1pt; line-height: 1.25;">As The "Controlling Person" of an entity, please fill out the information requested within the form.</div>
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      <div style="text-indent: -0.5pt; margin-left: 0.5pt; line-height: 1.25;"><font style="font-weight: bold;">Part 1 &#8211; Identification of Beneficiary </font>(in case of Legal Entity, please fill Annex I)</div>
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      <div style="text-indent: -21.3pt; margin-left: 21.3pt; line-height: 1.25; font-weight: bold;"><u>Beneficiary Information:</u></div>
      <div style="text-indent: -21.3pt; margin-left: 21.3pt; line-height: 1.25; font-weight: bold;"><u> <br>
        </u></div>
      <div style="text-indent: -21.3pt; margin-left: 21.3pt; line-height: 1.25;">Full Name of Beneficiary: (First and Last Name/Legal name of the corporation):________________________</div>
      <div style="text-indent: -21.3pt; margin-left: 21.3pt; line-height: 1.25;">____________________________________________________________</div>
      <div style="text-indent: -21.3pt; margin-left: 21.3pt; line-height: 1.25;"> <br>
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      <div style="text-indent: -21.3pt; margin-left: 21.3pt; line-height: 1.25;">ID No. /Passport No. /Incorporation No.: _______________________________________________________</div>
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      <div style="text-indent: -21.3pt; margin-left: 21.3pt; line-height: 1.25;">Date of Birth/Incorporation Date: _____________________________________________________________</div>
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      <div style="text-indent: -21.3pt; margin-left: 21.3pt; line-height: 1.25;">Place of Birth/Incorporation place: <font style="font-weight: bold;">Town:</font> ______________________<font style="font-weight: bold;"> Country:</font>
        _________________________</div>
      <div style="text-indent: -21.3pt; margin-left: 21.3pt; line-height: 1.25;"> <br>
      </div>
      <div style="text-indent: -21.3pt; margin-left: 21.3pt; line-height: 1.25;">Current Residence:<font style="font-weight: bold;">&#160;Address:</font> ________________________________________________________________</div>
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      <div style="text-indent: -21.3pt; margin-left: 21.3pt; line-height: 1.25;"><font style="font-weight: bold;">Town:______________________&#160; country:____________________ Postal code/zip code:</font> ________________</div>
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      <div style="text-indent: -21.3pt; margin-left: 21.3pt; line-height: 1.25;"><font style="font-weight: bold;">Mailing Address</font>: (please only complete if different from above) ______________________________________</div>
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      <div style="text-indent: -21.3pt; margin-left: 21.3pt; line-height: 1.25;"><font style="font-weight: bold;">Email:</font> __________________________________________________________________________________</div>
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      <div style="text-indent: -21.3pt; margin-left: 21.3pt; line-height: 1.25; font-weight: bold;">Telephone #1: ____________________________ Telephone #2: ____________________________________</div>
      <div style="line-height: 1.25">&#160;</div>
      <div style="line-height: 1.25;">
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        <div style="text-align: justify; line-height: 1.25;"><sup style="font-family: 'Times New Roman', serif; vertical-align: text-top; line-height: 1; font-size: smaller;">1</sup>&#160;"controlling person":</div>
        <div style="text-align: justify; line-height: 1.25;">(1) An individual with the ability to direct the actions of the corporation, whether alone or together with others or through them, whether directly or indirectly, including an ability arising
          from the articles of association of the corporation, by virtue of a contract in writing, verbally or otherwise, or an ability arising from any other source, except for the ability arising only from the fulfilling of the position of an office
          holder in the corporation:</div>
        <div style="text-align: justify; line-height: 1.25;">(2) Without derogating from the generality of the above said in paragraph (1), an individual will be deemed to be of controlling interest in the corporation if such person holds 25% or more of
          any type of means of control, and no other person holds the means of control of that type at a rate which is greater than his/her holdings: for this purpose, &#8216;holdings&#8217;- including holding together with others as defined in the Securities Law;</div>
        <div style="text-align: justify; line-height: 1.25;">(3) Without derogating from the generality of that stated in paragraphs (1) and- (2), in a corporation in which there is no individual as stated, the chairman of the board of directors in the
          company and a comparable office holder and the CEO, will be deemed to be as the controlling persons. If there are none of the above, the office holder who holds effective control in the corporation will be deemed the controlling person.</div>
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      <div style="line-height: 1.25; font-weight: bold;"><u>Please attach:</u></div>
      <div style="line-height: 1.25">&#160;</div>
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            <td style="width: 21.3pt; vertical-align: top; align: right;">&#10004;</td>
            <td style="width: auto; vertical-align: top;">
              <div><font style="font-weight: bold;"><u>A </u><u>copy of your identification card or your passport or your incorporation certificate.</u></font><br>
                * Israeli Citizen is requested to provide a copy of the identification card</div>
            </td>
          </tr>

      </table>
      <div style="line-height: 1.25">&#160;</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="z6ff5f46b3cd34e9485b1a5d36e78f95c">

          <tr>
            <td style="width: 21.3pt; vertical-align: top; align: right;">&#10004;</td>
            <td style="width: auto; vertical-align: top;">
              <div><font style="font-weight: bold;"><u>Please attach</u></font>:W-9 / W-8BEN / W-8BEN-E / W-8IMY / W-8EXP / W-8ECI</div>
            </td>
          </tr>

      </table>
      <div style="margin-left: 5.4pt; line-height: 1.25;">&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;*such forms can be downloaded from&#160;<font style="font-weight: bold;"><u>www.irs.gov</u></font></div>
      <div style="line-height: 1.25">&#160;</div>
      <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">&#160;</div>
      <div style="line-height: 1.25;"></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="font-weight: bold; font-style: italic;">Reason C</font><font style="font-style: italic;"> - </font>No TIN is required.<font style="font-style: italic;">&#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>
      <div style="line-height: 1.25;"></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="z556cb18fd38843449f39278bf6e17497">

          <tr>
            <td style="width: 4.6%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">&#160;</td>
            <td style="width: 29.46%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
              <div style="text-align: center; line-height: 1.25; font-weight: bold;">Country/Jurisdiction of tax residence</div>
            </td>
            <td style="width: 15.33%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
              <div style="text-align: center; margin-left: 1.1pt; line-height: 1.25; font-weight: bold;">TIN</div>
            </td>
            <td style="width: 50.61%; vertical-align: top; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px solid rgb(0, 0, 0);">
              <div style="text-align: center; margin-left: 2.95pt; line-height: 1.25; font-weight: bold;">If no TIN available enter Reason <font style="font-style: italic;">A, B or C</font></div>
            </td>
          </tr>
          <tr>
            <td style="width: 4.6%; vertical-align: middle; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
              <div style="margin-left: 3.95pt; line-height: 1.25; font-weight: bold;">1</div>
            </td>
            <td style="width: 29.46%; vertical-align: middle; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">&#160;</td>
            <td style="width: 15.33%; vertical-align: middle; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">&#160;</td>
            <td style="width: 50.61%; vertical-align: middle; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px solid rgb(0, 0, 0);">&#160;</td>
          </tr>
          <tr>
            <td style="width: 4.6%; vertical-align: middle; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
              <div style="margin-left: 3.95pt; line-height: 1.25; font-weight: bold;">2</div>
            </td>
            <td style="width: 29.46%; vertical-align: middle; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">&#160;</td>
            <td style="width: 15.33%; vertical-align: middle; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">&#160;</td>
            <td style="width: 50.61%; vertical-align: middle; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px solid rgb(0, 0, 0);">&#160;</td>
          </tr>
          <tr>
            <td style="width: 4.6%; vertical-align: middle; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-bottom: 2px solid rgb(0, 0, 0);">
              <div style="margin-left: 3.95pt; line-height: 1.25; font-weight: bold;">3</div>
            </td>
            <td style="width: 29.46%; vertical-align: middle; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-bottom: 2px solid rgb(0, 0, 0);">&#160;</td>
            <td style="width: 15.33%; vertical-align: middle; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-bottom: 2px solid rgb(0, 0, 0);">&#160;</td>
            <td style="width: 50.61%; vertical-align: middle; border-width: 2px; border-style: solid; border-color: rgb(0, 0, 0);">&#160;</td>
          </tr>

      </table>
      <div style="line-height: 1.25;"><br style="line-height: 1.25;">
      </div>
      <div style="line-height: 1.25;"><font style="font-style: italic;">Please explain why you are unable to obtain a TIN if you selected Reason</font><font style="font-weight: bold; font-style: italic;"> B </font><font style="font-style: italic;">above</font>:</div>
      <div style="line-height: 1.25">&#160;</div>
      <table cellspacing="0" cellpadding="2" border="0" style="font-family: 'Times New Roman',Times,serif; font-size: 10pt; width: 100%; text-align: left; color: rgb(0, 0, 0);" id="z00a5c94fdff844ea8a5df2fffdfd862f">

          <tr>
            <td style="width: 4.22%; vertical-align: middle; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
              <div style="line-height: 1.25; font-weight: bold;">1</div>
            </td>
            <td style="width: 95.78%; vertical-align: middle; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px solid rgb(0, 0, 0);">&#160;</td>
          </tr>
          <tr>
            <td style="width: 4.22%; vertical-align: middle; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
              <div style="line-height: 1.25; font-weight: bold;">2</div>
            </td>
            <td style="width: 95.78%; vertical-align: middle; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px solid rgb(0, 0, 0);">&#160;</td>
          </tr>
          <tr>
            <td style="width: 4.22%; vertical-align: middle; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-bottom: 2px solid rgb(0, 0, 0);">
              <div style="line-height: 1.25; font-weight: bold;">3</div>
            </td>
            <td style="width: 95.78%; vertical-align: top; border-width: 2px; border-style: solid; border-color: rgb(0, 0, 0);">&#160;</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: #000000;" class="DSPFListTable" id="z46bbe6d6ac1646f193f1c7b3db90ec9c">

          <tr>
            <td style="width: -3.8pt;"><br>
            </td>
            <td style="width: 18pt; vertical-align: top; align: right;">&#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: #000000;" class="DSPFListTable" id="z0218fb5b21154fd29b370a7b30527eff">

          <tr>
            <td style="width: -3.8pt;"><br>
            </td>
            <td style="width: 18pt; vertical-align: top; align: right;">&#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 style="text-align: justify; margin-left: 14.2pt; line-height: 1.25;"><br>
      </div>
      <div class="BRPFPageBreakArea" style="clear: both; margin-top: 10pt; margin-bottom: 10pt;">
        <div class="BRPFPageBreak" 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="text-align: justify; margin-left: 14.2pt; line-height: 1.25;"><font style="font-weight: bold;"><u> <br>
          </u></font></div>
      <div style="text-align: justify; line-height: 1.25; font-weight: bold;"><u>Part 3 &#8211; Type of Controlling Person</u></div>
      <div style="text-align: justify; line-height: 1.25; font-weight: bold;"><u>(Please only complete this section if you are tax resident in one or more Reportable Jurisdictions according to the CRS)</u></div>
      <div style="line-height: 1.25;"><br style="line-height: 1.25;">
      </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="ze4fa7822699246c4b882967de7e7e4df">

          <tr>
            <td style="width: 82.89%; vertical-align: bottom; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
              <div style="line-height: 1.25; font-weight: bold;">Please provide the Controlling Person&#8217;s Status by ticking the appropriate box.</div>
            </td>
            <td nowrap="nowrap" style="width: 17.11%; vertical-align: bottom; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px solid rgb(0, 0, 0);">&#160;</td>
          </tr>
          <tr>
            <td nowrap="nowrap" style="width: 82.89%; vertical-align: bottom; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
              <div style="line-height: 1.25;"><font style="font-weight: bold;">a</font>. Controlling Person of a legal person &#8211; <font style="font-weight: bold;">control by ownership</font></div>
            </td>
            <td nowrap="nowrap" style="width: 17.11%; vertical-align: bottom; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px solid rgb(0, 0, 0);">
              <div style="line-height: 1.25;">&#160;</div>
            </td>
          </tr>
          <tr>
            <td nowrap="nowrap" style="width: 82.89%; vertical-align: bottom; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
              <div style="line-height: 1.25;"><font style="font-weight: bold;">b</font>. Controlling Person of a legal person &#8211; <font style="font-weight: bold;">control by other means</font></div>
            </td>
            <td nowrap="nowrap" style="width: 17.11%; vertical-align: bottom; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px solid rgb(0, 0, 0);">
              <div style="line-height: 1.25;">&#160;</div>
            </td>
          </tr>
          <tr>
            <td nowrap="nowrap" style="width: 82.89%; vertical-align: bottom; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
              <div style="line-height: 1.25;"><font style="font-weight: bold;">c</font>. Controlling Person of a legal person &#8211; <font style="font-weight: bold;">senior managing official</font></div>
            </td>
            <td nowrap="nowrap" style="width: 17.11%; vertical-align: bottom; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px solid rgb(0, 0, 0);">
              <div style="line-height: 1.25;">&#160;</div>
            </td>
          </tr>
          <tr>
            <td nowrap="nowrap" style="width: 82.89%; vertical-align: bottom; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
              <div style="line-height: 1.25;"><font style="font-weight: bold;">d</font>. Controlling Person of a trust - <font style="font-weight: bold;">settlor</font></div>
            </td>
            <td nowrap="nowrap" style="width: 17.11%; vertical-align: bottom; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px solid rgb(0, 0, 0);">
              <div style="line-height: 1.25;">&#160;</div>
            </td>
          </tr>
          <tr>
            <td nowrap="nowrap" style="width: 82.89%; vertical-align: bottom; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
              <div style="line-height: 1.25;"><font style="font-weight: bold;">e</font>. Controlling Person of a trust &#8211; <font style="font-weight: bold;">trustee</font></div>
            </td>
            <td nowrap="nowrap" style="width: 17.11%; vertical-align: bottom; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px solid rgb(0, 0, 0);">
              <div style="line-height: 1.25;">&#160;</div>
            </td>
          </tr>
          <tr>
            <td nowrap="nowrap" style="width: 82.89%; vertical-align: bottom; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
              <div style="line-height: 1.25;"><font style="font-weight: bold;">f</font>. Controlling Person of a trust &#8211; <font style="font-weight: bold;">protector</font></div>
            </td>
            <td nowrap="nowrap" style="width: 17.11%; vertical-align: bottom; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px solid rgb(0, 0, 0);">
              <div style="line-height: 1.25;">&#160;</div>
            </td>
          </tr>
          <tr>
            <td nowrap="nowrap" style="width: 82.89%; vertical-align: bottom; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
              <div style="line-height: 1.25;"><font style="font-weight: bold;">g</font>. Controlling Person of a trust &#8211; <font style="font-weight: bold;">beneficiary</font></div>
            </td>
            <td nowrap="nowrap" style="width: 17.11%; vertical-align: bottom; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px solid rgb(0, 0, 0);">
              <div style="line-height: 1.25;">&#160;</div>
            </td>
          </tr>
          <tr>
            <td nowrap="nowrap" style="width: 82.89%; vertical-align: bottom; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
              <div style="line-height: 1.25;"><font style="font-weight: bold;">h</font>. Controlling Person of a trust &#8211; <font style="font-weight: bold;">other</font></div>
            </td>
            <td nowrap="nowrap" style="width: 17.11%; vertical-align: bottom; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px solid rgb(0, 0, 0);">
              <div style="line-height: 1.25;">&#160;</div>
            </td>
          </tr>
          <tr>
            <td nowrap="nowrap" style="width: 82.89%; vertical-align: bottom; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
              <div style="line-height: 1.25;"><font style="font-weight: bold;">i</font>. Controlling Person of a legal arrangement (non-trust) &#8211; <font style="font-weight: bold;">settlor-equivalent</font></div>
            </td>
            <td nowrap="nowrap" style="width: 17.11%; vertical-align: bottom; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px solid rgb(0, 0, 0);">
              <div style="line-height: 1.25;">&#160;</div>
            </td>
          </tr>
          <tr>
            <td nowrap="nowrap" style="width: 82.89%; vertical-align: bottom; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
              <div style="line-height: 1.25;"><font style="font-weight: bold;">j</font>. Controlling Person of a legal arrangement (non-trust) &#8211; <font style="font-weight: bold;">trustee-equivalent</font></div>
            </td>
            <td nowrap="nowrap" style="width: 17.11%; vertical-align: bottom; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px solid rgb(0, 0, 0);">
              <div style="line-height: 1.25;">&#160;</div>
            </td>
          </tr>
          <tr>
            <td nowrap="nowrap" style="width: 82.89%; vertical-align: bottom; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
              <div style="line-height: 1.25;"><font style="font-weight: bold;">k</font>. Controlling Person of a legal arrangement (non-trust) &#8211; <font style="font-weight: bold;">protector-equivalent</font></div>
            </td>
            <td nowrap="nowrap" style="width: 17.11%; vertical-align: bottom; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px solid rgb(0, 0, 0);">
              <div style="line-height: 1.25;">&#160;</div>
            </td>
          </tr>
          <tr>
            <td nowrap="nowrap" style="width: 82.89%; vertical-align: bottom; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0);">
              <div style="line-height: 1.25;"><font style="font-weight: bold;">l</font>. Controlling Person of a legal arrangement (non-trust) &#8211; <font style="font-weight: bold;">beneficiary-equivalent</font></div>
            </td>
            <td nowrap="nowrap" style="width: 17.11%; vertical-align: bottom; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-right: 2px solid rgb(0, 0, 0);">
              <div style="line-height: 1.25;">&#160;</div>
            </td>
          </tr>
          <tr>
            <td nowrap="nowrap" style="width: 82.89%; vertical-align: bottom; border-top: 2px solid rgb(0, 0, 0); border-left: 2px solid rgb(0, 0, 0); border-bottom: 2px solid rgb(0, 0, 0);">
              <div style="line-height: 1.25;"><font style="font-weight: bold;">m</font>. Controlling Person of a legal arrangement (non-trust) &#8211; <font style="font-weight: bold;">other-equivalent</font></div>
            </td>
            <td nowrap="nowrap" style="width: 17.11%; vertical-align: bottom; border-width: 2px; border-style: solid; border-color: rgb(0, 0, 0);">
              <div style="line-height: 1.25;">&#160;</div>
            </td>
          </tr>

      </table>
      <div style="line-height: 1.25;"><br style="line-height: 1.25;">
      </div>
      <div class="BRPFPageBreakArea" style="clear: both; margin-top: 10pt; margin-bottom: 10pt;">
        <div class="BRPFPageBreak" 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;"><br style="line-height: 1.25;">
      </div>
      <div style="line-height: 1.25; font-weight: bold;">Part 4 &#8211; Declarations and Signature</div>
      <div style="line-height: 1.25">&#160;</div>
      <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>&#160;and I will update you if the above will change in the future.</div>
      <div style="line-height: 1.25">&#160;</div>
      <div style="line-height: 1.25">
        <div style="border: #000000 2px solid; padding: 5px; width: 99%;">
          <div>&#160;
            <div style="line-height: 1.25;">
              <div style="line-height: 1.25; font-weight: bold;">I declare that all statements made in this declaration are, to the best of my knowledge and belief, correct and complete.</div>
              <div style="line-height: 1.25">&#160;</div>
            </div>
            <div style="line-height: 1.25;">
              <div style="text-indent: -0.5pt; margin-left: 0.5pt; line-height: 1.25;">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.</div>
              <div style="line-height: 1.25;"><br style="line-height: 1.25;">
              </div>
            </div>
            <div style="line-height: 1.25;">
              <div style="text-indent: -0.5pt; margin-left: 0.5pt; line-height: 1.25;">Signature:&#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160;&#160; ________________________________________________&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;</div>
              <div style="line-height: 1.25">&#160;</div>
              <div style="text-indent: -0.5pt; margin-left: 0.5pt; line-height: 1.25;">Print name:&#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; ________________________________________________</div>
              <div style="line-height: 1.25">&#160;</div>
              <div style="text-indent: -0.5pt; margin-left: 0.5pt; line-height: 1.25;">Date:&#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; ________________________________________________</div>
              <div style="line-height: 1.25">&#160;</div>
            </div>
            <div style="line-height: 1.25;">
              <div style="text-indent: -0.5pt; margin-left: 0.5pt; line-height: 1.25;"><font style="font-weight: bold;">Note</font>: If you are not the Beneficiary please indicate the capacity in which you are signing the form.&#160; If signing under a power of
                attorney please also attach a certified copy of the power of attorney.</div>
              <div style="line-height: 1.25">&#160;</div>
            </div>
            <div style="line-height: 1.25;">
              <div style="text-indent: -0.5pt; margin-left: 0.5pt; line-height: 1.25;">Capacity:&#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; _________________________________________________</div>
              <div style="line-height: 1.25">&#160;</div>
            </div>
          </div>
        </div>
      </div>
      <div style="line-height: 1.25"> <br>
      </div>
      <div style="margin-right: 21.3pt; line-height: 1.25;">For additional info, please contact us at: <font style="font-weight: bold;"><u>esop-sp@esop.co.il</u></font><br>
        972-3-7536823&#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; &#160; Domestic calls: 1700-70-37-67</div>
      <br>
      <hr noshade="noshade" align="left" style="background-color: #000000; border: 0px; height: 1px; width: 2in; margin-left: 0pt; margin-right: auto; color: #000000;">
      <div style="text-align: justify; line-height: 1.25;"><sup style="vertical-align: text-top; line-height: 1; font-size: smaller;">2</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 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;">3</sup><sup style="font-family: David, David, sans-serif; vertical-align: text-top; line-height: 1; font-size: smaller;">&#160;</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>
      <div><br>
      </div>
      <div>
        <div style="text-align: center; line-height: 1.25; font-family: 'Times New Roman',Times,serif;"> <img src="image00008.jpg"></div>
      </div>
      <div><br>
      </div>
      <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>
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<SEQUENCE>7
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<DOCUMENT>
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end
</TEXT>
</DOCUMENT>
</SEC-DOCUMENT>
