Power of Fiscal Representation

1. We hereby assign the company
[Name, address, VAT Registration Number for fiscal representation]
power of fiscal representation pursuant to Sections 22a et seq. UStG (Umsatzsteuergesetz = German VAT Law).

2. We hereby empower the company [Name of fiscalrepresentative]

a. [if companygiving power is an EU enterprise (Case 1 in leaflet):]

to fulfil the VAT obligations following customs clearance from inner-community delivery of goods from company [supplier in third country, address], as our fiscal representative;

b. [if company giving power is a third-country supplier (Case 2 in leaflet):]

to take on the VAT obligations in Germany as our fiscal representative following customs clearance from inner-community delivery of our goods to thecompany [Name of acquirer, address, VAT Registration Number];

c. to make the tax return pursuant to Section 22b para. 2 sentence 1 UStG as ourfiscal representative;

d. to make the aggregated sales listing pursuant to Section 22b para. 2sentence 3 UStG as our fiscal representative.

3. We confirm that we fulfil the conditions pursuant to Section 22a para. 1 UStG.

4. We undertake warranty vis-à-vis the company [Name of fiscalrepresentative] for the completeness and correctness of all indications necessary for the transaction of orders and give our assurance that an invoiced uplicate will be given to it for transactions in Germany where use is made of said fiscal representation.

Place,Date Company,Signature