DocuSign Envelope ID: 9B49A4F5-ECFB-428A-A4E2-6DB43809C0A6DocuSign Envelope ID: B66458D5-24B3-4835-84B2-0808C0F58CC0
**Registered Number 1110118**
## **THE DALBY CHARITABLE TRUST**
## **TRUSTEE’S REPORT AND FINANCIAL STATEMENTS**
## **5 April 2021**
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## **THE DALBY CHARITABLE TRUST**
## **CONTENTS**
||**Page**|
|---|---|
|Trustees’ annual report|1 – 2|
|Statement of trustees’ responsibilities|3|
|Independent examiners’ report|4|
|Receipts and payments|5|
|Statement of assets and liabilities|6|
|Notes to the financial statements|7 - 12|
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## **THE DALBY CHARITABLE TRUST**
## **TRUSTEES’ ANNUAL REPORT**
**REFERENCE AND ADMINISTRATION DETAILS:**
|**EFERENCE AND ADMINISTRATION**
**ETAILS:**||
|---|---|
|**Registered charity name:**|The Dalby Charitable Trust|
|**Registered charity number:**|1110118|
|**Principal address**|20 Brompton Square|
||London|
||SW3 2AD|
|**Trustees**|Patrick Claude John Dalby|
||Lucy Margaretta Hyacinthe Dalby|
||Patrick Valerian Smiley|
|**Advisors:**||
|**Banker**|Weatherbys Bank|
||Sanders Road|
||Wellingborough|
||Northants|
||NN8 4BX|
|**Solicitor**|Charles Russell|
||8-10 New Fetter Lane|
||London|
||EC4A 1RS|
|**Investment managers**|Cazenove Capital Management Limited|
||1 London Wall Place|
||London|
||EC2Y 5AU|
|**Accountant**|Deloitte LLP|
||1 Station Square|
||Cambridge|
||CB1 2GA|
|**Independent examiner (when required)**|C P J Dougherty, FCA|
||Lakin Rose Limited|
||Pioneer House|
||Vision Park|
||Cambridge|
||CB24 9NL|
|**STRUCTURE, GOVERNANCE AND**||
|**MANAGEMENT:**||
|**Governing document and**|The charity was formed under a declaration of|
|**Constitution**|trust for charitable purposes on 28 April 2005.|
|**Trustee selection methods**|The power of appointment of trustees is vested|
||in the existing trustees by a resolution passed at|
||a meeting of the trustees. There shall be at least|
||three and no more than five trustees.|
**1**
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**THE DALBY CHARITABLE TRUST TRUSTEES’ ANNUAL REPORT OBJECTIVES AND ACTIVITIES: Summary of objectives as set out in the governing document**
The objects of the charity are to pay the income and such part of the capital as the trustees may decide to such charity in any part of the world as are exclusively charitable and in particular for the relief of financial hardship either generally or individually of people living in the United Kingdom by making grants of money for providing or paying for items, services or facilities.
**Summary of main activities** Sixteen donations were made during the year **undertaken for the public benefit** totalling £100,000. Eleven donations repeated support given in previous years.
The donations were categorised as follows: -
Culture, education and service charities 4 donations Disabled welfare 3 donations General welfare 7 donations Holidays for the disadvantaged 2 donations
The trustees confirm that they have referred to the Charity Commission’s general guidance on public benefit when making donations and agreeing the distribution policy for the year. **Summary of main achievements** During the year Mr Patrick Dalby donated **for the year** shares to the trust which were valued at £70,527. Donations totalling £100,000 were granted to charitable organisations during the year.
**FINANCIAL REVIEW:** The trustees consider the assets of the trust as **Policy on reserves** “expendable endowment” to provide income from which to make donations and not as reserves.
Any unrestricted funds not committed or invested in tangible fixed assets (‘the free reserves’) are held to fund management, administration and support costs and continuing donations in furtherance of the charity’s objectives.
**…………………………….. ………………………………… …………………………….. TRUSTEE TRUSTEE TRUSTEE**
**2**
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## **THE DALBY CHARITABLE TRUST**
## **STATEMENT OF TRUSTEES’ RESPONSIBILITIES**
The Charities Act 2011 requires the trustees to prepare a statement of accounts for each financial year which comply with the regulations made under the Act. The financial statements are prepared on a cash basis and must properly present the receipts and payments for the financial year and the balances held at the end of the year.
The trustees are responsible for keeping proper accounts. The trustees must ensure that proper financial procedures are followed and that accounting records are maintained in the form prescribed, and all assets for which they are responsible are safeguarded.
**3**
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## **THE DALBY CHARITABLE TRUST**
**INDEPENDENT EXAMINER’S REPORT For the year ended 5 April 2021**
## **Independent examiner’s report to the trustees of The Dalby Charitable Trust**
I report on the accounts of the charitable trust for the year ended 5 April 2021, which are set out on pages 5 to 8.
This report is made solely to the charity’s trustees, as a body, in accordance with section 145 of the Charities Act 2011 and regulations made under section 145 (5) (b) of that Act. My work has been undertaken so that I might state to the charity’s trustees those matters I am required to state to them in an Independent examiner’s report and for no other purpose. To the fullest extent permitted by law, I do not accept or assume responsibility to anyone other than the charity and the charity’s trustees as a body, for my work, for this report, or for the opinions I have formed.
## **Respective responsibilities of trustees and examiner**
The charity’s trustees are responsible for the preparation of the accounts. The charity’s trustees consider that an audit is not required for this year (under section 145(1) of the Charities Act 2011 (the 2011 Act)) and that an independent examination is needed.
It is my responsibility to:
- examine the accounts (under section 145 of the 2011 Act);
- to follow the procedures laid down in the General Directions given by the Charity Commissioners (under section 145(5)(b) of the 2011 Act); and
- to state whether particular matters have come to my attention.
## **Basis of independent examiner’s report**
My examination was carried out in accordance with General Directions given by the Charity Commissioners. An examination includes a review of the accounting records kept by the charity and a comparison of the accounts presented with those records. It also includes consideration of any unusual items or disclosures in the accounts, and seeking explanations from the Trustees concerning any such matters. The procedures undertaken do not provide all the evidence that would be required in an audit, and consequently no opinion is given as to whether the financial statements present a ‘true and fair view’ and the report is limited to those matters set out in the statement below.
## **Independent examiner’s statement**
In connection with my examination, no matter has come to my attention:
(1) which gives me reasonable cause to believe that, in any material respect, the requirements:
- to keep accounting records in accordance with section 130 of the 2011 Act; and
- to prepare accounts which accord with the accounting records and comply with the accounting requirements of the 2011 Act
- have not been met; or
(2) to which, in my opinion, attention should be drawn in order to enable a proper understanding of the accounts to be reached.
Signed: Dated: 02 February 2022 | 09:26:47 GMT C P J Dougherty, FCA Lakin Rose Limited Pioneer House Vision Park Histon, Cambridge. CB24 9NL
**4**
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## **THE DALBY CHARITABLE TRUST**
## **RECEIPTS AND PAYMENTS year ended 5 April 2021**
||**Notes**||**2021**||**2020**|
|---|---|---|---|---|---|
|**RECEIPTS**|||**£**||**£**|
|**From voluntary sources**||||||
|Donation|||19,000||-|
|**Investment income**||||||
|UK Unit Trusts|5||12,187||18,967|
|Foreign Unit Trusts|5||4,687||10,718|
|UK Interest|||-||86|
|**Receipts sub-totals**|||35,874||29,771|
|**Miscellaneous receipts**||||||
|HMRC Repayment|||5,744||-|
|Equalisation|||1,464||480|
|Investment transactions - disposals|5||338,375||534,296|
|**TOTAL RECEIPTS FOR YEAR**|||381,457||564,547|
|**PAYMENTS**||||||
|**Charitable expenditure**||||||
|Donations|4||100,000||90,000|
|**Other expenditure**||||||
|Accountancy fee|||2,844||2,760|
|Independent examiner's fees|||840||840|
|LEI Application fee|||75||-|
|Management expenses|||3,380||3,738|
|**Payments sub-totals**|||107,139||97,338|
|**Miscellaneous payments**||||||
|Investment transactions - purchases|5||244,876||536,198|
|**TOTAL PAYMENTS FOR YEAR**|||352,015||633,536|
|**Net receipts/(payments)**|||29,442||(68,989)|
|**Cash funds held at 5 April 2020**|||13,786||82,775|
|**Cash funds held at 5 April 2021**||£|43,228|£|13,786|
**5**
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## **THE DALBY CHARITABLE TRUST**
## **STATEMENT OF ASSETS AND LIABILITIES 5 April 2021**
||**Notes**|||||
|---|---|---|---|---|---|
||||**2021**||**2020**|
|**CASH FUNDS**|||**£**||**£**|
|Cash at bank||£|43,228|£|13,786|
|**OTHER MONETARY ASSETS**||||||
|Debtor||||||
|Dividend due|||775||-|
|Tax reclaim - 2019|||-||5,727|
|||£|775|£|5,727|
|**INVESTMENT ASSETS**||||||
|Valuation provided by Schroder & Co. Limited|4|£|710,263|£|593,298|
|**LIABILITIES**||||||
|Management and administration expenses:||||||
|Accounts preparation|||(2,940)||(2,844)|
|Independent examination|||(840)||(840)|
|||£|(3,780)|£|(3,684)|
|||||||
|**TOTAL UNRESTRICTED FUNDS**||£|750,486|£|609,127|
|Approved by the trustees and signed by:||||||
|Patrick Claude John Dalby||||||
|Lucy Margaretta Hyacinthe Dalby||||||
|Patrick Valerian Smiley||||||
Date 28 January 2022 | 17:15:31 GMT
**6**
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## **THE DALBY CHARITABLE TRUST**
**NOTES TO THE FINANCIAL STATEMENTS year ended 5 April 2021**
## **1. ACCOUNTING POLICIES**
The financial statements are prepared on a Receipts and Payments basis in accordance with Section 133 of the Charities Act 2011.
Particular accounting policies adopted by the trustees are described below.
## **a) Income and expenditure**
Income and expenditure is accounted for on a receipts and payments basis.
## **b) Investments**
Investments listed on a recognised stock exchange are shown in the statement of assets and liabilities at their market value at the year end. The valuation was provided by Schroder & Co. Limited.
## **2. INVESTMENT ASSETS**
|**Quoted investments**
Market value at 6 April 2020
Additions at value/cost
Disposal proceeds
Realised and unrealised gains and losses
Market value at 5 April 2021
£
Book cost at 5 April 2021
£|**2021**
593,298
315,402
(338,375)
139,938
710,263
£
696,462
£|**2020**
766,573
536,198
(534,296)
(175,177)|
|---|---|---|
|||593,298|
||||
|||755,771|
## **3. RELATED PARTY TRANSACTIONS**
Donations of 100,000 and 70,000 Schroder unit trust moorgate I income units were received from Mr Patrick Dalby (trustee) during the year. The units were independently valued at £39,160 and £31,367 respectively at the date of the transfer.
**7**
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## **THE DALBY CHARITABLE TRUST**
**NOTES TO THE FINANCIAL STATEMENTS year ended 5 April 2021**
## **4. DONATIONS**
|**Payee**
3H Fund
Adapt
Bede House Association
Burma Star Memorial Fund
Childhood Trust
Combat Stress
Criminon
Demand
Dementia UK
Family Holiday Association
Fine Cell Work
First Step
Greatwood Charity Ltd
Happy Days
Horse Time
Huguenot Museum
Injured Jockeys
Just Different
Racing Welfare
React
Tall Ships
The Arnold Association
The Royal Ballet School
£|**2021**
**£**
5,000
-
10,000
5,000
5,000
5,000
-
5,000
-
5,000
5,000
5,000
-
10,000
5,000
5,000
5,000
-
-
10,000
5,000
-
10,000
100,000
£|**2020**
**£**
10,000
4,000
-
-
-
10,000
4,000
4,000
4,000
10,000
4,000
4,000
4,000
-
-
-
4,000
4,000
4,000
-
10,000
10,000|
|---|---|---|
|||90,000|
**8**
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## **DALBY CHARITABLE TRUST**
## **INVESTMENT SCHEDULE FOR THE YEAR ENDED 5 APRIL 2021**
|**Holding**|**Book Vlue**|**Additions**||**Disposals**|**Disposals**|**Profit**|**Holding**|**Book Vlue**|**Market**|**Value**|**Net Income**|
|---|---|---|---|---|---|---|---|---|---|---|---|
|**6April 2020**|**6April 2020**|**Quantity**|**Cost**|**Quantity**|**Proceeds**|**(Loss)**|**5April 2021**|**5April 2021**|**5 April**|**2021**||
||**£**||**£**||**£**|**£**||**£**|**£**||**£**|
|Ashmore Inv Mgmt (Ireland) Ltd||||||||||||
|Emerging Markets Total Return Z3 Gbp Dis||||||||||||
|||609.99400|80,378.83|609.99400|71,844.05|(8,534.78)|||||102.31|
||||||||||||120.90|
||||||||||||309.44|
|Ashmore Sicav||||||||||||
|Emerging Mkts Ttal Return Z2 GBP Inc||||||||||||
|851.00000|80,378.83|||851.00000|80,378.83||||||324.26|
|Capita Financial Managers||||||||||||
|Trojan Income S Inc||||||||||||
|27,000.00000|55,049.53||(136.13)||||||||425.33|
||||||||27,000.00000|54,913.40||47,528|775.01|
|Fil Investment Services(Uk)limited||||||||||||
|Global Dividend W Inc Nav||||||||||||
|54,800.00000|110,289.76||(261.13)||||||||998.17|
||||||||||||1,317.50|
||||||||||||293.45|
||||||||54,800.00000|110,028.63|114,258||652.12|
|Gar Sterling Management||||||||||||
|UK Eqty Income Semi Annual Z GBP Dis||||||||||||
|5,600.00000|53,959.31|||5,600.00000|39,234.01|(14,725.30)||||||
|Hipgnosis Songs Fund Ltd||||||||||||
|Ordinary No Par Value||||||||||||
|||27,500|31,535.17||||||||343.75|
||||||||||||360.94|
||||||||27,500|31,535.17||34,100|360.94|
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## **DALBY CHARITABLE TRUST**
## **INVESTMENT SCHEDULE FOR THE YEAR ENDED 5 APRIL 2021**
|**Holding**|**Book Vlue**|**Additions**||**Disposals**|**Disposals**|**Profit**|**Holding**|**Book Vlue**|**Market**|**Value**|**Net Income**|
|---|---|---|---|---|---|---|---|---|---|---|---|
|**6April 2020**|**6April 2020**|**Quantity**|**Cost**|**Quantity**|**Proceeds**|**(Loss)**|**5April 2021**|**5April 2021**|**5 April**|**2021**||
||**£**||**£**||**£**|**£**||**£**|**£**||**£**|
|Hsbc Global Asset Management UK||||||||||||
|Fte All World Index S Dis||||||||||||
|20,000.00000|28,048.80|5,000.00000|7,150.00|15,000.00000|28,601.10|7,867.94|||||178.25|
||||(214.51)|||||||||
||||(214.51)|||||||||
||||(214.51)||||10,000.00000|13,822.11||19,540||
|lshares Physical Metals Pie||||||||||||
|I Shs Physical Gold Etc USD||||||||||||
|||611.00000|17,660.22||||611.00000|17,660.22||14,881||
|Kba Consulting Management Limited||||||||||||
|Atlas Global Infrastructure B GBP Unhgd||||||||||||
|||450.00000|51,209.25||||450.00000|51,209.25||52,911|1,094.97|
|Link Fund Solutions Ltd||||||||||||
|Lf Majedie UK Equity Fundclass X Inc||||||||||||
|36,000.00000|54,043.73||(165.28)||||||||205.49|
||||||||36,000.00000|53,878.45||53,050|361.37|
|M&G Investment Management Ltd||||||||||||
|Global Dividend Fd Stg Cls I Inc||||||||||||
|54, 166.00000|124,532.69||(241.23)|54, 166.00000|124,291.46||||||1,284.90|
|M&g Securities Ltd||||||||||||
|Global Dividend Pp GBP Dis||||||||||||
|||125,614.32200|124,291.46||||||||902.41|
||||||||||||909.20|
||||||||125,614.32200|124,291.46|141,077||906.18|
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## **DALBY CHARITABLE TRUST**
## **INVESTMENT SCHEDULE FOR THE YEAR ENDED 5 APRIL 2021**
||**Holding**|**Book Vlue**|**Additions**||**Disposals**|**Disposals**|**Profit**|**Holding**|**Book Vlue**|**Market**|**Value**|**Net Income**|
|---|---|---|---|---|---|---|---|---|---|---|---|---|
|**6April 2020**||**6April 2020**|**Quantity**|**Cost**|**Quantity**|**Proceeds**|**(Loss)**|**5April 2021**|**5April 2021**|**5 April**|**2021**||
|||**£**||**£**||**£**|**£**||**£**|**£**||**£**|
|Ninety One Fund Managers|UK Lid||||||||||||
|Global Environment K GBP Dis|||||||||||||
|Changed from Investec Asset Management Lid Global Environment K GBP Dis on 27/04/2020|||||||||||||
||||20,000.00000|33,252.69||||20,000.00000|33,252.69||31,054||
|Polar Capital Funds|||||||||||||
|Emerging Markets Income S|Dist GBP||||||||||||
||8,600.000|60,076.95|||8,600.000|48,881.61|(11,195.34)||||||
|Polar Capital Funds|||||||||||||
|Global Insurance E GBP Dist|||||||||||||
||||5,000.00|26,857.42||||||||45.23|
|||||(17.27)||||5,000.00|26,840.15||28,897||
|Schroder Inv Mgmt Lux Sa|||||||||||||
|Diversified Alternative Assets S Gbp Dis|||||||||||||
||375.00000|39,544.74||||||||||199.80|
|||||||||||||696.28|
|||||||||375.00000|39,544.74||38,921|727.92|
|Schroder Investment Fund Management|||||||||||||
|European Income S Inc Nav|||||||||||||
|16,200.00000||12,047.41|||16,200.00000|6,889.86|(5,157.55)|||||145.40|
|Schroder Unit Trusts|||||||||||||
|Moorgate I M Inc|||||||||||||
||||100,000.00|39,160.00|100,000.00|38,366.45|(793.55)||||||
||||70,000.00|31,367.00|70,000.00|31,902.93|535.93||||||
- 11 -
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## **DALBY CHARITABLE TRUST**
## **INVESTMENT SCHEDULE FOR THE YEAR ENDED 5 APRIL 2021**
|**Holding**|**Book Vlue**|**Additions**||**Disposals**|**Disposals**|**Profit**|**Holding**|**Book Vlue**|**Market**|**Value**|**Net Income**|
|---|---|---|---|---|---|---|---|---|---|---|---|
|**6April 2020**|**6April 2020**|**Quantity**|**Cost**|**Quantity**|**Proceeds**|**(Loss)**|**5April 2021**|**5April 2021**|**5 April**|**2021**||
||**£**||**£**||**£**|**£**||**£**|**£**||**£**|
|Schroder Unit Trusts||||||||||||
|Asian Income Maximiser S Inc||||||||||||
|100,000.00000|62,274.65||||||||||641.00|
||||||||||||993.50|
||||||||||||1,189.20|
||||||||100,000.00000|62,274.65||55,570|784.00|
|Vnguard Investment Series||||||||||||
|Japan Stock Index lnstl Plus Inc Nav||||||||||||
|||60.00000|10,398.76|||||||||
|||60.00000|10,300.24||||120.00000|20,699.00||21,024||
|Vritas Funds||||||||||||
|Global Equity Income GBP D||||||||||||
|396.030|75,525.00|||396.030|72,654.65|(2,870.35)||||||
|Wellington Mgmnt Funds (Ireland)||||||||||||
|Global Health Care Eqty**N**GBP Dis Unhgd||||||||||||
|||4,500.00000|56,512.11|4,500.00000|56,512.11|||||||
|Wellington Mgmnt Funds (Ireland)||||||||||||
|Gbl Health Care Eqty Un Gbp Dis Unhedged||||||||||||
|||6, 193.04200|56,512.11||||6, 193.04200|56,512.11||57,452||
|**TOTL:**|**755,771.40**||**575,120.69**||**599,557.06**|**(34,873.00)**||**696,462.03**|**710,263**||**17,649.22**|
- 12 -
DocuSign Envelope ID: B66458D5-24B3-4835-84B2-0808C0F58CC0
## **Certificate Of Completion**
Envelope Id: 9B49A4F5ECFB428AA4E26DB43809C0A6 Subject: Please DocuSign: Accounts The Dalby Charitable Trust 2021 Source Envelope: Document Pages: 14 Signatures: 6 Certificate Pages: 2 Initials: 0 AutoNav: Enabled EnvelopeId Stamping: Enabled Time Zone: (UTC) Dublin, Edinburgh, Lisbon, London
Status: Completed
Envelope Originator: Ruth Loader Head office 1 New Street Square London, London EC4A 3HQ rloader@deloitte.co.uk IP Address: 31.53.180.118
## **Record Tracking**
Status: Original Holder: Ruth Loader 1/28/2022 2:41:14 PM rloader@deloitte.co.uk
Location: DocuSign
**Signer Events Signature** Patrick Dalby pdalby@ukgo.com Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 81.155.232.179
## **Timestamp**
Sent: 1/28/2022 3:35:43 PM Viewed: 1/28/2022 5:13:58 PM Signed: 1/28/2022 5:15:31 PM
## **Electronic Record and Signature Disclosure:**
Not Offered via DocuSign
Patrick Smiley Patrick.Smiley@smithandwilliamson.com MR Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 176.26.248.20
Sent: 1/28/2022 5:15:33 PM Viewed: 1/31/2022 9:25:28 AM Signed: 1/31/2022 9:26:18 AM
## **Electronic Record and Signature Disclosure:**
Not Offered via DocuSign
Lucy Dalby lucydalby@hotmail.com Security Level: Email, Account Authentication (None)
Sent: 1/31/2022 9:26:20 AM Viewed: 2/2/2022 8:39:13 AM Signed: 2/2/2022 8:41:01 AM
Signature Adoption: Pre-selected Style Using IP Address: 81.97.157.160 Signed using mobile
## **Electronic Record and Signature Disclosure:**
Not Offered via DocuSign
|**In Person Signer Events**|**Signature**|**Timestamp**|
|---|---|---|
|**Editor Delivery Events**|**Status**|**Timestamp**|
|**Agent Delivery Events**|**Status**|**Timestamp**|
|**Intermediary Delivery Events**|**Status**|**Timestamp**|
|**Certified Delivery Events**|**Status**|**Timestamp**|
|**Carbon Copy Events**|**Status**|**Timestamp**|
DocuSign Envelope ID: B66458D5-24B3-4835-84B2-0808C0F58CC0
|**Carbon Copy Events**|**Status**|**Timestamp**|
|---|---|---|
|Ryan Bevan||Sent: 2/2/2022 8:41:03 AM|
|rjbevan@deloitte.co.uk|||
|Security Level: Email, Account Authentication|||
|(None)|||
|**Electronic Record and Signature Disclosure:**|||
|Not Offered via DocuSign|||
|**Witness Events**|**Signature**|**Timestamp**|
|**Notary Events**|**Signature**|**Timestamp**|
|**Envelope Summary Events**|**Status**|**Timestamps**|
|Envelope Sent|Hashed/Encrypted|1/28/2022 3:35:43 PM|
|Certified Delivered|Security Checked|2/2/2022 8:39:13 AM|
|Signing Complete|Security Checked|2/2/2022 8:41:01 AM|
|Completed|Security Checked|2/2/2022 8:41:03 AM|
|**Payment Events**|**Status**|**Timestamps**|
## **Certificate Of Completion**
Envelope Id: B66458D524B3483584B20808C0F58CC0 Subject: Please DocuSign: The Dalby Charitable Trust Report & Financial Statement Source Envelope: Document Pages: 16 Signatures: 1 Certificate Pages: 1 Initials: 0 AutoNav: Enabled EnvelopeId Stamping: Enabled Time Zone: (UTC) Dublin, Edinburgh, Lisbon, London
Status: Completed
Envelope Originator: Ruth Loader Head office 1 New Street Square London, London EC4A 3HQ rloader@deloitte.co.uk IP Address: 31.53.180.118
## **Record Tracking**
Status: Original Holder: Ruth Loader 2/2/2022 9:13:25 AM rloader@deloitte.co.uk
Location: DocuSign
**Signer Events Signature** Chris Dougherty chris.dougherty@lakinrose.co.uk Director Lakin Rose Limited Signature Adoption: Pre-selected Style Security Level: Email, Account Authentication (None) Using IP Address: 89.38.125.26
**Timestamp** Sent: 2/2/2022 9:20:25 AM Viewed: 2/2/2022 9:24:15 AM Signed: 2/2/2022 9:26:47 AM
## **Electronic Record and Signature Disclosure:**
Not Offered via DocuSign
|**In Person Signer Events**|**Signature**|**Timestamp**|
|---|---|---|
|**Editor Delivery Events**|**Status**|**Timestamp**|
|**Agent Delivery Events**|**Status**|**Timestamp**|
|**Intermediary Delivery Events**|**Status**|**Timestamp**|
|**Certified Delivery Events**|**Status**|**Timestamp**|
|**Carbon Copy Events**|**Status**|**Timestamp**|
|**Witness Events**|**Signature**|**Timestamp**|
|**Notary Events**|**Signature**|**Timestamp**|
|**Envelope Summary Events**|**Status**|**Timestamps**|
|Envelope Sent|Hashed/Encrypted|2/2/2022 9:20:25 AM|
|Certified Delivered|Security Checked|2/2/2022 9:24:15 AM|
|Signing Complete|Security Checked|2/2/2022 9:26:47 AM|
|Completed|Security Checked|2/2/2022 9:26:47 AM|
|**Payment Events**|**Status**|**Timestamps**|