## 

## 
















|B3Investment assets|Details||Fund to whish <br>belongs|asset||Cunent value<br>(opgonag|
|---|---|---|---|---|---|---|
|84Assets retained for the|Details||Fund to whish <br>belongs|sama|0 (o~g|Cummt value<br>(opgonal)|
|char(I)r's own use|||||||
|BSLiabilities|Details||Fund toeakh<br>rrabigtp mtatm||Amount due<br>(opbonal)|When due<br>(opgonal)|
|Sternal<br>b)rone ur huo hostess oii behalf<br>otsg pmbusbms||Signature||Print Name||Oats ofapproval|
|||||ECR)sp||01 Fsh 2023|