Mosaic Research Management - Pre-Consultation Compliance Questionnaire

Instructions:

All Mosaic clients require this basic questionnaire be completed prior to each consultation, to avoid potential conflicts. Thank you for taking the time to complete it.

Target Companies

First Name

Last Name

Email (must be the email address in our system)

Employment History

EH Id

Employer Name

Job Title

Start Date

End Date

1. Are you currently, or have you been within the last six (6) months, an officer, director, employee, or consultant for any company named in the project title or description?

If yes, please explain

2. Are you currently, or have you been within the last six (6) months, an officer, director, employee, or equivalent (e.g., a contractor) of a publicly-traded company (or subsidiary of a publicly-traded company)?

If yes, please explain if the publicly-traded company is affiliated or in any way related to the proposed company?

3. Are you and/or your employer prohibited from discussing information relating to any industry participant and/or individual security that you intend to discuss with MRM clients?

If yes, please explain

4. Put another way, do you and/or your employer owe a duty of confidentiality to any industry and/or individual entity that you intend to discuss with us?

If yes, please explain the following: (a) Do you maintain a confidentiality or non-disclosure agreement with the proposed company or with your current employer?, and (b) when did you enter into such agreement(s), if applicable?

5. Do you maintain any relationship, personal or professional, with any person employed by or in any way affiliated with a company that will be discussed in the proposed consultation?

If yes, please explain the following: (a) Do you discuss only personal matters with any individual(s)? (b) Do you discuss the company proposed with any individual(s)?

6. Are you currently in possession of any confidential or material non-public information that may in any way relate to a company that may be discussed in the proposed consultation?

If yes, please explain when you received material non-public information relating to the proposed company?

7. Are you currently or have you within the past twelve (12) months, been employed by or affiliated with any government entity, agency, authority or any government owned or majority controlled company?

If yes, please explain

8. Are you currently working on any clinical trial study OR have you in the past two years worked on any clinical trial study with unpublished results that may be discussed in the proposed consultation?

If yes, please explain

9. Are you, or is your employer, a significant (>5%) customer, distributer, supplier, producer or reseller of any goods or services provided to or by any company which is, or may be, the subject of this consultation?

To reiterate, does your current employer buy, sell, or distribute the target company's products or services that amount to 5% or more of the target company's annual revenue?

10. What is the name of your current employer? (Please list the company name or indicate "not currently working" if that is the case)

11. Is the employment history listed for you above accurate and complete dating back at least 3 years from now?

If No, please indicate what needs to be added/changed below

12. Are you currently domiciled (your legal residence) in China or Hong Kong?

13. You agree to comply with all applicable anti-corruption laws, including, but not limited to, the U.S. Foreign Corrupt Practices Act and the U.K. Bribery Act, as well as the anti-corruption laws of other applicable jurisdictions.

14. You agree that the call may be recorded to ensure the accuracy of a written transcription of your conversation. The recording or transcription, which do NOT include your name, may be distributed to select paying clients of MRM.

15. MRM clients are investment managers that invest long and short in, among other things, publicly-traded securities of companies. As such, you must confirm your understanding and agreement to the items below:

(i) Please confirm that you are authorized to discuss the information you are being asked to provide to the MRM client, and that if you are not authorized to discuss an item, you agree to decline to provide that information. For example, if you are asked about generalized trend information relating to your employer, you will provide that information only if you are authorized to do so.

(ii) If you are currently employed, please confirm that you have the consent of your employer to participate in consultations through MRM.

(iii) Please confirm that you understand that the MRM client is not looking to receive material non-public information arising, directly or indirectly, from any person with a non-disclosure obligation, or confidential information.

(iv) Please confirm that you understand that MRM clients may decide to use any or all information provided by you in the decision-making process to purchase and sell securities.

(v) Please confirm that you understand that you may be required to re-affirm your understanding verbally prior to any consultation, and that a member of the MRM client's Compliance department may monitor the call.

(vi) You attest that all communication you have with MRM Clients, to whom you are first introduced by MRM, will be initiated by either MRM or the MRM Client (so as not to breach any restrictions MRM Clients may have on inbound communications from industry experts).

Please confirm and acknowledge your agreement with the foregoing:

Contact Information