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Tificate N.B. Please enclose proper documents with the form (if not submitted yet) Area of operation for this period: (Please tick multiple area if you work in those area) Software development IT Service Company Others, specify: Confirmation: Knowing the fact that giving inaccurate data may lead to cancellation of our membership, we confirm that we have given the above information correctly. If BASIS requires, we will provide supporting documents for verification. Signature of Autho.

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