I, .............................................. (duly authorised person)

Have prepared and/or compiled, or directly supervised those who have prepared all or parts of this application and/or information constituting this application.

To the best of my knowledge, the application information contained herein, and any attachment thereto, is accurate and not misleading.

I further understand that should any information included herein be found to be false, misleading and/or inaccurate the entire application will be disqualified and the applicant precluded from further consideration within the application process.

Name and title of the person authorised to sign this undertaking:

Authorised Signature: ____________________

Date:________________2010

I certify that this declaration was signed and sworn to before me at ............................... on the .............. day of ........................... 2010, by the deponent who acknowledged that he/she: