{"id":"court_ctb_1797_19","court":"CTB","case_no":"22-50073","doc_number":1797,"sub_number":19,"doc_type":"EXHIBIT","filed_date":null,"title":"Exhibit 19 VISTRA V","summary_zh":null,"summary_en":null,"body_en":"## **Exhibit 19**\n\nVISTRA V\n\n## BRITISH VIRGIN ISLANDS\n\nForm: DDBVI - P2\n\nDue Diligence Verification of Identity Form for Individual Clients\n\nThe information below is required to comply with the Anti-Money Laundering Laws of the relevant jurisdiction, and to eliminate the risk that the legal operation of your company is affected in the future.\n\n|                                                                                                                                                                                                                                                                                             | Name of Company: ALLIED CAPITAL GLOBAL LIMITED                    |                     |                            |               |\n|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------|---------------------|----------------------------|---------------|\n| Nature of Business: (please 'v' as appropriate)                                                                                                                                                                                                                                             |                                                                   |                     |                            |               |\n| (i)                                                                                                                                                                                                                                                                                         | V Investment Holding                                              |                     | C Consultancy              | Import/Export |\n| Trading<br>C Manufacturing                                                                                                                                                                                                                                                                  |                                                                   |                     | O Others (please specify): |               |\n|                                                                                                                                                                                                                                                                                             |                                                                   |                     |                            |               |\n| (ii) Please provide a brief description of Company's business activities: Finance Investment, Management                                                                                                                                                                                    |                                                                   |                     |                            |               |\n| Source of Funds: Personal Assets of Beneficial Owner O Public Listing & Borrowings/Loans                                                                                                                                                                                                    |                                                                   |                     |                            |               |\n| O Others (please specify) : _                                                                                                                                                                                                                                                               |                                                                   |                     |                            |               |\n| Beneficial Owner / Applicant for Business                                                                                                                                                                                                                                                   |                                                                   |                     |                            |               |\n| (a) Full Name:                                                                                                                                                                                                                                                                              | Guo Mei                                                           |                     |                            |               |\n| (b) Business address:                                                                                                                                                                                                                                                                       | Room 2106, Yardley Commercial Building, No 3 Connaught Road West, |                     |                            |               |\n|                                                                                                                                                                                                                                                                                             | Sheung Wan, Hong Kong                                             |                     |                            |               |\n| (c) Permanent Residential Address: 22 SOUTH BAY ROAD, LEVEL 1 (UNIT B1), HONG KONG                                                                                                                                                                                                          |                                                                   |                     |                            |               |\n|                                                                                                                                                                                                                                                                                             |                                                                   |                     |                            |               |\n| (d) Telephone:                                                                                                                                                                                                                                                                              | 2160 0816 / 2160 0888                                             |                     |                            |               |\n| (e) Fax:                                                                                                                                                                                                                                                                                    | 2160 0808                                                         |                     |                            |               |\n| (f) Email:                                                                                                                                                                                                                                                                                  | hk.company.secretary@gmail.com                                    |                     |                            |               |\n| (g) Date of Birth:                                                                                                                                                                                                                                                                          | 1989-01-28                                                        |                     |                            |               |\n| (h) Nationality:                                                                                                                                                                                                                                                                            | HONG KONG                                                         |                     |                            |               |\n| Occupation:<br>(1)                                                                                                                                                                                                                                                                          | MANAGER                                                           |                     |                            |               |\n| Please attach: (1) a certified copy* of Current Passport or Identity Card;                                                                                                                                                                                                                  |                                                                   |                     |                            |               |\n| and (2) One of the following:<br>- Residential address proof (e.g. original or certified copy* of utility bill / bank statement); or<br>- Reference from bank or qualified professional (see attached sample wording)                                                                       |                                                                   |                     |                            |               |\n| * Copy may be certified by Lawyer/CPA/Bank in the attached format                                                                                                                                                                                                                           |                                                                   |                     |                            |               |\n| I / We confirm that the above information is true and accurate, and you are authorised to supply any or all of such<br>information for due diligence purposes to the Regulators if so requested by them. We also undertake to notify you of any<br>future changes to the above information. |                                                                   |                     |                            |               |\n| Client Signature:                                                                                                                                                                                                                                                                           |                                                                   | Print Name: Guo Mei |                            |               |\n|                                                                                                                                                                                                                                                                                             |                                                                   | Date:               | 2017-07-04                 |               |\n\nPlease return this form and attachments to: Compliance Department Vistra Hong Kong 19/F, Lee Garden One, 33 Hysan Avenue, Causeway Bay, Hong Kong\n\n![](_page_2_Picture_1.jpeg)\n\n## CERTIFIED TRUE COPY\n\nI, the undersigned, hereby certify that this document is a true and complete copy of the original or a properly certified true copy of the original Dated 4 24124 2017\n\n5\n\nYU FIONA KA WING Barrister, Hong Kong SAR\n\n![](_page_2_Picture_6.jpeg)\n\n![](_page_3_Picture_0.jpeg)","body_zh":"证物 19\n\nVISTRA V（瑞致达）\nBRITISH VIRGIN ISLANDS（英属维尔京群岛）\n\n表格：DDBVI - P2\n\n个人客户尽职调查身份核验表\n\n以下信息系为遵守相关司法管辖区的反洗钱法律，并消除贵公司未来合法运营受到影响的风险所必需。\n\n公司名称：ALLIED CAPITAL GLOBAL LIMITED（联资全球有限公司）\n\n业务性质：（请在适用的选项打勾）\n(i) [勾选] 投资控股 [ ] 咨询 进/出口\n贸易\n[ ] 制造 [ ] 其他（请注明）：\n\n(ii) 请简要说明公司的业务活动：财务投资、管理\n资金来源：受益所有人的个人资产 [ ] 上市及借款/贷款\n[ ] 其他（请注明）：_\n受益所有人 / 业务申请人\n(a) 全名：Guo Mei（郭美）\n(b) 营业地址：Room 2106, Yardley Commercial Building, No 3 Connaught Road West, Sheung Wan, Hong Kong（香港上环干诺道西3号亿利商业大厦2106室）\n(c) 永久居住地址：22 SOUTH BAY ROAD, LEVEL 1 (UNIT B1), HONG KONG（香港南湾道22号1楼B1室）\n\n(d) 电话：2160 0816 / 2160 0888\n(e) 传真：2160 0808\n(f) 电子邮箱：hk.company.secretary@gmail.com\n(g) 出生日期：1989-01-28\n(h) 国籍：HONG KONG（中国香港）\n职业：\n(1) 经理\n请附上：(1) 当前护照或身份证的认证副本*；\n以及 (2) 以下材料之一：\n- 住址证明（例如公用事业账单/银行对账单的原件或认证副本*）；或\n- 银行或合资格专业人士出具的推荐信（参见所附样本用词）\n* 副本可由律师/注册会计师/银行按所附格式进行认证\n本人/我们确认上述信息真实准确，且在此授权贵方在监管机构提出要求时，为尽职调查之目的向其提供上述任何或全部信息。我们亦承诺将上述信息的任何未来变更通知贵方。\n客户签名： 印刷体姓名：Guo Mei（郭美）\n日期：2017-07-04\n\n请将本表格及附件交回至：Compliance Department Vistra Hong Kong 19/F, Lee Garden One, 33 Hysan Avenue, Causeway Bay, Hong Kong（香港铜锣湾希慎道33号利园一期19楼瑞致达香港合规部）\n核证无误副本\n\n本人（即下述签署人）特此证明，本文件为原件的真实完整副本，或原件经适当认证的真实副本，日期：4 24124 2017\nYU FIONA KA WING（余嘉颖），大律师，香港特别行政区","key_entities":["Guo"],"ecf_references":[],"word_count":517,"status":"published","published_at":null,"created_at":null,"updated_at":"2026-08-23 13:02:16"}