5. Signatory’s phone number 4. Signatory’s permanent address 3. E-mail of the Signatory for which the certificate is issued 2. Signatory’s Personal Identification Number or date of birth(yymmdd) Spektar Org ® Revision: 1.4/29.01.08 Form 2.9 Application form for Spektar PersonalNonUniversal Certificate FORM 2.9 APPLICATION APPLICANT REGISTRATION NUMBER given at registration on the certification services provider’s website To be filled in by the Date / / ã. Spektar PersonalNonUniversal Certificate ². Electronically certificated information FIELD CONTENT 1. Signatory’s name in full John Jameson for example for example for example: street,¹,block,entr.,city,*country. 1234567890 jjameson@spektar.org South Street,26,London,UK +359 2 9688 180 1 6. Owner’s name in full John Jameson 7. Owner’s Signatory’s Personal Identification Number for example: 8. Region of the Owner’s address Sofia for example for example for example for example 1234567890

2 9. Owner’s address Karnegi 11A,Sofia for example: str.,¹,block,entr.,town,*country 10. Postal code of the Owner’s address 11. Country II. Additional data concerning the OWNER Responsible Person Invoice addressee Contact phone number of the invoice addressee I²². Information for additional identification/check The PROVIDER uses this password (between 4 and 8 symbols) for authentication in case of forgotten log in password in the personal profile and in case of application for termination of the certificate. Password For example: R2DI5N78 Owner’s SIGNATURE: UK for example Spektar Org ® Revision: 1.4/29.01.08 Form 2.9 Application form for Spektar PersonalNonUniversal Certificate