LOAN APPLICATION AND AGREEMENT ON HANDLING OF PERSONAL INFORMATION
Money Lending Registration No.: Governor of Tokyo

No. 31653

To Shinsei Investment & Finance Limited

Applicant and the co-signer who intend to act as the joint debtor・joint guarantor・collateral provider (hereinafter, the “Applicants”, “our” or “we”)
have read and agree to the below terms and clauses stipulated in “Provisions on Handling of Personal Information”, “Elimination of AntisocialForces” and “Elimination of Anti-Money Laundering and Financing of Terrorism” and would like to apply for a loan with Shinsei Investment &Finance Limited (hereinafter, the “Company”).
Applicants agree to accept all solicitation, in accordance with the Money Lending Business Act, in regard to the applicable loan agreements
Applicants understand that credit assessment will be separately conducted by the Company. Further, the Applicants will not make any objections in the casewhen loan is not granted as a result of the credit assessment, whatever the reason may be
Applicants acknowledge that all supporting documents submitted to the Company will not be returned regardless of the results of the credit assessment bythe Company

Tick here↓□ Applicant□ Joint Debtor・Joint Guarantor

Applicants agree to the clauses stipulated in “Provisions on Handling of PersonalInformation”, “Elimination of Antisocial Forces” and “Elimination of Anti-Money
Laundering and Financing of Terrorism”.
Application DateYYYY / MM / DD

SIGNATURE

Telephone No.

Address

NT

〒DOB

㊞

YYYY / MM / DD

(Establishment Date)

Name(Company Name)

Furigana（フリガナ）

Gender□Male□

FemaleNo. of Employees

if applicableTEL
MOBILE
Preferred Point of Contact:□ Mobile□ HomeE-Mail Address□ Home □ Mobile □ Office□ Other <Foreign PEPs

Politically Exposed Persons□ No □ Yes ⇒ Please note status:□ Office@>A

Immediate Family Members and Heirs
NameDOB

Relationship

Address

TELHeir□

C□
□

I□
□

EmployerType ofIndustry

L(Name of Representative Director)

Address□Company Employee□Self-Employed□Government Employee□OtherP

Occupation

TELDivision□Statutory Director□Representative Director

Position
Name of Company

PeriodP～～

Employment History

A～<Highest Level of Education>

Year of Graduation:

Last Year

Previous YearSalaryLoans (Annual Income

Business Income

PensionCurrency:

Rental Income

Expenses
per monthTotal)

Insurance

Total

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改定 2023.06

LOAN DETAILS

Requesting Loan
Amount (unit in JPY 100,000)

JPY

Loan Purpose□ Purchase□ New□ Investment

Source of Repayment□ Income

RentalRequesting
Drawdown Date
YYYY/MM/DD□ Refinance□ Secondhand□ Self-Occupancy
Salary/□ Business

Loan Term□

Property Location& Building Name

Overhead Expenses

Self-Funds/
EquityRequesting Loan
AmountTotal

Total

FINANCIAL
PLANS
OTHER
PROPERTIES

Do you own other properties in Japan?

□ YES※If yes, please fill out property details below

TAXES①□ NO

Property Location & Building Name②

Property Location & Building Name

Are your real estate tax, fixed asset tax & city planning taxes,
income taxes, all company/business related taxes, etc. paid up todate?
BORROWINGS

Savings, term deposits, etc.

ASSETS

Years

Real Estate Agentand Contact

Purchase Price

Stocks & other assets
Real estate

TotalNamePEPs□ NO

If answered “NO”, state reason:

OutstandingBalance

Purpose㊞
SIGNATURE

Relationshipwith ApplicantDate of Birth□Representative Director □Spouse□Parent □Child □OtherTELYYYY / MM / DDTEL
MOBILE

EMail(Politically Exposed Persons)□ No □ Yes ⇒ Please note status:

Employer

Annual Income

SUBSTANTIAL CONTROLLER(S)If the Applicant is a corporate, please refer to “Substantial Controller(s) and Foreign PEPs” flow chart.
Name

Foreign PEPs

①Relation WithCompany

Name

Foreign PEPs②

②追・再a ・ b ・ c ・ d・ A ・ B ・ C ・ D□ No □ Yes ⇒ If yes, please note status:

DOBAddress<当社使用欄>If applicable, fill out the below.

□ No □ Yes ⇒ If yes, please note status:

DOB

Address①情報調査

Monthly Payment

Total

Furigana（フリガナ）〒□ YES

LenderAddress

JOINT DEBTOR/GUARANTOR□Principal & Interest Equal Payment⇒□with balloon/bullet payment□Principal Equal Payment

Repayment
MethodRelation WithCompany

BL

JICC 照会件数
STARS II
CIC

KSC

BL

JICC 照会件数
STARS II
CIC

KSC

a ・ b ・ c ・ d・ A ・ B ・ C ・ D

チェック者

照会日：時間

照会者

検証担当

取引形態

依頼日

チェック者

照会日：時間

照会者

検証担当

取引形態

依頼日

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Applicants have read and agree to the terms and clauses stipulated below in “Provisions on Handling of Personal Information”, “Elimination ofAntisocial Forces” and “Elimination of Anti-Money Laundering and Financing of Terrorism” and wish to apply for a loan and conclude all relative
agreements to the loan (hereinafter the “Contracts”). Applicants hereby confirm that we have received and accepted a copy of this agreement.

PROVISIONS ON HANDLING OF PERSONAL INFORMATION
Article 1 Collection, Retention and Use of Personal Information
1.
Applicants agree and authorize Shinsei Investment & Finance Limited (hereinafter the “Company”) to collect and use our information outlined
below (hereinafter the “Personal Information”) with protective measures, for the reasons specified in the following articles (hereinafter the“Agreements”) in respect to the Contracts, the Company’s credit assessment and further management.
(1) Name, age, date of birth, address, telephone no., e-mail address, company name, family structure, living conditions, and personalidentification code (official codes such as driver’s license no., passport no., etc.)(2) Application date, agreement date, type of loan, agreed loan amount and number of payments in regards to the Contract(3) Outstanding loan balance following the commencement of the loan and monthly repayment status in regards to the Contract(4) Declared assets, liabilities, income, expenses, credit history obtained by the Company and past debt histories to assess our payment
abilities.
2.
If the Contract is an affiliated loan, Applicants agree and authorize the Company and the affiliated entity to mutually share such Personal
Information outlined in the preceding paragraphs (1) and (2), and any necessary information related to ongoing operational transactions,
within the extent required for business fulfillment.
Article 2 Use of Personal Information Other than for Credit Business
1.
Applicants agree and authorize the Company to use our Personal Information specified in Article 1 Paragraph 1 (1) and (2) to conduct theCompany’s loan business, insurance service business and other business operations specified in the Company’s Articles of Incorporation forthe following purposes.
(1) Introduction and information of new products and its aftercare services(2) Market research and development of new products and services(3) Advertisements and printed handouts on business information
2.
Applicants agree and authorize the Company to send advertisements and printed handouts on business opportunities on behalf of SBI Shinsei
Bank Limited (hereinafter "SBI Shinsei Bank”) and its group companies (hereinafter collectively referred to as "SBI Shinsei Bank Group").
※SBI Shinsei Bank Group is comprised of SBI Shinsei Bank and its consolidated subsidiaries and equity method affiliated companies outlined in
SBI Shinsei Bank’s financial statement.
Article 3 Use and Registry with Personal Credit Information Institutions
1.
Applicants agree and authorize the Company to make inquiries with the personal credit information institutions which the Company belongs
to, regarding Applicants’ and Applicants’ spouse’s registered information (if any and applicable) for the purpose in extent to make informed
decisions of the Applicants’ debt servicing abilities. (Personal credit information institution is a credit reference agency which maintains andprovides consumer credit data as a service. Hereinafter referred to as the "Member Credit Institution”. This data is also shared by all membersof the Member Credit Institution and its affiliated credit institutions, hereinafter referred to as the "Affiliated Credit Institutions”)
2.
Applicants agree and acknowledge that Applicants’ Personal Information in regards to the Contract and its transaction facts will be registeredwith the Member Credit Institution for a period specified in the following chart. Applicants also understand that this information will beshared with its members and the Affiliated Credit Institutions for the purpose in extent to make informed decisions of the Applicants’ debt
servicing abilities.
Registered Information

Period of Registration

A period not exceeding 6 months from the inquiry with the personal credit
information institution
Duration of the Agreement and period not exceeding 5 years from terminationof the Agreement
Duration of delinquency and period not exceeding 5 years from termination ofthe Agreement
A period not exceeding 1 year from the occurrence of assignment of loan claims① Personal information based on application fact of the Agreement② Information on the objective facts of transactions of the Agreement③ Information on the facts of payments in arrears④ Information on the facts of assignment of loan claims

3.

4.

5.

Member Credit Institution mentioned above which the Company belongs to are as follows.
If the Company shall belong and register with other personal credit information institution in the future, the Company shall notify theApplicants in writing in advance and obtain our consent.
•Japan Credit Information Reference Center Corp. (JICC)
HP: https://www.jicc.co.jp/※For details regarding membership and qualifications with JICC, please visit the above HP above (available in Japanese only).
Affiliated Credit Institution in alliance with JICC:•
The Personal Credit Information Center (PCIC) HP: https://www.zenginkyo.or.jp/※For details regarding membership and qualifications with PCIC, please visit the above HP above (available in Japanese only).
•Credit Information Center Corporation (CIC) HP: https://www.cic.co.jp※For details regarding membership and qualifications with CIC, please visit their HP above (available in Japanese site only).
Information to be registered with the Member Credit Institution specified in preceding 3. are the following: such as name, date of birth,gender, address, telephone no., employer and telephone no., personal identification code and information to specify an individual, marital
status if applicable, etc., type of agreement, agreement date, agreed loan amount, drawdown amount, type of loan, number of paymentsand other agreement details, outstanding balance, repayment date, maturity date and all information on delinquency status.

Article 4 Joint Use of Personal Information within SBI Shinsei Bank Group
Applicants agree and authorize the Company to jointly use our Personal Information, listed in Article 1 Paragraph 1 (1) thru (4) (excluding all PersonalInformation obtained from personal credit information institutions listed in Article 3), with the affiliated companies within SBI Shinsei Bank Group,to the extent required for the fulfillment of the following purposes. SBI Shinsei Bank will be in charge of all management of jointly used PersonalInformation.
(1) Offering of information on various products and services(2) Offering of aftercare services of products and services we are currently using, and offering of compliments and benefits by SBI Shinsei BankGroup(3) Judgement on offering of various products and services(4) Awareness of various risks and appropriate management of operations within SBI Shinsei Bank Group※The Company will announce, on its homepage, of all names of affiliated companies within SBI Shinsei Bank Group, which the Company will
jointly use the Personal Information.

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Article 5 Other Use of Personal Information
Loan claims may be transferred to other entities by means of assignment or by securitization. If and when such transfer should take place,
Applicants agree and acknowledge that our Personal Information will be provided for the purpose of claims management and collection to anassignee or to a special entity established to handle securitization (hereinafter the “Assignees"), to the extent required for the transfer.
Article 6 Disclosure, Corrections and Deletion of Personal Information
1.
Applicants acknowledge, in accordance with the Personal Information Protection Act, that we may request the Company, personal credit
information institutions specified in Article 3 and the Assignees noted in Article 5 to disclose our own Personal Information andthird-party provision records.
(1) For any Personal Information disclosures with the Company, please contact the inquiry desk described in Article 9. The inquiry desk shallguide you with the procedures in obtaining the disclosure (request counter, receiving method, necessary documents, fees, etc.)(2) For disclosures registered with the personal credit information institutions, please contact the respective institutions directly as listed inArticle 3.
(3) For disclosures regarding loan claims noted in Article 5, please contact the Assignees directly.
2.
If any personal details registered are found to be false, the Company will ensure that the details are amended or deleted.
Article 7 Measures Against Objections
Applicants acknowledge that if we object to provide or fill out the necessary details pertaining to the Contract or failing to acknowledge all or partof this Agreement, the Company may refuse the Contract. However, the Company will not refuse this application and the Contract though Articles2
and 4 of this Agreement are not agreed.
Article 8 Discontinuance of Use
Upon Applicants request, we understand that the Company will discontinue the once agreed use of our Personal Information for the purposes
stated in Articles 2 and 4.
Article 9 Inquiry Desk Concerning the Handling of Personal Information
For any inquiries regarding disclosure, amendment, discontinuance of use or for any matters regarding your Personal Information, please refer tothe Company’s Policy Concerning Protection of Personal Information (available in Japanese only) below.
• Policy Concerning Protection of Personal Information
https://www.shinsei-if.com/privacy-policy/
Article 10 Failure in Concluding the Contract
Applicants understand and agree to the use of our Personal Information listed in Article 1 and Article 3 Paragraph 2 ① for a specified period
regardless of the conclusion of the Contract. Applicants also agree that our Personal Information may continue to be used for the purpose statedin Article 2 Paragraph 1 (1).
Article 11 Amendment of the Agreement
The Company may amend the articles in this Agreement, in accordance with the laws and regulations, to the extent required.

ELIMINATION OF ANTISOCIAL FORCES
1.

2.

3.

Applicants represent and make a definite promise that we do not, or will not, fall within the definition of a Boryokudan (organized crimegroup), a Boryokudan member, a person who left a Boryokudan within five years, a quasi-member of a Boryokudan, a company affiliated witha Boryokudan, a Sokaiya, a hoodlum who claims to advocate for social activities, etc., a violent group misusing professional knowledge or aperson similar to any of the foregoing (hereinafter, the "Boryokudan Member, etc.”) or any of the following items:(1) Those who have relationships with a Boryokudan member, etc., who is recognized to be controlling their operations;(2) Those who have relationships with a Boryokudan member, etc., who is recognized to be substantially involved in their operations;(3) Those who have relationships which are recognized to be willfully using a Boryokudan member, etc., for the purpose of obtaining unjust
profits for the person himself/herself, their own company, or a third party, or for the purpose of causing damage to a third party;(4) Those who have relationships which are recognized to be providing funds or benefits, etc., for a Boryokudan member, etc.; or(5) An officer or a person who is substantially involved in its operation has relationships with a Boryokudan member, etc., that are
unacceptable from the standpoint of social norms.
Applicants make a definite promise not to do any of the following acts by ourselves or by using a third party:(1) Making a threatening demand (boryoku-teki yokyu koui);(2) Making an illegal or unjustifiable demand;(3) In relation to a transaction, engaging in a threatening speech or behavior or threatening to use or using illegal forces;(4) Starting a malicious or false rumor, or discrediting the company or disturbing the company’s business by fraudulent means or illegal
force; or(5) Any activities similar to any of the foregoing.
Applicants represent and make a definite promise that we do not, and will not, engage in or be involved in any transnational organized crime,etc., or any act or conduct that is equivalent thereto.

ELIMINATION OF ANTI-MONEY LAUNDERING AND FINANCING OF TERRORISM
Applicants represent and warrants that we will not make use of this agreement for transactions in conflict with anti-money laundering, counter
financing of terrorism and/or any laws and regulations related to economic sanctions.

※ If and to the extent there is any inconsistency or conflict between the Japanese and English language versions of all documents, theJapanese language version shall prevail.

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