I, [•], Filipino, of legal age, am a stockholder of FIGARO COFFEE GROUP INC. (hereinafter the “Company”), do hereby state as follows:

I hereby grant my consent to the collection, recording, retention, use, storage, updating, modification, and processing by the Company of my personal and sensitive personal information which I have provided for the purpose of registration for the Company’s Special Stockholders’ Meetings, in the event I am a director or officer of the Company, for the purpose of attendance and keeping of records of the board meetings of the Company, for listings, offerings (either debt or equity), issuances of debt or equity, disclosures, filings, and submissions as required by the Securities and Exchange Commission, Philippine Stock Exchange, and other government agencies in compliance with law and the regulations of the Philippine Stock Exchange, for announcements to shareholders and the public, for record keeping by the corporate secretary and the stock and transfer agent, and for all other legitimate purposes that are necessary or incidental to the same, or are necessary or related to such;

I hereby grant my consent for the disclosure by the Company of my personal and sensitive personal information to third parties duly designated by the Company, and for the processing by such third parties of said information for the purpose of registration/attendance and keeping of records for the Company’s Special Stockholders’ Meetings; in the event I am a director or officer of the Company, for the purpose of attendance and keeping of records of the board meetings of the Company; for listings, offerings (either debt or equity); issuances of debt or equity; disclosures, filings, and submissions as required by the Securities and Exchange Commission, Philippine Stock Exchange, and other government agencies in compliance with law and the regulations of the Philippine Stock Exchange; for announcements to shareholders and the public; for record keeping by the corporate secretary and the stock and transfer agent; and for all other legitimate purposes that are necessary or incidental to the same, or are necessary or related to such;

I hereby voluntarily grant my consent to the storage and retention by the Company of my personal and sensitive personal information throughout the period allowed by law, the applicable rules regulations, and policies of the Company;

I acknowledge and agree that the Company has put in place appropriate organizational, physical, and technical security measures to protect my personal and sensitive personal information. I am also aware that notwithstanding the said privacy protection measures that have been put in place by the Company, there is a risk that my information may be subject to unauthorized disclosure, processing, or breach.

I agree to hold the Company, its directors, officers, employees, and agents, free and harmless from any damage, loss, liability, or injury that I may suffer account due to any unauthorized disclosure, processing, or breach of personal and sensitive personal information, provided that there is no bad faith or gross negligence on the part of the Company or any of its officials or employees or agents who directly process my personal and sensitive personal information;

This consent shall be effective for a period of five (5) years hereon or for the entire duration of the registration/attendance and keeping of records for the Company’s Special Stockholders’ Meetings; in the event I am a director or officer of the Company, for the purpose of attendance and keeping of records of the board meetings of the Company; for listings, offerings (either debt or equity); issuances of debt or equity; disclosures, filings, and submissions as required by the Securities and Exchange Commission, Philippine Stock Exchange, and other government agencies in compliance with law and the regulations of the Philippine Stock Exchange; for announcements to shareholders and the public; for record keeping by the corporate secretary and the stock and transfer agent; and for all other legitimate purposes that are necessary or incidental to the same, or are necessary or related to such, whichever period comes later.