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I understand and accept the terms and conditions of my holding office as a Director set out above, and
confirm my acceptance of them. I confirm and certify that the information, consent, certification and any
disclosures provided by me to Penny Stonyer or Julie Saddington pursuant to my Appointment
Disclosure, Consent and Certification Form (Form) as part of the director appointment process remain
true and correct or I have otherwise enclosed updated information and/or disclosures. I consent to any
disclosure of interests in Part 3 of my Form being provided to Bell Gully, the NZIST Council and the
Company.
_____________________________
_____________________________
Signed
Date
