: Contact person: Email: Name of local representative: Contact person: Email: Name of local intermediary: [in case of an ETF, please state the names of market maker and participating dealer of ETF] Contact

: Contact person: Email: Name of local representative: Contact person: Email: Name of local intermediary: [in case of an ETF, please state the names of market maker and participating dealer of ETF] Contact

: Contact person: Email: Name of local intermediary:[in case of an ETF, please state the names of market maker and participating dealer of ETF] Contact person: Email: * Please choose the following form that

: Name of local representative: Contact person: Email: Name of local intermediary: [in case of an ETF, please state the names of market maker and participating dealer of ETF] Contact person: Email

government agency and state enterprise under the law on budgetary procedure; (8) the Financial Institutions Development Fund; (9) a juristic person having total assets of five hundred million baht or more

in the firm Address City State Postcode Country E-mail address Telephone number Fax number Does your firm belong to an international network ? Yes No If yes, please state the – Name of the network

and must have been approved by the provident fund committee or the provident fund director to participate in the contest. The contest holds 3 categories which are (1) single fund of state enterprise

of the CIS Operator. The person who signs shall state his/her full name and capacity, and shall ensure the declaration is dated.) “I have duly examined the information contained in this registration

local representative: Name of local intermediary:[in case of an ETF, please state the names of market maker and participating dealer of ETF] Warnings: An investor considering the purchase of units of

operator: Name of local representative: Name of local intermediary: [in case of an ETF, please state the names of market maker and participating dealer of ETF] Warnings: An investor considering the purchase