E-mail address Telephone number Fax number Mobile phone number 2. Principal place of practice Firm Name Position in the firm Address City State Postcode Country E-mail address Telephone number Fax

: _________________________________________________ 11) Home Economy of CIS Operator: _________________________________________ 12) Home Regulator of CIS Operator: ________________________________________ 13) Address of principal place of business

_______ Country _______ Expiry date _______ Home Address _______ City State Postcode Country E-mail address Telephone number Fax number Mobile phone number 2. Principal place of practice Firm Name Position

.: _________________________ 15) Is the CIS Operator currently licensed or authorised to conduct fund management in the jurisdiction of its principal place of business? Yes No If “No”, please specify

ข้อตกลง Principal …………. ราย Agent ……………. ราย 2. มูลค่าหลักประกันต่ำกว่าข้อตกลง Principal …………. ราย Agent ……………. ราย ขอรับรองว่ารายงานนี้ถูกต้องครบถ้วนตรงต่อความเป็นจริง …………………………… (เจ้าหน้าที่ผู้มี

: ________________________________________ 12) Home Regulator of the CIS Operator: ________________________________________ 13) Address of principal place of business: _______________________________________

Covered Management Company: ______________________________________________________________________ 9) Address of principal place of business: _______________________________________

. 2 Registration Statement for Securities Offering (Form 69-1) Company: .......... (Name of Securities Offeror) ….....… Offers for Sale

Checklist for Registration Statement for an offer for sale of units of foreign collective investment scheme Form 69 – CIS full [ ] 1. Fund Fact Sheet/ Product Highlight Sheet (Part I) [ ] [ ] 2. Key

Checklist for Registration Statement for an offer for sale of units of foreign collective investment scheme Form 69 – CIS annually update [ ] 1. Fund Fact Sheet / Product Highlight Sheet (Part I