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

depositor shall be entitled to withdraw the principal in full and at any time from the counter party comparable to the deposit accepter; (3) savings deposit lottery issued under the Law governing the Bank for

.: _________________________ 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

amount of money required to be segregated each day shall not be less than the total amount of the net balance calculated at the end of the prior working day or at the end of the present working day from

of more than one product line or business group, disclose the income proportion of each in the table below, which shall include at least those contributing more than 10 percent of the total income in

........ Year ............. Year ............. Year ............ Total assets Total liabilities Shareholders’ equity Total income Cost Net profits Earnings per share (EPS) Debt/equity ratio (D/E ratio) Return on

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

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

years; 1.1.5 Name and location of the head office, type of business, company registration number, telephone number, facsimile number, the Company’s website (if any), the number and type of the total