specify) Full name as per Passport Date of birth (DD/MM/YYYY) Passport number Identification number Country of issue of Passport CPA license number Issued by Country Home address City State Postcode Country

established under specific law which are not persons under (9); (7) Bank of Thailand; (8) International financial institutions; (9) Government agencies and state enterprises under the laws on budgetary

sources and has a lower impact on the environment than fossil energy; (6/1)1 “ state ” means: (a) government administration; (b) government organization under the Law on Establishment of Government

_______ 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

Thailand; (3) an international financial institution; (4) a juristic person established under a specific law; (5) a government agency and a State enterprise under the law on budgetary procedure; (6) the

(company) (* The registration statement shall be signed either by a CIS Operator or an authorised person of the CIS Operator. The person who signs shall state his/her full name and capacity and shall ensure

) _________________________________________ (company) (* The registration statement shall be signed either by a CIS Operator or an authorised person of the CIS Operator. The person who signs shall state his/her full name and capacity and

signs shall state his/her full name and capacity and shall ensure the declaration is dated.) Form updated as of June 2021 Name of foreign collective investment scheme (CIS): Home jurisdiction: Name of

) international financial institutions; (8) government agencies and state enterprise under the law on budgetary procedure; (9) the Financial Institutions Development Fund; (10) the Government Pension Fund; (11

securities company; or (b) an appointment is made in accordance with Section 145; (c) the securities company is a state enterprise under the law relating to budget procedures. (8) being a manager or a person