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
_______ 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
Instruments (No. 11) dated 25 October 2006; (3) Clause 3 and Clause 4 of the Notification of the Securities and Exchange Commission No. KorThor. 24/2549 Re: Rules, Conditions and Procedures for Supervision of
which is supervised by a regulator located in a country whose supervisory measures on investment management are recognized by the SEC Office; For the purpose of intermediaries’ compliance with the
category of derivatives dealer in its home country where it is subject to an official supervision or a derivatives trading regulator whose regulation on certain derivatives business is equivalent to those
derivatives contracts; “Foreign derivatives business operator” means any person undertaking derivatives business under the law of foreign country and under supervision of authority or agency which regulates
………………..Baht Information updated until (date)…………………………………………. 2. Information in detail for supplementing the consideration. 2.1 The business operation of the applicant is under the supervision of the State or
supervision of…………………………………………………… ……………………...……… (in case of a juristic person under supervision) (4) Type of Business…………………………………………………………… (5) Date of incorporation/registration …………….……. Country
; “State agency” means central administration, regional administration, local administration, financial institutions development fund, Bureau of Crown Property and other agency as specified by the Office
intermediary ; “ executive ” means a manager and a person responsible for control, supervision and management of the business units relating to investment advice, investment planning, analysis of investment or