Checklist for Foreign Exchange-Traded Fund (ETF) Application Form Name of foreign ETF: ________________________________________________________ Home Economy
Home Regulator’s jurisdiction ( issued by Home Regulator ) [ ] 3. Evidence on the appointment of a brokerage firm to perform duty as local intermediary in Thailand ( issued by CIS Operator ) [ ] 4
Home Jurisdiction: ___________________________________________________________ [ ] 1. Form 69 – CIS full ( completed by Qualifying CIS Operator ) [ ] 2.* Standard letter issued by the Home Regulator to a
established under the law of Home Regulator’s jurisdiction ( issued by Home Regulator ) [ ] 3. Evidence on the appointment of a securities company to perform duty as local intermediary in Thailand ( issued by
with the Home Regulator does not contain the information specified in the registration statement listed above and other disclosure requirements stipulated by the SEC Thailand. Part III Certification of
approved by, registered, or filed with the Home Regulator does not contain the information specified in the registration statement listed above and other disclosure requirements stipulated by the SEC
reference. The SEC, Thailand cannot undertake any responsibility for its accuracy, nor be held liable for any loss or damages arising from or related to its use. Notification of the Securities and Exchange
application. b. Please mark an X in the appropriate box corresponding to your answer c. Send completed and signed forms to - Accounting Supervision Department The Securities and Exchange Commission, Thailand
, Thailand 333/3 Vibhavadi-Rangsit Road, Chomphon, Chatuchak Bangkok 10900, Thailand Tel. +66 1207 or +66 2695 9587 Fax. +66 2695 9793 e-mail : oca@sec.or.th 1. Applicant details Mr. Miss Mrs. Other (please
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