_______ 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

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

UNOFFICIAL TRANSLATION PAGE 12 Certification and Consensus of Audit Firm Date ........ Month ....................... Year ............... Dear Secretary-General of the Office of the Securities and

Form 61-2F Certification and consensus of audit firm Date ........ Month .......................... Year ............... Dear Secretary General of the Securities and Exchange Commission of Thailand

securities sold is less than the minimum amount specified by the issuer, the reasons for the cancellation of the offer for sale, and the securities subscription, etc.) - State the warning statement for

แบบแสดงราการข้อมูลประจำปี (UNOFFICIAL TRANSLATION) (Updated 2015) PAGE 4. Certification of Leader of Audit Firm Date ........ Month ............ Year.......... To: Secretary-General Office of the

แบบแสดงราการข้อมูลประจำปี UNOFFICIAL TRANSLATION Notification of the Change of Audit Firm Date ....... Month ............ Year ....…. Dear Secretary-General of the Office of the Securities and

manager in accordance with Section 144 or Section 145 or in accordance with the provisions of other laws; (6) being a political official; (7) being a government official with responsibility to supervise

แบบแสดงราการข้อมูลประจำปี (UNOFFICIAL TRANSLATION) (Revision 2015) PAGE 8. Audit Firm Profile and Details Name of Audit Firm................................. For the year ending

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