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
_______ 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
persons. Companies should arrange a call tree and a name list of customers, the main service providers and other relevant persons, including contact information, such as an office phone number, home phone
preparation and submission of daily status report in text file via OFAR Version 1.7 Intermediaries Supervision Policy Department Telephone: 0-2263-6257 Facsimile: 0-2263-6487
: ............................................(authorized person) for and on behalf of ................................... Contact person: .................................................... Phone: ......................... E-mail
: Type of Business: __________________________ Head Office: __________________________________________________________________ Registration Number: Home Page (if any): ________________________ Telephone
comply with the requirements accordingly. Sincerely -signature- (Mr. Vorapol Socatiyanurak) Secretary-General Intermediaries Supervision and Development Department Telephone: 0-2263-6255 Fax: 0-2263-6446
the responsible officer and a person having authority to decide and preparing the list of names and telephone numbers of related persons and notifying the responsible person (For example: call out tree
: ......................... Sub-district: ................. District: ...................... Province: .................. Telephone: ................................................... Facsimile
) ………………………………………………………… Location of head office ……………………………………………………………… …………………………………………………………………..…………………… Telephone number …………………….. Facsimile number ……………………….. Part 2: Category of an applicant □ A commercial bank under the