) ………………………………………………………… Location of head office ……………………………………………………………… …………………………………………………………………..…………………… Telephone number …………………….. Facsimile number ……………………….. Part 2: Category of an applicant □ A commercial bank under the

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

keeping the password in the safe etc. and restriction for the necessary case only · Specifying the compliance period and instantly when that period had lapse. · Change the password strictly in case of the

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

_______ 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

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

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

: ......................... Sub-district: ................. District: ...................... Province: .................. Telephone: ................................................... Facsimile

…………................................................................. …………………………….......................................................................... telephone number…………………….. facsimile number ………………………… 2. Details for supplementing the consideration: 2.1 A license granted by the authorized organization or agency under the law (only in the case of a CB

....................................................................................................................... telephone:................., facsimile: ..................., Website /home page: ………………..................., e-mail: address..........................., branch office located at (if any