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
………………..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
of the country), hereby certify follows; 1. My immediate family member, including spouse (or equivalent) and dependent, and I do not hold any share of my audit clients and or its related entities. 2
conforming to the rules under Clause 6/1; (3) in case of investment units having been sold in a foreign country, the appointment to be an agent therein shall be conforming to the rules under Clause 8. Clause 6
to the rules under Clause 6/1; (3) in case of investment units having been sold in a foreign country, the appointment to be an agent therein shall be conforming to the rules under Clause 8. Clause 6 In
sources and has a lower impact on the environment than fossil energy; (6/1)1 “ state ” means: (a) government administration; (b) government organization under the Law on Establishment of Government
; “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
/ Soi Road Sub-district District Province Zip Code Country Tel. Fax. E-mail Overseas Address : (only for a non-Thai national, please specify overseas contact address) 1.6 Academic Background Highest
:- (1) the client’s name is listed on the database in Clause 14(1) or (2), or the client’s nationality, residential address, source of fund, country of origin, contact address, or business address is in a