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
/ 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
Thailand; (3) an international financial institution; (4) a juristic person established under a specific law; (5) a government agency and a State enterprise under the law on budgetary procedure; (6) the
(company) (* The registration statement shall be signed either by a CIS Operator or an authorised person of the CIS Operator. The person who signs shall state his/her full name and capacity and shall ensure
) _________________________________________ (company) (* The registration statement shall be signed either by a CIS Operator or an authorised person of the CIS Operator. The person who signs shall state his/her full name and capacity and
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
in the house register: Address No. …………... Moo No. ………... Trok/Soi ………...…… Street ………….... Tambol/Khwaeng ……….. Ampoe/Khet…… Province ………… Postcode ……….. Telephone number …………...... Name of
securities company; or (b) an appointment is made in accordance with Section 145; (c) the securities company is a state enterprise under the law relating to budget procedures. (8) being a manager or a person
government agency and state enterprise under the law on budgetary procedure; (8) the Financial Institutions Development Fund; (9) a juristic person having total assets of five hundred million baht or more