: ......................... Sub-district: ................. District: ...................... Province: .................. Telephone: ................................................... Facsimile
appeared in the census registration: Address No. …….………... Moo No. ………….... Trok/Soi ………......…. Road …………….... Tambol/Subdistrict …………... Amphur/District ……. Province …………… Postal code ……..…….. Telephone
แบบแสดงรายการข้อมูลการเสนอขายหลักทรัพย์ (UNOFFICIAL TRANSLATION) Readers should be aware that only the original Thai text has legal force, and that this English translation is strictly for reference. 2 Registration Statement for Securities Offering (Form 69-1) Company: .......... (Name of Securities Offeror) ….....… Offers for Sale ....................................................................................................................................................... .................
/ 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
in the house register: Address No. …………... Moo No. ………... Trok/Soi ………...…… Street ………….... Tambol/Khwaeng ……….. Ampoe/Khet…… Province ………… Postcode ……….. Telephone number …………...... Name of