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

: ............................................(authorized person) for and on behalf of ................................... Contact person: .................................................... Phone: ......................... E-mail

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

reference. 4 Notification of the Securities and Exchange Commission No. Kor Khor. 8/2554 Re: Approval for Undertaking Derivatives Business in the Category of Derivatives Brokerage Limited to Precious Metals

Securities and Exchange Commission No. KorKhor. 8/2554 Re: Approval for Undertaking Derivatives Business in the Category of Derivatives Brokerage Limited to Precious Metals Derivatives _____________ By virtue

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

: Type of Business: __________________________ Head Office: __________________________________________________________________ Registration Number: Home Page (if any): ________________________ Telephone

........................... Contact person: .................................................... Phone: ........................ E-mail:............................ Remarks : 1. In case of domestic branch office, the applicant is

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