: ......................... 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

/ 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

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

securities sold is less than the minimum amount specified by the issuer, the reasons for the cancellation of the offer for sale, and the securities subscription, etc.) - State the warning statement for

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

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