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

: _________________________________________________________ 3) Home Regulator: _________________________________________________________ 4) Main/Home Exchange: _____________________________________________________ 5) Legal Structure of Foreign ETF

_______ 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

main objective is to promote and develop securities businesses in the category of investment management; “Private fund manager” means a director or an employee of a securities company licensed to

Securities and Exchange Commission; □ A limited company or a public limited company whose main principles are in the business of securities or financial instruments custody and of other businesses as approved

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

institution which is governed by a main regulator and later obtains a license to undertake securities business, but not including a financial institution licensed to undertake securities borrowing and lending