- Translation - Tender Offer for Securities (Form 247-4) Of Glow Energy Public Company Limited By Global Power Synergy Public Company Limited (The Tender Offeror) The Siam Commercial Bank Public Company Limited And Phatra Securities Public Company Limited (Tender Offer Preparers) Phatra Securities Public Company Limited (Tender Offer Agent) “This English language translation of the Tender Offer has been prepared solely for the convenience of the foreign shareholders of Glow Energy Public Company...
: ............................................................. Province: .................................... Zip code: ........................... E-mail: .............................................................. Telephone
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
appeared in the census registration: Address No. …….………... Moo No. ………….... Trok/Soi ………......…. Road …………….... Tambol/Subdistrict …………... Amphur/District ……. Province …………… Postal code ……..…….. Telephone
. …….………... Moo No. ………….... Trok/Soi ………......…. Road …………….... Tambol/Subdistrict …………... Amphur/District ……. Province …………… Postal code ……..…….. Telephone number …………….... (4) Contact address (Blank if the same
/ 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
: ............................................................. Province: .................................... Zip code: ........................... E-mail: .............................................................. Telephone
/ Building Moo Trok / 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
, exporting of cars, buses, transportation vehicles and all types of vehicles. Location No. 88 Village No. 2, Kalong Sub district, Mueang Samut Sakhon District, Samut Sakhon Province, Postal Code 74000 Before
_______ 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