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Supplement 13 Information on Associated Entity
(For completion by an associated entity. Not applicable where the associated entity is a licensed corporation or registered institution.)
[Specified under section 402 of the Securities and Futures Ordinance (Cap. 571)]
Section 1: Name of Corporation Becoming an Associated Entity
Name (in English)
Name (in Chinese)
Business name (if applicable)
Section 2: Corporate Details (please enclose a copy of your incorporation document (e.g. certificate of incorporation)
Place of incorporation
Date of incorporation (dd) (mm) (yyyy)
Financial year end (dd) (mm)
Name of auditor
Section 3: Contact Information (please provide information on your principal place of business, registered office and correspondence addresses)
1 Address (Please tick “” where applicable)
Principal place of business Registered office Correspondence
Flat, floor and block no.
Building name
Street no. & name
District & city
State & country
Postal code, if any
Telephone and facsimile numbers (telephone) (facsimile)
E-mail and website addresses
(e-mail) (website)
Effective date (dd/mm/yyyy)
1February 2017(SFC logo updated in November 2018)
2 Address (Please tick “” where applicable)
Principal place of business Registered office Correspondence
Flat, floor and block no.
Building name
Street no. & name
District & city
State & country
Postal code, if any
Telephone and facsimile numbers (telephone) (facsimile)
E-mail and website addresses
(e-mail) (website)
Effective date (dd/mm/yyyy)
3 Address (Please tick “” where applicable)
Principal place of business Registered office Correspondence
Flat, floor and block no.
Building name
Street no. & name
District & city
State & country
Postal code, if any
Telephone and facsimile numbers (telephone) (facsimile)
E-mail and website addresses
(e-mail) (website)
Effective date (dd/mm/yyyy)
February 2017(SFC logo updated in November 2018)
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Section 4: Premises for Keeping Books and Records on Intermediaries’ Client Assets Received or Held in Hong Kong
1 Address
Flat, floor and block no.
Building name
Street no. & name
District & city
State & country
Postal code, if any
Telephone and facsimile numbers
(telephone) (facsimile)
Effective date (dd/mm/yyyy)
2 Address
Flat, floor and block no.
Building name
Street no. & name
District & city
State & country
Postal code, if any
Telephone and facsimile numbers
(telephone) (facsimile)
Effective date (dd/mm/yyyy)
February 2017(SFC logo updated in November 2018)
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Section 5: Bank Accounts for Holding Intermediaries’ Client Assets Received or Held in Hong Kong(Not applicable to an associated entity which is an authorized financial institution)
1Name of bank
Account number
2Name of bank
Account number
3Name of bank
Account number
4Name of bank
Account number
5Name of bank
Account number
Section 6: Financial Status(Not applicable to an associated entity which is an authorized financial institution)
Is there any matter that may render you insolvent or lead to the appointment of a liquidator?
Yes (please specify)
February 2017(SFC logo updated in November 2018)
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No
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Section 7: Circumstances of Becoming an Associated Entity
Please describe your circumstances of becoming an associated entity of an intermediary.
1 Name of associated intermediary: CE No.
Circumstances of becoming an associated entity:
2 Name of associated intermediary: CE No.
Circumstances of becoming an associated entity:
3 Name of associated intermediary: CE No.
Circumstances of becoming an associated entity:
February 2017(SFC logo updated in November 2018)
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Section 8: List of Executive Officers“Executive officer” in the context of an associated entity means any director of the associated entity who is responsible for directly supervising the receiving or holding of the intermediaries’ client assets.
1 Name of executive officer
(in English)
(in Chinese)
HK identity card/Passport number^
Passport issuing country^
Passport expiry date^
Residential address in Hong Kong
Flat, floor and block no.
Building name
Street no. & name
District & city
State & country
Postal code, if any
Telephone and facsimile numbers (telephone) (facsimile)
E-mail address
Correspondence address
Flat, floor and block no.
Building name
Street no. & name
District & city
State & country
Postal code, if any
Telephone and facsimile numbers (telephone) (facsimile)
E-mail address
^ Only applicable to individuals who do not hold a Hong Kong Identity Card.
February 2017(SFC logo updated in November 2018)
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February 2017(SFC logo updated in November 2018)
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2 Name of executive officer
(in English)
(in Chinese)
HK identity card/Passport number^
Passport issuing country^
Passport expiry date^
Residential address in Hong Kong
Flat, floor and block no.
Building name
Street no. & name
District & city
State & country
Postal code, if any
Telephone and facsimile numbers (telephone) (facsimile)
E-mail address
Correspondence address
Flat, floor and block no.
Building name
Street no. & name
District & city
State & country
Postal code, if any
Telephone and facsimile numbers (telephone) (facsimile)
E-mail address
^ Only applicable to individuals who do not hold a Hong Kong Identity Card.
February 2017(SFC logo updated in November 2018)
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February 2017(SFC logo updated in November 2018)
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3 Name of executive officer
(in English)
(in Chinese)
HK identity card/Passport number^
Passport issuing country^
Passport expiry date^
Residential address in Hong Kong
Flat, floor and block no.
Building name
Street no. & name
District & city
State & country
Postal code, if any
Telephone and facsimile numbers (telephone) (facsimile)
E-mail address
Correspondence address
Flat, floor and block no.
Building name
Street no. & name
District & city
State & country
Postal code, if any
Telephone and facsimile numbers (telephone) (facsimile)
E-mail address
^ Only applicable to individuals who do not hold a Hong Kong Identity Card.
February 2017(SFC logo updated in November 2018)
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February 2017(SFC logo updated in November 2018)
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Section 9: List of Individual Controlling Entities
“Controlling entity” is defined in Part 1 of Schedule 1 to the Securities and Futures Ordinance.
1 Name of controlling entity (individual)
(in English)
(in Chinese)
HK identity card/Passport number^
Passport issuing country^
Passport expiry date^
Residential address in Hong Kong
Flat, floor and block no.
Building name
Street no. & name
District & city
State & country
Postal code, if any
Telephone and facsimile numbers (telephone) (facsimile)
E-mail address
Correspondence address
Flat, floor and block no.
Building name
Street no. & name
District & city
State & country
Postal code, if any
Telephone and facsimile numbers (telephone) (facsimile)
E-mail address
^ Only applicable to individuals who do not hold a Hong Kong Identity Card.
February 2017(SFC logo updated in November 2018)
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February 2017(SFC logo updated in November 2018)
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2 Name of controlling entity (individual)
(in English)
(in Chinese)
HK identity card/Passport number^
Passport issuing country^
Passport expiry date^
Residential address in Hong Kong
Flat, floor and block no.
Building name
Street no. & name
District & city
State & country
Postal code, if any
Telephone and facsimile numbers (telephone) (facsimile)
E-mail address
Correspondence address
Flat, floor and block no.
Building name
Street no. & name
District & city
State & country
Postal code, if any
Telephone and facsimile numbers (telephone) (facsimile)
E-mail address
^ Only applicable to individuals who do not hold a Hong Kong Identity Card.
February 2017(SFC logo updated in November 2018)
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Section 10: List of Corporate Controlling Entities
1 Name of controlling entity (corporation)
(in English)
(in Chinese)
Business registration number
Principal business address inHong Kong
Flat, floor and block no.
Building name
Street no. & name
District & city
State & country
Postal code, if any
Telephone and facsimile numbers (telephone) (facsimile)
E-mail and website addresses
(e-mail) (website)
Correspondence address
Flat, floor and block no.
Building name
Street no. & name
District & city
State & country
Postal code, if any
Telephone and facsimile numbers (telephone) (facsimile)
E-mail and website addresses
(e-mail) (website)
February 2017(SFC logo updated in November 2018)
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2 Name of controlling entity (corporation)
(in English)
(in Chinese)
Business registration number
Principal business address inHong Kong
Flat, floor and block no.
Building name
Street no. & name
District & city
State & country
Postal code, if any
Telephone and facsimile numbers (telephone) (facsimile)
E-mail and website addresses
(e-mail) (website)
Correspondence address
Flat, floor and block no.
Building name
Street no. & name
District & city
State & country
Postal code, if any
Telephone and facsimile numbers (telephone) (facsimile)
E-mail and website addresses
(e-mail) (website)
February 2017(SFC logo updated in November 2018)
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Section 11: Declaration
We:
Declare that all the information provided in this Supplement and any associated documentation is complete, true and correct.
Understand that providing false or misleading information in support of this Supplement or its relating application or notification is an offence under section 383 and/or 384 of the Securities and Futures Ordinance.
Understand that the Commission may take criminal and/or disciplinary action against a person who has made a false or misleading representation in, or in support of, this Supplement or its relating application or notification.
Understand that if any information contained in this Supplement, or any associated documentation changes prior to the Commission making a decision in respect of any relating application, we must notify the Commission in writing immediately of the changes.
Understand that the Commission may make such enquiries and seek such further information as it thinks appropriate.
(To be signed by two directors#, chief executive or person authorized by the Board of Directors of the associated entity.)
For and on behalf of:Name of firm
Name of director/chief executive/person
authorized by the board of directors*Signature Date
Name of director/chief executive/person
authorized by the board of directors*Signature Date
# Can be signed by one director if the associated entity has only one director. * Delete where not applicable.
February 2017(SFC logo updated in November 2018)
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Vetting Authorization Form – Corporation
We, (“the Company”), hereby:
1. Give consent to the Securities and Futures Commission to release the particulars of the Company to the Commissioner of Police/Commissioner of Customs and Excise/any local or overseas criminal investigatory body or regulatory authority, or their representatives for vetting purposes.
2. Authorize the Commissioner of Police/Commissioner of Customs and Excise/any local or overseas criminal investigatory body or regulatory authority, or their representatives, to release full particulars of any pertinent information and materials on the Company, including all criminal convictions recorded against the Company, to the Securities and Futures Commission.
The particulars of the Company are as follows:
Name of company:
Registered address of the company:
Date and place of incorporation:
Company number:
Name of Signature Datedirector / person authorized bythe board of directors*
Name of Signature Datedirector / person authorized by the board of directors*
Witnessed by**:
Signature of witness:
Name of witness:
Designation:
Company name:
Notary Public number (where applicable):
HKID / Passport number***:
Country of issue***:
* Delete where not applicable. ** The witness must be one of the following persons:
(i) a practicing solicitor, notary public or Justice of the Peace; or (ii) a director or responsible officer of the licensed corporation/corporation applying for a licence.
*** Only applicable where the person does not possess a Hong Kong Identity Card.
February 2017(SFC logo updated in November 2018)
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February 2017(SFC logo updated in November 2018)
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