DECLARATION hereby declare the following: I, …………………………………………………, I am aware that should I knowingly or intentionally supply false or misleading information herein, I may be liable to prosecution. …………………………………………………………………….. SIGNATURE …………………………………..… DATE I certify that the above statement was taken by me and that the deponent has acknowledged that he/she knows and understands the content of this statement. This statement was signed in my presence at: ............................................……………… on this of ….....… day ...................……………………………. (mm/yy) ………………………………………………………. Justice of the Peace/Notary Public Other documents to be attached to the Application: A copy of Work Permit or Permanent Residence Permit with the right to work (for – citizens); A copy of the relevant pages of the name, date of birth, applicant’s passport (to include nationality, signature, expiration date and photograph); current Police Certificate (not more than three months old) or an affidavit in Applicant’s the acceptable form, if the Police Certificate is not available; Three recent photographs of the Applicant, individually signed on the back by the Applicant; Copy of any relevant degree, educational or professional course(s) passed;
DECLARATION I, …………………………………………………, hereby declare the following: I am aware that should I knowingly or intentionally supply false or misleading information herein, I may be liable to prosecution. …………………………………………………………………….. SIGNATURE …………………………………..… DATE I certify that the above statement was taken by me and that the deponent has acknowledged that he/she knows and understands the content of this statement. This statement was signed in my presence at: ............................................……………… on this ….....… day of ...................……………………………. (mm/yy) ………………………………………………………. Justice of the Peace/Notary Public Other documents to be attached to the Application: A copy of Work Permit or Permanent Residence Permit – with the right to work (for citizens); A copy of the relevant pages of the applicant’s passport (to include name, date of birth, nationality, signature, expiration date and photograph); Applicant’s current Police Certificate (not more than three months old) or an affidavit in the acceptable form, if the Police Certificate is not available; Three recent photographs of the Applicant, individually signed on the back by the Applicant; Copy of any relevant degree, educational or professional course(s) passed;
Form%204%20-%20Personal%20Questionnaire%20-%20Directors,%20Officers%20and%20Security%20Holders%20of%20Registered%20Firms.docx