APPLICANT’S/TRANSFER AGENTS’S NAME: _____________________________________________ DATE: __________________________________ engaged in fraudulent transactions? YES NO failed to comply with its procedures or of a registered clearing agency? YES NO failed to comply with its procedures or those of an exchange? YES NO Ownership: Shareholders (only who are officers of registrant and shareholders who owns 5% or more of the issued and outstanding shares) or partners of registrant: Percentage of Profession and Name Address Shares Held Occupation Directors and Officers of registrant: Percentage of Profession and Name Address Shares Held Occupation
APPLICANT’S/TRANSFER AGENTS’S NAME: _____________________________________________ DATE: __________________________________ engaged in fraudulent transactions? YES NO failed to comply with its procedures or of a registered clearing agency? YES NO failed to comply with its procedures or those of an exchange? YES NO Ownership: Shareholders (only who are officers of registrant and shareholders who owns 5% or more of the issued and outstanding shares) or partners of registrant: Name Address Percentage of Shares Held Profession and Occupation Directors and Officers of registrant: Name Address Percentage of Shares Held Profession and Occupation
SEC-Form-36-TA-Application-for-Registration-as-Transfer-Agent-and-Amendments-Thereto-revised.docx