Shanghai Authority Application Form for Change of Administrative License (Entity) Name of matter of administrative license: grant Drainage License Acceptance No.: SHPX20XXXXXX (Filled in by the acceptance department) Name Shanghai XX Co., Ltd. Address XX, XX ROAD, XX DISTRICT Legal representative Wang x Title General manager (person in charge) Tel XXXXXXXX Liaison Li xx XX Fax XXXXXXXX Address of No. 389, Jiangsu Road Postal 2xxxxx service code Original decision on SHPX20XXXXXX/H.S.W.P.Z.Z. No. granting administrative (XXXXXXXXX) license/administrative license No. Before (Original licensed contents) Matter to be changed After (Change under application) Reason of (Specify the reason of change based on actual conditions, additional pages may be attached) change Number Original / No. Name of Remark Application photocopy copies materials Identity certificate of 1 1 Original representative (person in
Shanghai Authority Application Form for Change of Administrative License (Entity) Name of matter of administrative license: grant Drainage License Acceptance No.: SHPX20XXXXXX (Filled in by the acceptance department) XX Name Shanghai XX Co., Ltd. Address XX, XX ROAD, XX DISTRICT Legal representative (person in charge) Wang x Title General manager Liaison Li xx Tel Fax Address of service No. 389, Jiangsu Road Postal code 2xxxxx Original decision on granting administrative license/administrative license No. SHPX20XXXXXX/H.S.W.P.Z.Z. No. (XXXXXXXXX) Matter to be changed Before (Original licensed contents) After (Change under application) Reason of change (Specify the reason of change based on actual conditions, additional pages may be attached) Application materials No. Name Number of copies Original / photocopy Remark 1 Identity certificate of representative (person in 1 Original XXXXXXXX XXXXXXXX
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