Details of Shareholder(s) and the Board of Director(s): Name of Directors % of Relations, if any, with other Remarks director(s)/ shareholder (s) if any * 1. 2. 3. *The total of % shareholding shall add up to 100%. Details of Affiliations of Shareholder(s) and Director(s) with other organizations (covering last 5 years) Name of List of Company Nature of Roles & Period Remarks Shareholder(s) / (ies)/ activities Responsibilities (MM/YYYY) Director(s)* Organizations 1 a. b. c. 2. a. b. c. 3. a. b. c. 4. a. b. c. *please add additional rows if necessary Details of Family members of Shareholder (s) and Director (s): Name of List of Family Relationship Affiliation/ activities of family Shareholder (s) / Members members covering last 5 years* Director (s) 1 a. b. c. 2 a.
Details of Shareholder(s) and the Board of Director(s): Name of Directors % of if any * Relations, if any, with other director(s)/ shareholder (s) Remarks 1. 2. 3. *The total of % shareholding shall add up to 100%. Details of Affiliations of Shareholder(s) and Director(s) with other organizations (covering last 5 years) Name of Shareholder(s) / Director(s)* List of Company (ies)/ Organizations Nature of activities Roles & Responsibilities Period (MM/YYYY) Remarks 1 a. b. c. 2. a. b. c. 3. a. b. c. 4. a. b. c. *please add additional rows if necessary Details of Family members of Shareholder (s) and Director (s): Name of Shareholder (s) / Director (s) List of Family Members Relationship Affiliation/ activities of family members covering last 5 years* 1 a. b. c. 2 a.
Application%20Form%20for%20Provisional%20Certification%20bodies%20NCCF%20FM.DOCX