3 form6a
- 2. $SSOLFDWLRQ IRU LQFOXVLRQ RI QDPH LQ HOHFWRUDO UROO E DQ RYHUVHDV HOHFWRU
7R
7KH (OHFWRUDO 5HJLVWUDWLRQ 2IILFHU
^
$VVHPEO
3DUOLDPHQWDU RQVWLWXHQF
'LVWULFW
6WDWH LQ ,QGLD
6LU
, UHTXHVW WKDW P QDPH EH LQFOXGHG LQ WKH HOHFWRUDO UROO IRU WKH
RQVWLWXHQF LQ ZKLFK P SODFH RI UHVLGHQFH DV SHU WKH SDUWLFXODUV IXUQLVKHG
EHORZ LQ LWHP +
- 3. LV ORFDWHG
3$57$
3DUWLFXODUV LQ VXSSRUW RI P FODLP IRU LQFOXVLRQ LQ WKH HOHFWRUDO UROO DUH JLYHQ
EHORZ
D
- 32. 'DWH RI H[SLU RI FXUUHQW ,QGLDQ SDVVSRUW
RSLHV RI WKH UHOHYDQW SDJHV RI WKH SDVVSRUW FRQWDLQLQJ WKH SDUWLFXODUV
PHQWLRQHG DW LWHPV D
- 34. DERYH WR EH HQFORVHGDWWHVWHG E WKH ,QGLDQ
0LVVLRQ LI VHQW E SRVW DQG SURGXFHG ZLWK WKH RULJLQDO SDVVSRUW LI SUHVHQWHG
LQ SHUVRQ EHIRUH WKH UHJLVWUDWLRQ RIILFHU
- 38. 7SH RI 9LVD 6LQJOH (QWU0XOWLSOH (QWU7RXULVW:RUN 9LVD HWF
- 43. 1DPH RI WKH ,VVXLQJ $XWKRULW
RSLHV RI WKH UHOHYDQW SDJHV RI WKH SDVVSRUW FRQWDLQLQJ WKH FXUUHQW
YDOLG YLVD HQGRUVHPHQW PHQWLRQHG DERYH WR EH HQFORVHGDWWHVWHG E WKH ,QGLDQ
- 44. 0LVVLRQ LI VHQW E SRVW DQG SURGXFHG ZLWK WKH RULJLQDO SDVVSRUW LI SUHVHQWHG LQ
SHUVRQ EHIRUH WKH UHJLVWUDWLRQ RIIHU
- 52. )XOO UHVLGHQWLDO DGGUHVV LQ WKH FRXQWU RXWVLGH ,QGLD ZKHUH FXUUHQWO
UHVLGLQJ
)XOO 2IILFLDO DGGUHVV LQ WKH FRXQWU RXWVLGH ,QGLD FXUUHQWO UHVLGLQJ
DGGUHVV RI WKH SODFH RI HPSORPHQW RU WKH HGXFDWLRQ LQVWLWXWLRQ ZKHUH
VWXGLQJ
- 55. , DP D FLWL]HQ RI ,QGLD E ELUWKGRPLFLOHQDWXUDOL]DWLRQ
F
- 56. , KDYH QRW DFTXLUHG FLWL]HQVKLS RI DQ RWKHU FRXQWU
G
- 57. %XW IRU EHLQJ DEVHQW IURP WKH SODFH RI P RUGLQDU UHVLGHQFH LQ
,QGLD RZLQJ WR WKH UHDVRQ JLYHQ LQ D
- 58. DERYH , ZRXOG KDYH EHHQ
RUGLQDULO UHVLGHQW DW WKH DGGUHVV JLYHQ LQ P ,QGLDQ 3DVVSRUW
ZKLFK KDV EHHQ UHSURGXFHG DW J
- 60. , XQGHUWDNH WR LPPHGLDWHO LQIRUP WKH (OHFWRUDO 5HJLVWUDWLRQ 2IILFHU
WKURXJK WKH ,QGLDQ 0LVVLRQ LQ WKH RXQWU RI P FXUUHQW UHVLGHQFH
LI , UHQRXQFH P ,QGLDQ LWL]HQVKLS RU LI DFTXLUH WKH FLWL]HQVKLS RI
DQ RWKHU FRXQWU
I
- 61. , XQGHUWDNH WR LPPHGLDWHO LQIRUP WKH (OHFWRUDO 5HJLVWUDWLRQ 2IILFHU
WKURXJK WKH ,QGLDQ 0LVVLRQ LQ WKH FRXQWU RI P FXUUHQW UHVLGHQFH
RI DQ FKDQJH LQ P UHVLGHQWLDO DGGUHVV LQ WKH FRXQWU RI P
UHVLGHQFH IRU WKH UHFRUGV RI WKH (OHFWRUDO 5HJLVWUDWLRQ 2IILFHU ,
XQGHUVWDQG WKDW DQ QRWLFH VHQW WR PH DW WKH DGGUHVV ZKLFK LV P
UHVLGHQWLDO DGGUHVV LQ WKH FRXQWU RI P FXUUHQW UHVLGHQFH
DFFRUGLQJ WR WKH UHFRUGV RI WKH (OHFWRUDO 5HJLVWUDWLRQ 2IILFHU VKDOO
EH FRQVLGHUHG DV GXH VHUYLFH RI QRWLFH WR PH XQGHU WKH
5HSUHVHQWDWLRQ RI WKH 3HRSOH $FW DQG WKH UXOHV PDGH WKHUH
- 62. XQGHU DQG WKDW LW LV P UHVSRQVLELOLW WR NHHS WKH (OHFWRUDO
5HJLVWUDWLRQ 2IILFHU LQIRUPHG RI P ODWHVW UHVLGHQWLDO DGGUHVV LQ WKH
FRXQWU RI P FXUUHQW UHVLGHQFH
J
- 63. ,I , UHWXUQ WR ,QGLD DQG EHFRPH RUGLQDULO UHVLGHQW LQ ,QGLD , VKDOO
LPPHGLDWHO LQIRUP WKH (OHFWRUDO 5HJLVWUDWLRQ 2IILFHU RI WKH
FRQFHUQHG $VVHPEO3DUOLDPHQWDU RQVWLWXHQF
K
- 64. , KDYH QRW DSSOLHG IRU LQFOXVLRQ RI P QDPH LQ WKH HOHFWRUDO UROO RI
DQ RWKHU FRQVWLWXHQF
L
- 65. 0 QDPH KDV QRW DOUHDG EHHQ LQFOXGHG LQ WKLV RU DQ RWKHU
FRQVWLWXHQF
2U
0 QDPH PD KDYH EHHQ LQFOXGHG LQ WKH HOHFWRUDO UROO RI
RQVWLWXHQF LQ 6WDWH LQ ZKLFK ,
ZDV RUGLQDULO UHVLGHQW HDUOLHU DW WKH DGGUHVV PHQWLRQHG EHORZ DQG LI
VR , UHTXHVW WKDW WKH VDPH PD EH GHOHWHG IURP WKDW HOHFWRUDO UROO RU
WUDQVSRVHG DV PD EH DSSURSULDWH
)XOO DGGUHVV (DUOLHU SODFH RI RUGLQDU UHVLGHQFH
- 68. , KDYH QRW EHHQ LVVXHG DQ (3, LQ ,QGLDKDYH EHHQ LVVXHG DQ (3,
ZKLFK LV HQFORVHG ZLWK WKLV DSSOLFDWLRQ IRU FDQFHOODWLRQ
6LJQDWXUH
3ODFH
'DWH
- 69. 3$57%
)RU XVH LQ WKH RIILFH RI (OHFWRUDO 5HJLVWUDWLRQ 2IILFHU
- 72. $FFHSWHG DQG WKH QDPH KDV EHHQ UHJLVWHUHG LQ WKH HOHFWRUDO UROO RI
FRQVWLWXHQF
- 75. 3$57
$FNQRZOHGJHPHQW IRU $SSOLFDWLRQ
:KHQ SUHVHQWHG LQ SHUVRQ WR WKH UHJLVWUDWLRQ RIILFHU
- 76. 5HFHLYHG WKH DSSOLFDWLRQ LQ )RUP $ RI
6KUL6KULPDWL.XPDUL
$GGUHVV
'DWH
6LJQDWXUH RI WKH 9HULILQJ 2IILFHU
$GGUHVV
)1R+
- 79. 1.1$0%227+,5 $GGO 6HF
1RWH 7KH SULQFLSDO UXOHV ZHUH SXEOLVKHG LQ WKH *D]HWWH RI ,QGLD
([WUDRUGLQDU YLGH QRWLILFDWLRQ QXPEHU 62 (