Form 5 (Dealer Investment Adviser Renewal)

Form 5 (Dealer Investment Adviser Renewal)

APPLICATION FOR RENEWAL OF DEALER’S LICENCE OR INVESTMENT ADVISER’S LICENCE

Application is hereby made for the renewal of a Dealer’s/an Investment Adviser’s* licence and the following statements are made in respect of the applicant:

1. (a) Applicant’s name:

(b) Expiry date of licence:

(c) Licence No.:

2. Where the applicant is a company to complete the following: (Answer “Yes” or “No” in space provided. If “Yes” attach annexures giving all relevant particulars.)

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