| FORM 1 |
| (Regulation 3) |
| SAINT LUCIA |
| (International Insurance Act, Cap. 12-15: Section 4) |
APPLICATION FOR LICENCE TO CARRY OUT
INTERNATIONAL INSURANCE BUSINESS |
| (To be completed in English language or with certified translation attached) |
Please complete all parts of the application, attaching appendices where appropriate.
Is the insurance business of the Incorporated Cell Company “general insurance business, 'long-term' insurance business or both? Please tick the appropriate box:- |
| Class A – General insurance business | Subclass [ ] |
| Class B – Long term insurance business | Subclass [ ] |
| Class C – Long term and General Insurance business | Subclass [ ] |
| APPLICANT DETAILS |
| 1. Name of Applicant |
2. International Business Company No.
and Date of Incorporation |
| 3. Registered Office of Applicant |
| 4. Business address of Applicant |
| 5. Contact person for this application |
6. Telephone No.
Fax No.
Email address |