| FORM 1B |
| (Regulation 3) |
| APPLICATION FOR LICENCE REGISTERED TRUSTEE |
| (Registered Agent and Trustee Licensing Act: Section 5) |
| (TO BE COMPLETED IN DUPLICATE) |
| 1. | Indicate Registration number if previously registered as an agent: ...... |
| 2. | Name of applicant: ................................................................................ |
| 3. | Address, telephone and facsimile number in Saint Lucia of the principal place of business of the applicant and, in the case of a company, its registered office: |
| Address: ........................................................................... |
| Telephone: ........................ | Facsimile: .......................... |
| 4. | If the applicant is a company or partnership, the names, addresses, telephone and facsimile numbers, and professional profile of all directors or partners and their nationalities (complete attachment 1b for each director or partner). |
| 5. | If the applicant is a company, the names, addresses, telephone and facsimile numbers, and professional profiles of all shareholders and their nationalities (complete attachment 2b for each shareholder). |
| 6. | If the applicant is a company or partnership, the names, addresses, telephone and facsimile numbers of all officers and managers, and of the foreign agents or offices of the company or partnership (complete attachment 3b for each officer, manager, or foreign agent). |
| 7. | Attach a description of any material contractual arrangements with such persons, and a written agreement by which such persons and their employees agree to be bound by the provisions of this Act and to submit to the jurisdiction of the High Court of Saint Lucia for purposes of enforcement of such agreement. |
| 8. | If the applicant is a company or partnership: |
| (a) | The name, address, telephone and facsimile number of one of its officers or partners who is the authorised agent resident in Saint Lucia to accept on behalf of the applicant service of process and any notices required to be served on it: |
| Name: ........................................................................... |
| Address: ........................................................................... |
| Telephone: ........................ | Facsimile: .......................... |
| and |
| (b) | the name, address, telephone and facsimile number of another of its officers or partners who, in the absence or inability to act of the officer named in subparagraph (a), is the authorised agent resident in Saint Lucia of the applicant for the purposes of subparagraph (a): |
| Name: ............................................................................ |
| Address: ........................................................................... |
| Telephone: ....................... | Facsimile: .......................... |
| 9. | If the applicant is a company, attach a copy of the Certificate of Incorporation or Memorandum and articles of incorporation or articles of continuation and bye-laws of the applicant in Saint Lucia under the Companies Act, verified by an affidavit sworn by a director or officer and notarised. |
| 10. | If the applicant is a natural person, a professional profile of the applicant (complete Attachment 4b). |
| 11. | Names, addresses, telephone and facsimile numbers of the attorneys-at-law, if any, of the applicant: |
| Name: ........................................................................... |
| Address: ........................................................................... |
| Telephone: ....................... | Facsimile: .......................... |
| Attach a letter from the attorneys-at-law confirming that they act for the applicant. |
| 12. | Names, addresses, telephone and facsimile numbers of the chartered accountants of the applicant: |
| Name: ............................................................................ |
| Address: ........................................................................... |
| Telephone: ....................... | Facsimile: .......................... |
| Attach a letter from the chartered accountants confirming that they act for the applicant. |
| 13. | Attach evidence in writing that the applicant or some person or company directly or indirectly connected with the applicant is possessed of solid and practical experience as an agent and/or trustee. Such evidence may include a curriculum vitae, letters of past employment, or other pertinent materials. |
| 14. | Attach written references, such as but not limited to police certificates, demonstrating that neither the applicant, nor, in the case of a company, any director or officer of the applicant has a criminal record either in Saint Lucia or elsewhere. |
| 15. | Attach applicant's annual accounts or the annual accounts of applicant's holding company, if any, for the preceding 3 years. |
| 16. | Attach a statement of applicant's assets and liabilities at the end of the month prior to the submission of the application certified by a director or senior officer of the applicant. |
| 17. | Attach details of the names of all subsidiary companies of the applicant with addresses of their registered offices and names of their registered agents, and a statement of capital of any other company held, directly or through a subsidiary, as an asset of the applicant. |
| 18. | Attach at least 3 references, including one from an internationally recognised bank or trust company. |
| 19. | Attach a statement describing the aspects of international financial services representation the applicant will seek to undertake, and the experience, academic and professional qualification of the applicant or its directors or employees in such business. |
| 20. | Where the applicant holds, or intends to hold, one or more other licences or authorisations to conduct business or professions other than the business of international financial services representation, attach details of such other licences, businesses or professions. |
| 21. | Attach a signed copy of the Code of Conduct – Attachment 5. |
| The undersigned hereby confirms that it is authorised to execute this application on behalf of the applicant, and that the information contained in this application is true and accurate as of the date shown below. |
| This ........................ day of .............................. |
| APPLICANT |
| Name: .................................... |
| Signature: ................................ |