APPLICATION BY A COMPANY FOR INVESTMENT ADVISER LICENCE |
Application for an investment adviser licence under the Act is made as follows: |
Notes: |
(1) If space is insufficient to provide details, where necessary, please attach annexure, and the annexure must be identified as such and signed by the signatory to this application. |
(2) This application must be accompanied by the last audited balance sheet and profit and loss account certified as required by regulation 5. |
Part 1 |
INFORMATION ON THE APPLICANT |
1. | (a) | Name of applicant: |
| (b) | Registered office: |
| (c) | Place of incorporation: |
| (d) | Full address and telephone number of the principal place at which the business of the applicant is or is to be carried on: |
| (e) | The authorised and paid-up capital of the applicant, including the types of shares issued or to be issued: |
(e) | The details of shareholders of the applicant, including the name, address, amount of shares being held and date of acquisition | _______________ |
Names | Address | Amount of Shares | Date of acquisition |
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| (g) | Address of place at which applicant's register under section 86 of the Act will be kept: |
| (h) | Set out as an annexure to this application details of each director and senior officer showing the full name, residential address, date of birth, academic qualifications and experience, office held and date of appointment. |
| (i) | Set out as an annexure to this application details of each (prospective) principal and representative showing full name, date of birth, residential address, academic qualifications and experience. |
2. State the nature of the principal business of the applicant: |
3. | (a) | Indicate areas of proposed business for which the applicant requires an investment adviser licence: |
| | | advises others concerning securities. |
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| | | issues or promulgates analyses or reports concerning securities. |
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| | | pursuant to a contract or arrangement with a customer, undertakes on behalf of the customer (whether on a discretionary authority granted by the customer or otherwise) the management on behalf of customers of a portfolio of securities for the purpose of investment. |
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| (b) | For each indicated area of proposed business, state in detail the manner in which the business will be conducted and the experience of the applicant and its management staff in that business. |
| (c) | The type of customers with whom the applicant proposes to do business. |
| (d) | Describe in detail the organisational structure and internal control procedures which the applicant has adopted or proposes to adopt in the conduct of the business. |
4. Name and address of auditors or proposed auditors. |
5. Name and address of attorneys-at-law or proposed attorneys-at-law. |
6. Name and address of bankers or proposed bankers. |
7. If the company is a subsidiary of another company give the name, address, and nature of business of the parent company. |
8. Give the name and address of subsidiaries, if any, of the company, or any enterprise in which it has a shareholding or similar interest, give details and nature of business pursued. |
9. Set out the name and address of each person who directly or indirectly exercise or has power to exercise a controlling influence over the management and policies of the applicant other than those shown as directors: |
Name | Address |
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10. Is a director of the applicant a director of any other company? Using an annexure, answer “Yes” or “No” for each person; if “Yes”, give details of: |
| (a) | names of company; |
| (b) | places of incorporation; and |
| (c) | dates of appointment. |
(For questions 6 and 7 answer “Yes” or “No” in the space provided. If “Yes” attach annexure giving all relevant particulars.) |
11. Has any director of the applicant within the past 10 years |
| (a) | been licensed or registered in any place under any law which requires licensing or registration in relation to dealing in securities or acting as an investment adviser? | _______________ |
| (b) | been licensed, registered or otherwise authorised by law to carry on any trade, business or profession in any place? | _______________ |
| (c) | been refused the right or restricted in its or his or her right to carry on any trade, business or profession for which a specific licence, registration or other authority is required by law in any place? | _______________ |
12. Has any director of the applicant within the past 10 years |
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| (a) | been a member or partner in a member firm of any securities exchange? | _______________ |
| (b) | been suspended from membership of any securities exchange or otherwise disciplined by a securities exchange? | _______________ |
| (c) | been refused membership of any securities exchange? | _______________ |
| (d) | been known by any name other than the name or names shown in this application? | _______________ |
| (e) | been convicted of any offence other than a traffic offence in Saint Lucia or elsewhere or are there any proceedings now pending which may lead to such a conviction? | _______________ |
| (f) | had judgement including findings in relation to fraud, misrepresentation or dishonesty been given against the applicant in any civil proceedings, in Saint Lucia or elsewhere? (If “Yes”, using an annexure, give full details, including whether judgement is unsatisfied.) | _______________ |
| (g) | been declared bankrupt or compounded with or made an assignment for the benefit of the applicant's creditors, in Saint Lucia or elsewhere? | _______________ |
| (h) | been engaged in the management of any company other than a company referred to in answer to question 5? | _______________ |
| (i) | been refused a fidelity or surety bond in Saint Lucia or elsewhere? | _______________ |
| (j) | been disqualified as a director, or been a director of a company that has gone into receivership or liquidation, in Saint Lucia or elsewhere? | _______________ |
13. In relation to each director and staff management member of the applicant, set out below details of the officer's employment and business activities, during the previous 10 years: |
Name of Director of staff member | Name and address of employer (if self- employed, so state) | Nature of business | Description of duties in relation to the employment or activity ) | Period of employment or activity (give exact dates |
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14. Set out any additional information (including any formal qualifications or training of the directors, or management staff of the applicant and the name of the institution that conducted the relevant course) considered relevant to this application. |
15. Set out below details of two persons (who must not be related to the applicant, and neither of whom has any interest in the success or otherwise of this application) with whom each director and management staff member of the applicant has had regular contact over the past 5 years and of whom the Commission may enquire regarding their character and reputation. |
Name of Character Referee | Address of Character Referee | Occupation of Character | Name of Director or Management Staff Member in Respect of Whom Enquiries May be Made |
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