... Application for Proposed Appointment of an Individual to be a Responsible Officer of a Licensed Insurance Agency or Licensed Insurance Broker Company For Official Use D E N C S F Date of Receipt 1st Review 2nd Review Approved † Please tick the appropriate box. Version: September 2019 1 Form A3...

... the appropriate box. Version: September 2019 1 Form A2 Please complete all items in BLOCK LETTERS. All amendments must be signed by Applicant. I. Basic Information on Principal Name in English Name in Chinese (if any) † Type of Principal ☐ Authorized Insurer (Please provide Company Registration No....

...)? (Please put a “” in the appropriate box. If your answer is ‘no’, please indicate the shortfall of CPD hours and fill in Part D) Yes  No  Total Shortfall2: 1 This is the total number of CPD hours you are required to earn during the CPD Assessment Period, which includes the compulsory CPD hours required...

...)? (Please put a “” in the appropriate box. If your answer is ‘no’, please indicate the shortfall of CPD hours and fill in Part D) Yes  No  Total Shortfall2: 1 This is the total number of CPD hours you are required to earn during the CPD Assessment Period, which includes the compulsory CPD hours required...