... and Date: Company Chop: Name of Signatory: (in block letters) Position: (Note: Part II of this declaration must be signed by the sole proprietor or a partner/director/chief executive/controller/secretary of the insurance broker.) *Delete whichever is inappropriate Insurance Authority December 2017 1 ...

...: *************************************************************************** Part II I certify that has supplied the above (name of relevant person) information and that in respect of (name of insurance broker) *he/she is the *sole proprietor/partner/director/controller. Signature and Date: Company Chop: Name of Signatory: (in block letters) Position: (Note: Part II of this...

... and Date: Company Chop: Name of Signatory: (in block letters) Position: (Note: Part II of this declaration must be signed by the sole proprietor or a partner/director/chief executive/controller/secretary of the insurance broker.) *Delete whichever is inappropriate Insurance Authority December 2017 1 ...

...: *************************************************************************** Part II I certify that has supplied the above (name of relevant person) information and that in respect of (name of insurance broker) *he/she is the *sole proprietor/partner/director/controller. Signature and Date: Company Chop: Name of Signatory: (in block letters) Position: (Note: Part II of this...

... and Date: Company Chop: Name of Signatory: (in block letters) Position: (Note: Part II of this declaration must be signed by the sole proprietor or a partner/director/chief executive/controller/secretary of the insurance broker.) *Delete whichever is inappropriate Insurance Authority December 2017 1 ...

...: *************************************************************************** Part II I certify that has supplied the above (name of relevant person) information and that in respect of (name of insurance broker) *he/she is the *sole proprietor/partner/director/controller. Signature and Date: Company Chop: Name of Signatory: (in block letters) Position: (Note: Part II of this...

... the appropriate box. Version: July 2020 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....

... the appropriate box. Version: July 2020 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....