The Securities (Licensing and Registration) Regulations, 1996

THE SECVRlTLES (LICENlNG AND REGISTRRTION) REGULATIONS, 1996 FIRST SCHEDULE (Regulatim 3,4,6(2), Wand 9(1)) FORM A THE SECURITIES ACT Tbe Securities (Licensing and Registration) Regulations, 1996 APPLICATION FOR DEALER'S LICENCE OR INVESTMENT ADVISER'S LICENCE

1. This Form is to be used by every Applicant for a Dealer's or Investment Adviser's licence unda the Securities M.
2. All applicable questions must be anawered. Failure to do so may cause delays in the pracc#sing of the Application.
3. If qaca provided for anawera is ineufficierd, then fiunish required iddon on an ;Idtschmeot
4. lRia Form md all atkchmsnts added thereto must be twwritten. All simaium must be orirdarls.
5. AU dwments pataining to any qwstion must be attached to the Form a~d be clearly nuked with the number of the relevant question.
6. The Applicaat for lidng under the Acl and the Justice of the Peace or Notary Public Mae whom the Application is sworn, are each required to initial all attachments.
7. Name ....................................................................................................... Surname First Middle Maiden ..............................................................................................................
8. Telephone No(s). ................................... Facsimile No.. ............................ ??Eax!E!.B: PURPOSE OF APPLICATION Applicatioo is made fot- ( ) Wcr's Licence ( ) lnveatment Adviser's Licence Please tick the appropiate box. %!ac??! s. PARTICULARS OF APPLICANT Indicak -her Applicant is a wmpany ( ) inclusion of thia pas h suthorizcd by LN. 1350003 ]

THE SECURITIES (LICENSING AND REGISTRATION) REGULATIONS, 1996 (a) Set out on an attachment the names, business and residence addresses, and dates of appointment of directors, chief executive officer, company secretary and other senior officers. (b) Country and Date of Incorporation or Registration (c) Branch (if any): Addresses.. .................................................. ............ Telephone No(s) ............................................................................... (4 Share Capital Par Value Authorized Issued (Jt) (No) (No) Preference Shares.. ........................................................................................ Ordinary Shares.. .......................................................................................... (e) Set out on an aitachment the names, addresses and country of domicile and share￾holdings of all shareholders holding mare than 10% of any class of shares of the applicant. (a) Set out on an attachment the names, business and residence addresses, dates of admission to partnership and partnership interests of all partners. (b) Date of formation of (i) original Partnership ..................................................................... (ii) existing Partnership ..................................................................... (c) Date of Registration under the Registration of Business Names Ad (d) Date of Recording at Island Record Office (e) Branch if any ........................................................................................ Address ............................................................................... Telephone No. .............................................................................. (a) Residence Address.. ................................................................................ (The Grbmn of this pap is authorized by LN. 13512003 ]

THE SECURITIES (LICENSING AND REGISTRATION) REGULATIONS, 1996 FORM A. contd. (b) Date of establi~hmen~t ofproprietorship ............................................. (c) Date of Registration under the Registration of Business Names Act ........................................................................................................ (d) Personal Description of Applicant￾Date of Birth .............................. Sex. .......................... ........................................................................................................ Place of Birth ........................................................................................................ Height ,Weight Colour of eyes Colour of hair .................................... If not a Jamaican citizen answer Citizenshjp Questions (i) and (ii) below Name of spouse.. ................................................................................ Surname First Middle Nature of spouse's employment in Jamaica.. ........................................... Name of spouse's employer .................................................................. (i) Are you a permanent resident of Jamak~a? YES ( ) NO ( ) (ii) For how long have you been resident in Jlwaica? ....................................................................................................... Change of Name List name changes resulting from marriage, divorce, court order or any other prooess, giving appfiopriate dates Previous name Date changed Reason ,Have you ever aarried on business under any name other than the name mentioned in Question 1 d this Form? YES ( NO ( If YES, give details ........................................................................................................ [The inclusion of this page is authorized by L.N. 73119991

THE SECURITIES (LICENSING AND REGISTRATION) REGULATIONS, 1996 Passpont Information In pfoviding the information reqwstd below, the Alpplicant must also attaoh a copy of their passipnt centifid by a Justice of the Peace or Notary Pubhc. ........................................................................................................ Country Place of issue Date of issue Nmlber Photograph Attach hereto 4x0 copies of a oolcvur passport-size photograph, full Brucd, ghowing a true likeness of the Applicant as the Applicant now appears and taken within #the last six mntfhs. The photographs must mearmre 2" x 3", and bar on the back the date on whioh they were taken, edified by @ Justice of ofe Peace or N&ny FuMc. 4. Applicant's Bank (s) Name : ....................................................................................... Address : .................................................................................... Telephone No (8): ...................................................................... Telephone No (s): ............................................... ,, ................... 6. Applicant's Legal Adviser Nme : ...................................................................................... . - Telephone No (s) : ...................................................................... SIE~rnON D : HZtmORY QF m1w Tick the appropriate box. If 'CYES" give parti~~h

1. (a) Has the Applicant ever applied for a licence or regiataation under any Act and been refused? () ON0 -. -. - - - . - - - - fThe inclusion of this page is authorized by L.N. 73119991

THE SECURITIES (LICENSING AND REGISTRATION) REGULATIONS, 1996 (b) Has the Applicant ever been licensed or registered under l!he Securities Act? ( )Yrn ()NO 2. Is the Applicanct- (a) now, or has the Applicant been previously licensed in any aarpaci,ty in any other oountry which requires licensing to deal or trade in securities? ................................................................................................. (b) licensed in Jamaica or any other country under any legislation which requires licensing to deal with the public in any capacicty? (e.g. as an insurance agent, real estate agent, mortgage broker, etc.). Hae- the Gpplican,t been refused a licence mentioned in pamgraph 2 (a) or 2 (b) iabove, or has such licence been suspended or cancelled? OWS ON0 Has the Applicant operated under or carried on ihsiness under any name other than the me shown in this application? OkfE1S ON0 Hw the A~pplicant ever- (a) been the defendant or reapondent in any prodigs in any civil cou~ in any jurisdiction in any pant of uhe world in whiah fraud was aueged? ()= ON0 ............................................................................................... (b) at any 'he declared '~~iptoy or made a voluntary assignment in bankruptcy 7 .................................................................................................. If YES, in addition to giving particulars, attach a certiiied conry of Discharp. ,- [The ~Ic~s~M of this page is authorized by L.N. 731 19991

THE SECURITIES (LICENSING AND REGISTRATION) REGULATIONS, 1996 FORM A, contd. Attach audited financial statement for a period ending not 'later than 180 days (prior to the date of this application. If Applicant is presently aa~rying on the activity for which application for a licence is made, attach Ole Applicant's audited financial statement, whioh must not be more than 360 days old. The Applicant must also ensure that a Credit Repmt is submitted directly to ale Commisshner by the Applicant's bank for consideration with this application. List on an attachlment the names and laddresses of xgistered, direct and I -- .______. indire?, beneficial owners of each debt obligation and the amoupt and maturity date of each obligation. Has 'my person or company guaranteed, or undertaken to aot as guarantor of, the finan~aial or other obligations of the Applicant? i)~ ONO Has ian agreemenlt been executed providing for tlie deferral 04 claim8 against the Applicant by creditors? ( 1 Yas ( ) NO Is there any person or company whose name is not disclosed above who has any financial interest in the Applicant, either beneficially or obherwise? om ON0 In responding to the Questions in this seotion, We Applicant is required to provide a statement from an Attorney-b-Law indicating if there is any Migation pending or outstanding against Ehe Applicant. (i) Have you ever plsaded guilty or )been found guilty under any law of Jamaica or any other country of .any offence inwlving dishonesty or relating to trading in securities, aommodlties, commodity futures contracts or options or the theft thereof or been a pkwty in any proceedings taken on account or fraud mising out of any trade in or advice in respect thereof? ......................................................................................................... (ii) Have you ever been convioted of any criminal offence not mentioned in paragraph (i)? ........................................................................................................ [The inclusion of this page is authorized by L.N. 73119991

THE SECURITIES (LICENSING AND REGISTRATION) REGULATIONS, 1996 FORM A, contd. (iii) ,Are you currently the subject of a ah~ge or indictment under any law of Jamaica or any other country for contravention of any llaw or for any conduct of the type described in paragra$phs (i) and (ii)? omis ON0 A. Bas any alaim been successfully made in any civil matter before a court or other tribunal in Jamaica or any other country whioh was based in whole or in part on fraud, bhdt, deceit or misrapresenation or similar condud againsh (i) you? (ii) any company d which you am or were itid the time of the event or at the time that such praceedings were commenced an authorized officer, a director or holder of voting securities carrying more than 5% of the votes carried by all outstanding voting securities? (iii) any partnership of which you were a flamer at the time d the event or at mhe time such proceedings co'mmenced? B. To the best of your kn'olwledge such company or panhership? is any such pending against you or Have you complied with all requirements for the payments of statutory deductions? ( ) YES ( ) NO ....................................................................................... .......... If YES, kindly provide copies of compliance certifiaa'tes. [The inclusion of this page is authorized by L.N. 73119991

THE SECURITIES (LICENSING AND REGISTRATION) REGULATIONS, 1996 m0N I: ------- CONTTNG-ENCY FUND Does the Aplpliclant have a Contingency Fund in place, which can be used to reitnbwse depositors in oase of defiault, bankrugtcy or suspension of operations? .............................................................................................................. If YES, indicate the amount h 'the Fm'd. Dated ,We ............... @y d ...................... .................. 19. ........ I,. ....................................... ..of.. .............................................. ............................................. in ,the Parish of. ........................... MkKZ WTH AND SAY:

1. That I am the Applicant (or a partner or officer of the Applicant) herein and hme signed the application.
2. 1Phait the stlakments of fact made in this application are true and oomt to the kt d my knowledge, inhrmatibn and bdief. STVW before me at ........................................... .) in the Parish ob ................... ..... ..................... .) this ............... day of .................................... I9.. ....) ................................. Signature of Appliamt ............................................................................ Justice d the Peace or Notq Public 1 [The inclusian of this page in authorized by L.N. 73/19991

THE SECURITIES (LICENSING AND REGISTRATION) REGULATIONS, 1996 FORM ~4, contd. FiOlR OPFICIAL UISIE ONLY licensing Period Date Application received (a) Number of Abtachments (b) " " RepresenMatives- (c) " " Branohes Identification Verification Application Fee paid % -- Submitted to Codssion on Date Approvedl Rejected Terms and Conditions of Licensing (9 (ii) - (iii) Licensing Fees % Certifying Officer Chairman / Executive Director Supensions or Cancellations Aotion Taken Effective Date [The inclusim of this page is authorized by L.N. 73119991

THE SECURITIES (LICENSING AND REGISTRATION) REGULATIONS, 1996 TIHE SEICUIRTTJES ACT The Securities (Lioensing and Registration) Regulations, 1996 APPLICXTION FOR REGlSTRATICNN (4F REPFWEN'PAT~S) Notes for Com~pleting Application -----------------

1. This. Form is to be used by every Alpplicanlt and individual for whom Appl~ation is made for registnation under the Securi.ties Act.
2. All appliable quesltiwns must be answered. Failure to do so may cause delays in the processing of the Application.
3. If space provided for answers is insufficient, then furnish required information on an attachment.
4. This Form and all attachments added thereto must be typewritten. All signatures must be originals.
5. All doauments pertaining t~ any question must lb a%ta+ed to be Fom and clearly marked with the number of the relevant questmn.
6. The Applicant and the individual for whom hp~plication is made for registration under the Aot and the Justice of the Peace or Notary Public before whom the Application is sworn, me each required to inltial all attachments. 'IME SECURITIES ACT Tbe Securities (Lioensing land Registration) Regulations, 1996 APPLICATION F'OR REGLWRATIOIN OF RBPlRES5NTAirrI1VE 0 ....................................................................................................... Surname Fint Middle Maiden ........................................................................................................ Home Address Telephone No. ........................................................................................................ Present position with Employer a0mmeru:ed employment on .............................................................. Day Month Year ......................................................................................... .......... Name Tdephone No. ........................................................................................................ Address of ofice where Representative will be working Date on which Dealer's ~icence or Invesitment ~dviser's Licence was granted ............................................................................................. [The inclusion of tbis page in authorized by L.N. 73119991

THE SECURITIES (LICENSING AND REGISTRATION) REGULATIONS, 1996 FORM B, contd. 3. TYPE OF RBGISTRATION REQUESTED ..................... Dealer's Representative ( 1 Investment Adviser's Represenhtive ( ) 4. PERSONAL DESCRIPTION OF REPRESENTATIVE ............................ A. Date of Birth ................................................ Sex ........................ .................................................................................................. Place of Birth .................................................................................................. Height Weight Colo.ur of eyes Colour of hair ................................. If not 0 Jamaican citizen answer Ci'tizenship Question B below Name of spouse ........................................................................... Burnme First Middle Mlaiden Nature of spouse's employment in Jamaiaa ....................................... Name of spouse's employer ............................................................ B. (Are you a permanent resident of Jamaica? YES ( ) N'O ( ) C. For how long have you been resident in Jamaica? D. Change of Name List name changes resullting from marriage, divorce, court order or any other procas, giving appropriate dates. Previous dame Date changed Reason Have you ever carried on business under any name other than the name mentioned in Quesltion 1 of this Form? [The inclusion of this page is authorized by L.N. 73119991

THE SECURITIES (LICENSING AND REGISTRATION) REGULATIONS, 1996 E. Passport Infonmation In providing the information requested below, the Represenave must also attach a copy of their passport centified by a Justice of the Peace or Notary Public. ................................................................................................... Country Place of issue Date of issue Number F. Photograph Aittach hereto two copies of a colour passiport-size photograph, full face, showing a true likeness of the Representative as the Representative now appears and taken within the last six mlonths. The photographs must measure 2 x 2", and bear on the back the date on Whidh they were taken and be certified by a Ju&ice of the Peace or an authonized officer, Director, Pantner or Bnamh Mmager of the Applicant. EDUCATION -------- List names of institutions attended and qualifications attained below School/Insti tution Yew artended Qualifications EMPLOYMENT HISTORY --------------- In answering questions 6-8 give full disclosure of your business activities, intduding any periods of self-employment and unemployment for 5 years immediately prior to the date of this application, excluding any summer employment while a £dl-time student, but including all securities or commodities industry employment during and prior to the 5-year period. ................................................ ................... Name of present employer .................................................................................................. Address of present employer ................................................................................................... Position of employment Period of employment Duties ....................................................................................... [The inclusion of this page is authorized by L.N. 73119991

THE SECURITIES (LICENSING AND REGISTRATION) REGULATIONS, 1996 ......................................................... Niane of previous employer ..................................................... Address e£ previous employer Period of employment ..................................... Fm To Reasons for leaving ..................................................................... ............................................................................................... ,C. ~-EMrnOYM'ESIpT ------------ .. Give details if any D. Haw yw ever been discharged by an employer for dishonesty, negligence or incompetence? YESO NO0 IF YES, explain ................................... ..... Give dl home addresses for the past 5 years, include street, postal code and parieh. ........................................................ ........ 19 to 19 ...... Street Postal Code Parish Previous ..................... .................. .................................. 19 ...... mo 19 ...... street Postal Code Parish A. On an attachment provide three (3) names as references, excluding relatives and persons ~rking with the Representa~tive's employer. Inolude business address with postal code, telephone number ad occupation. vhe hclusirm ef this page is authorized by L.N. 731 19991

THE SECURITIES (LICENSING AND REGISTRATION) REGULATIONS, 1996 FORM B, contd. 8. Banks or ather Financial institutions. .................................................. .......................................... Name of bank (8) A. Are you now licensed or registered in any capacity under my law of Jamaica or any other country regdating trading in adtier, commod~ties or commodity futures omtracts7 wo NO0 If YES, give details ........................................................................ .................................................................................................. B. Have you been previwly licd or registored as mentioned & paragraph A? If YES, give details and dates ...........................................-........... C. Are you now a shareholder, direator or officer of any company or a partner in a partnership which is now licensed under any law regulating the trading of securities, commodities or commodity futurcn conaacts in Jamaica or any other country? If YES, which company? ............................................................ D. )Are you now a shareholder, director or officer d my ampmy or a partner in a partneahip which 'has been previously licensed under any law regulating the trading in securities, commoditier or ummqdity futures conWs in Jamaica or any other country? Y!C YES, which company and when? ................................................................................................... 8. 'Have you ever been a shareholder, director or officer of any company or a pantner i,n a partnership licensed as mentioned in C or D above? mso NO0 If YES, which company and when? ..................................................... ...............................)............ 10. A. [Are you now registem3 under any lam which requirea regirmioa to deal wis+ the public in any capacity other than trading in 8eCutitiq comanod~tiea or commodity futures coatraots in Jwnaiua or any othe country? mo NO0 If YES, which company and under what law? .................................................................................................. [The inclusion of this page is authorized by L.N. 73119991

THE SECURITIES (LICENSING AND REGISTRATION) REGULATIONS, 1996 FORM B, conrd. B. Fbve you ever applied for or Wned registrahn mentioned h panargraph A above? mso NO0 If YlB, when and in which country and under what law? .................................................................................................. QUESTIONS 11-16 anmuwering Questions 11-16 you may need assistance from an authorized

• dcer of the Nplicant or from a Lepl Adviser. Full details are required aa a*chments in reqwt of any question to which the RepresemWiva wwem "YEIS". l$we details mu& inolude the cirmstances, relevant dabs, names of the Wes involved and bl deteminkitim if known. klso Mosc any convictions under all laws, excluding convictions under the Road Trac Aot, and my conviction in respect of whioh an absolute or ~~ndihnd discharge bae been granted. If a conviction has been expunged fxm the radords purmant the WnJ Reds $Reha!Mitatbn of Offenders) Act, the appropriate response n'abld be "NO". An authbrized aflicer means any of the following: - President, Viceipmident, Chaiman, Vie-Chairmian, Chief Executive OfRcar, Managing Director, Gmeql Mkmger, Ex80uItive Director, Corqmy Secretary, Cmpmy Trepswer, Rnkimal Controller or Ohief Fmanc~M Officer. A. &ve you ever been refused regismtion or has your registdon been euepended or cancelled under any law regulkting trading in securida, ammodi~tiea or commodity futures contnaot in Jmnioa or any other Wunhry? mo NO( 1 If YES, rtate in whiuh counbry, under whM law, and when. B. Arc you ncw or hrwc you cver hen m ofecer or direotor d a company or a parmer in a partnership- (i) which has beea refused registration during the time of your associsti~n wifh b; or (ii) whose registration lras been suspended or cancelled under any law regula6ing trading in aecmiItiw, bmm6diIties or ammdity future8 contmds in Jamaica or any othei country? If YES, give detaih ..................................................................... ................................................................................................... - [The 1Dclusion of thu page is authorized by L.N. 73/1999]

THE SECURITIES (LICENSING AND REGISTRATION) REGULATIONS, 1996 FORM B, contd. A. Have you ever pleaded guilty or been found guilty under any law of Jamaica or any other country of any offence invollving dishonesty ot relating b trading in securities, commodities, commodity futures contracts or options or the theft thereof or been a party in any proceedings taken on account of fraud arising out of any trade in or advice in respeot thereof? B. Have you ever been aonvicted of any criminal offence not mentimed in paragraph A? ........................................... .......................................*a C. Are you currently the subject of a charge or indictment under any hw of Jamaica or any other country for contravention of any law or for any conduot of the type described in paragraphs A and B? D. Has a company of which you are or were at the time of the event an officer, director or holder of voting securities carrying more than 5% of the votes carried by all outstanding voting securities, or any partnership of which you are or were at the time of the offence a partner, ever pleaded guilty or been found guilty under any law in Jamaica or any other country of offences or conduct of the type described in paragraphs A and D? E. Is any such company or Mnership mentioned in para- D currently the subject of a charge or indictment? 13. aVIL PROCEEDINGS - A. Has any daim been sumssfully made in any civil matter before a court or other tribunlal in Jamaica or any other country which was based in whole or part on fraud, theft, deceit or misrepresentation or similar conduct against- (9 YOU YES( 1 NO( 1

• ---. [The inclusion of this page is authorized by L.N. 73119991

THE SECURZTIES (LICENSING AND REGISTRATION) REGULATIONS, 1996 FORM B, contd. (ii) any company of which you are or were at the time of the event or at the time that such proceedings were commenced an officer, a director or holder of voting securities carrying more than 3% of the votes carried by all outstanding voting securities? (iii) any partnership of which you were a partner at the time of the event or at the time suoh proceedings were commenced? B. To the best of your knowledge is any suoh claim pending against you or such company or partnership? 14. BANKRUPTCY --------- A. Have you or any company of which you are or were at the time of the event an au'thorized officer, a director or holder of voting securities carrying more than 5% of the votes carried by all outstanding voting securities; or B. Have you or any partnership of which you are a partner under the laws of Jamaica or any other country, ever- (i) lken declared banlkrupt or made a voluntary assignment in bankruptcy? ................................................................................................... (ii) made a proposal rdating to bankrupky or insolvency? YE'S() NO() ................................................................................................ (iii) been subject to or instituted any proceedings, arrangement or compromise with creditors or had a receiver or manager, or both. appointed to hold your assets or the assets of the wmpany or partnership? (a) Has any judgement or attachment ever been rendered against you in any civil court in Jamaica in respect of damages or other relief for fraud or for any other reason? YES ( NO ( [The inclusion of this page is authorized by L.N. 731 19991

THE SECURITIES (LICENSING AND REGISTRATION) REGULATIONS, 1996 (b) Is any judgement ior mdbachmnt outsitanding against you in any dd cowt in Jamaica or any other country for damages or other relied in reqlect of fraud or for any reason &atsoever? mo NQO Have you ever applied for a surety bond or fidelity tynd and been refused ? mo NO0 If YJ3.9, give partidara. .................................................................................................. Are you presently bonded? mo NO0 ......................................................... If YES, with whom and for how muoh? A. Will you be actively engaged in the busincrs d tho Appliaa~ md devote tihe major portion of your time thereto? mi90 NO0 W NO, give details. ..................................................... ............... B. Are you engaged in my other buginess or have any other employment for gam except your ompation w~lh the Applicant? .................................................................................................. If YES, set out full details on an abohnent including the name and mklms of the businas, the nature of the business, your title or pocition ad the amount of time you devote to the business. C. (Am you an offiker, dirwtor, shareholder, partner o? other contrilbwr of capital or employee of a company having as its pFincipal businew fi,& of a dealer or adviser in secuddes, commodities, commodity futurer coatraots or options other than the hn with which yo^ are now WP~YW mo NO0 If YES, give details. [The inclusion of this page is authorized by L.N. 731 19991

THE SECURITIES (LICENSING AND REGISTRATION) REGULATIONS, 1996 'fie undersigned individual for whom Apfliwtion is &de for regisWon hereby- (a) certifies that the foregoing statement8 are to the best of hislher howl￾edge, information and belief true and correot, and hereby underbkea ta n'&iy the Commission in writing of any material chanlge in the information provided in Part 11 of this Applicalon; and (b) acknowledges md consents to the Oomission obtaining information from any source as pedtted 'by law in Jamaica or any other jusis- diction for the purpose of verifying information furnished in this Application. The undersigned authorized efficer of the A,pplicant hereby certifies that he or she has discussed the questions in this Application with @he individual for whoan Application is made for registration and that 60 the best of his knowledge and belief the individual fully understands the qudons, and funkher certifies that such individual is or will be engaged by Ohe Amlid as a Representative. Dated this ........ .......day of ........................................... 19. ..... ................................................................................................... (Nanne of Representative) (Signature of Representative) By ................................................ (Au@horid Ofilcer, hrh61 or Individual Appliamt) I, the undersigned, make oath and say that I have rdad and understood tthe questi~ns in this Application as wdl as the amwers made by myself thereto and that the sbtementa of faot made thefein and the attachnmta am to the best of my knowledge, infonmah and bel~d Wue and mrrect. WORN behe me & .................................... 1 in oh8 garish d ................................................................................... this ................ ..&y of ....................... .19,. ... .) @gnatwe d RepresenMve ) 1 ................................................................... ) Justice 04 the Baaa or Notary Public me inclusion of this page is authorized by L.N. 73119991

THE SECURITIES (LICENSING AND REGISTRATION) REGULATIONS, 1996 FORM B, cortrd. POlR OFFICIAL USE ONLY Regismtion Period Date AipDlication received (a) Number d Attachments (b) " " RepresenItls!tives (c) *' Branaha Identification Verifioation Application Fee paid $ . hbmibted to Oommission on Date Approved/ Rejected Terms md Conditions of Licensing (ii) (iii) (iv) Licensing Fees $ Dsute Paid Certifying Officer Chairman /i3xecutive Director Sugpansions or Cancellations Aation Taken Effeotive Date Reasons Ehe inclusion of thia page L authorized by L.N. 731 19991

THE SECURITLES (WCENSING AND REGISTRATION) REGULR TIONS. 1996 FIRST S~~DULE, contd. FORM c THE SECURlTIES ACT Ihe Sdes (Licensing and Registration) Regulat~ons, 1996 Licence to deal in Securities No. of Licence .......................... lhis Licence authorizer .................................................................................... of ...................................................................................................... in the puish of ...................................... to cany on business as a deala in securities in acexdance with the Seauities Ad and regulations made thereunder. lhis licence is issued subject to the tams and conditiong if any, annexed her-. 'Ibis licence is nd transferable. Dnted this.. ........... ...day of ............................. ., 19.. ... .................................................................. Chairman. Securities Commission FORM D THE SECURITIES ACT lhe Seadies (Licensing and Registration) Regulations, 1996 Investment Adviser's Licence No. of Li cence... ....................... lhis Licence authorizes .................................................................................... of .....in the pui& .................................................................................................. of ...................................... to olry on business as an inv&ent adviser in accudma with the Sdes Act end regulations madethereunder. This licence is issual subject to the tenns and conditions, if any, annexed hado. ?his licence is ndtransferable. Datedthis ................ day of ............................ .., 19.. ..... .................................................................. Chairman, Secun'ries Commission [The inclusion of this page is authorized by L.N. 28/2003]

THE SECURITIES (LICENSLVG AND REGISTRATION) REGULATIONS, 1996 FIRST SCHEDULE, conrd. FORM E THE SECURlTIES ACT The Securities (Licensing and Registration) Regulations, 1996 Certi$cate of Registrotion as a Dealer's Representative No. of Cdficate .......................... ...................................................................................................... in the parish of ...................................... has beem registered to carry on business as the representative of .......................................................... a dealer in securities in accordance with the Seuuitim Ad and regulations made thereunda. 'Ihi Wificate is issued subjed to the tams and conditions, if any, annexed hereto. This cetifiade is not transferable. Datedthis .............. ..day of.. ........................ ...., 19 ....... .................................................................. Chairman, Securities Commission FORM F THE SECURlTIES ACT The Seavities (Licensing and Registration) Regulations, 1996 Certificate of Registration as an Investment Adviser's Representative No. of Ccrcif~cate .............................. ...................................................................................................... intheparish of ................................. has been registered to carry on business as the representative of ..................................................... an investment adviser in accordance wah the Sdim Ad and regulations made thereunder. 'Ihir catificate is issued subject to the tams and conditions, if any, annexed hsdo. 'Ihir cetiiicatc is not transferable. -this ............... day of ....................... ., 19.. ... ............................................................... Chairman, Securities Commi~~ion [The inclusion of this page is authorized by L.N. 28120031

WE SECURITIES (WCENSING mD REGISTRATION) RMiULA TIONS, 1996 FIRST SCHEDULE, contd. FORM G THE SECURITIES ACT The Securities (Licensing md Registration) Regulations, 1996 Application for Registration ofResponsible Wcer N*E for m!&!~~~~~cati.qr!

1. This Fmm is to be used by every Applicant for registration under the Securities Act.
2. GU cpsrticms be answered. Failure to do so may cause delays in the processing of the Appliation.
3. If pra provided for answers is insuficim then hish required information on an stt.ctynalt.
4. This Fam and all attachments added thereto must be twewritten. All sirnatures must be oriainrls.
5. AU documnts paining to my question must be attached to the Form and clearly marked with the numk ofthe relevant question.
6. The Applicant and the Justice of the Peace or Notary Public before dom the Appliation is sworn, are each required toinitial all attachments. THE SECURITIES ACT The Securities (Licensing and Registration) Regulations, 1996 Applidm for Registration of Responsible Officer
7. APPLICANT ............................................................................................................... Surname First Middle Maiden ............................................................................................................... Home Address Telephone No. ............................................................................................................... Rarcld position with Employer Commmcd employment on ............................................................................ Day Month Year
8. EMPU)YER ............................................................................................................... Name Telephone No. Addrsss of flee where Responsible qcer will be working
9. PERSONAL DESCRIFllON OF RESPONSIBLE OFFICER A. -of Bath .............................................. Sex ...................................... ......................................................................................................... Phx of Birth [The iiicli~sion of this page is authorized by L.N. 28120031

THE SECURITIES (LJCEh'SNG AND REGISTRATIOh') REGULATIONS, I996 FIRST SCHEDULE, contd. FORM G, contd. ......................................................................................................... Height Weight Colour @eyes Colour of hair .......................................... If nd a Jamaican citizen answa Question B below Citizenship Name of spouse ..................................................................................... Surname First Middle Maiden Nature of spouse's employment in Jamaica ..................................................... ......................................................................................................... Name of spouse's employer ...................................................................... B. Are you a pennanmt resident of Jamaica? YES ( ) NO( ) C. For how long have you been residing in Jamaica? D. 'Change of name Lid name changes resulting fiom marriage, divorce, murt order or any dha process, giving appropriate dates. Previous name Date changed Reason ......................... ............................ .............................. Have you ever carried on business unda any name dha than the name mentioned in Question 1 of this Form? YES( 1 NO( 1 If YES, give details E. Passport Information In providingthe information requested below, the Responsible OtXcer must also attach a copy of his passport certified by a Justice ofthe Peace or Ndary Public. ......................................................................................................... Couniry Place of issue Date of issue Number Attach haeto two copies of a colour passport size phdograph, hll face, showing a hue Iiimas of the Responsible Ofker as the Responsible OlEcer now appears md Wrm [The inclusion of this page is authorized by L.N. 28120031 aded this.. .............. day of ............................. ., 19.. ..... .................................................................. Chairman, Securities Commission

THE SECURITIES (WCENSING AND REGISTRATION) REGULATIONS. I996 m the last six months. 7he phdogrsphs mu& mauaue 2" x 2", and baar on the bskthe drde on whiQ they were takm end be catified by a Jubtice of the Peace a Ndray Public. 4. EDUCATION Li& Mow names of institutions attended and qualifications attained SBoollIn~on Yearatrrmded Quali6cations Attd~ original doaunart a &a artified documart evidencing qualification. EMPLOY MEW HISTORY In answering qudions 5-7 give full disclosure of your bueinesa adivities, induding my paid of self-enploymat end menploymat for 5 yearn immedislely prim to the date of thn application, excluding any summa arploymat while a fulllme studmt, but including all ncuuities a commodities industry umloymmt during and prior to the 5-veu wiod AtL.ch Idta, signed by the ~ea~onible &As aimauQVrPdor f- emplk &uming the Rssponsible OfFiccr's years of service in the securities a related industry. ......................................................................................................... Name of present employer ......................................................................................................... Addras of present employer Duties ................................................................................................. B. Rwious Employmart ......................................................................................................... Name of previous enploya A&irc1u1 of previous employa Paiod of employmart .............................................................................. From To Reams fa leaving ................................................................................. C. Sdf-Employment [The inclusion of this payc is authorid by L.N. 2800031

THE SECURITIES (UCENSING AND REGISTRATION) REGULATIONS, 1996 Give details if any D. Have you ever been disdarged by an employer for dishonesty, negligence or inwmpdmce? YES( 1 NO( 1 If YES, explain ..................................................................................... ......................................................................................................... 6. RESIDENTIAL HISTORY Give all home addresses for the past 5 years, include stred, postal wde and parish. Current ...................................................................................... 20 ...... to 20 ......... Sweet Postal Code Parish Previous ...................................................................................... 20 ...... to 20.. ....... Sweet Postal Code Parish 7. REFERENCES A On an attadmart provide three (3) names as references, excluding relatives and persons working with the Responsible Ofica's employer. Include busmess address with postal wde, telephone number and occupation. B. Banks or other Financial Institutions. ......................................................................................................... Name of bank (s) ......................................................................................................... Address (es) 8. PRIOR REGISTRATION OF RESPONSIBLE OFFICER A Are you now licensed or registered in any capacity under any law of Jamaica or any other country regulating trading m securities, commodities or commodity futures contracts? YES( 1 NO( 1 If YES, give details ................................................................................. B. Have you been previously licensed or registered as mentioned in paragraph A? YES( 1 NO( If YES, give details and dates .. .:. ................................................................ C. Are you now a shareholder, director or ofica of any company or a partner m a partner￾hip whid is now licensed unda any law regulating the trading of seauitia. commodities or commodity futures cantrads in Jamaica or any dha cwntry? YES( 1 NO( 1 If YES, which ampany? .......................................................................... [Tile inclusion of this page is authorized by L.N. 28120031

THE SECURITIES (LICENSLVG AND REGISTRATION) REGULA TIOM 1996 D. Are you now a shholder, director or officer of any company or a partner in a partner￾ship which has been previously limsed under any law regulating the trading in dies, commodities or commodity futures in Jamaica or any other country? YES( NO( ) IfYES, which company and when? ............................................................. E. Have you ever been a shareholder, diredor or officea of any company or a partner in a pattnershq licensed as mentioned m C or D above? YES( )NO( ) IfYES, which company and when? 9. A Are you now registwed under any law which requires registration to deal with the public in my capacity other than trading in sdes, commodities or commodity fidurcs contracts in Jamaica or any other countxy? YES( )NO( ) If YES, which company and when? B. Have you ever applied for or obtained registration mentioned m paragraph A above? YES( ) NO( ) IfYES, when and in which country and under what law? QUESTIONS 10-15 In mswukg Qudaas 10-15 you may need assistance &om a Legal Adviser. Full details are requid .s It.cbmads m resped of any question to which the Responsible Officer answers "YES". 'Ibac must include the circumrrtances, relevant dates, names of the patties involved ad fhul determination if known. Also disclose any conviaions under all laws, exctuhg amvidaas mder the Road Traffic A& and any conviction in resped of which an abmm a COIW~~~ discharge has beam granted. Ifa conviaion has been expunged hm the rmada plrauat to the Criminal Records (Rebabiliiion of Offenders) Ad, the appropriate respoasc would be "NO". 10. REFUSAL, SUSPENSION, CANCELLATION, OR DISCIPLINARY MEASURE A Have you ever been r&sed registration or has your registration been suspended or canalled under any law regulating trading in securities, commodities or commodity frdrrres contract in Jamaica or any other country? YES( )NO( 1 If YES, &te in which country, under what law and when? B. Are you now a have you ever been an officer or diredor of a company or a partner in a patn* (i) wbi& hs been refused registratim during the time of your B880Ciatim with a (ii) wh- registdm hrs been sq~dcd or canalled mda my law regfJlrting [The inclusion of this page is authorized by L.N. 2812003]

THE SECURITIES (WCENSING AND REGISTRATION) REGULATIONS, 1996 trading in seauities, commodities or annmodity futures contracis in Jamaica or any her country? YES( )NO( ) If YES, give details .......... ................................................................ 11. OFFENCES k Have you ever pleaded or been found guilty unda any law of Jamaica or any &ha country of any offmce involving dishonesty or relating to trading in securitias, commodities, commodity futures contracis or options or the theff thereof or been a party in any prooxdings takm on account of fraud arising out of any trade in or advice in respect thereof? IF YES, give details. ................................................................................ B. Have you ever been amvided of any criminal offence nd mentioned in paragaph A? IF YES, give details.. .............................................................................. C. Are you aurently the subject of a Qarge or indictment under any law of Jamaica or any othe country for contravmtion of any other law or for any conduct of the type described in paragraphs A and B? D. Has a company of which you are or were at the time of the event an officer, diredor or holder of voting sdes carrying more than 5% of the votes carried by all outstanding vding securities, or any p-ership of whiQ you are or were at the time of the offcnce a partner, ever pleaded guilty or been found guilty under any law in Jamaica or any other country of offmces or amdud of the type described in paragraphs A and D? E. Is any such company or partnership mmtioned in paragraph D currently the subject of a charge or indidmat? 12. CIVIL PROCEEDINGS k Has any claim been successfblly made in any civil matter before a court or other tribunal in Jamaica or any her country whicb was based in whole or part a fraud, the& deceit or misrepresdution or similar amduct against- (i) You YES( )NO( 1 .............................................................................................. (i) my mmpauy of whim YOU are or were at the time ofthe evat or at the time [The i~iclusion of this page is authorized by L.N. 28120031

TiiE SECURITIES (LICENSING AND REGISTRATION) REGULATIONS, 1996 that such proceedings were commenced an officer, a director or holder of voting securities carrying more than 5% of the votes carried by all outstanding voting securities? YES( )NO( (iii) any partnership of which you were a partner at the time of the event or at the time sul proceedings were commenced? YES( )NO( B. To the best of your knowled@ is any such claim pending against you or such company or partnership? YES( ) NO( 1 13. BANKRUPTCY k Have you or any company of which you are or were at the time of the event an authorized officer, a dkctor or holder of voting securities carrying more than a 5% of the votes carried by all outstanding voting securities; or B. Have you or any partnership of which you are a partner under the laws of Jamaica or any other country, ever- (i) been declared bankrupt or made a voluntary assignmen! in bankruptcy? YES( )NO( (ii) made a proposal relating to bankruptcy or insolvency? YES( )NO( (iii) been subject to or instituted any proceedings, arrangement or compromise with creditors or had a receiver or manager, or both, appointed to hold your assets or the assets of the company or partnership? 14. JUDGMENT OF Al'TACHMENT k Has any judgment or dchrnent ever been rendered against you in any civil court in Jamaica in respect of damages or other relief for bd or for any other reason? YES( )NO( ....................................................................................................... B. Is any judgment or aliachment outstanding against you in any civil court in Jamaica or any other country for damages or other relief in respect of hud or for any reason whatsoever? [The inelasion of this page is authorized by L.N. 28120031

THE SECURITIES (LICENSING AND REGIS?IRATION) REGULATIONS, 1996 15. SURETY BOND Off FIDELITY BOND A Have you eve applied for a surety bond or fidelity bond and been refused? YES( )NO( ) If YES, give particulars ..................................................................................................... B. Are you prdly bonded? YES( )NO( ) If YES, with whom and for how much? ......................................................................................................... 16. BUSINESS ACTlVITIES A Will you be actively engaged in the business ofthe Dealer and devotethe major portion of yout timetherdo? B. Are you engaged in any other business or have any other employment for gain except your occupation with the Dealer? If YES, set out full details cn an attachment including the name and address of the business, the nature of the business, your title or position and the amount of time you devote to the business. C. Are you an offices, director, shareholder, paitner or other contributor of capital or employee of a company having as its principal business that of a dealer or adviser in securities, commodities, commodity htures amtrads or options &er thp the firm with which you are now working? YES( )NO( 1 If YES, give details. .................................................................................................... >...., 17. CERTIFICATE AND AGREEMENT OF APPLICANT I .................................................................................................... ..who make application for registration hereby make oath and say- (a) that I have read and understood the questions in this applicaticn as well as the answers made by me thereto and that the statements of fad made therein and the mchments thdo are to the best of my knowledge, information and belieftrue and caed; and (b) that I undertake to notify the Commission in writing of any mataial change in the information provided in this application; and (c) that I acknowledge and consent to the Commission obtsiniig information fiom my source as permitted by law in Jamaica or any &er jurisdiction for the purpose of verifying infomudion furnished m this application. [The ~nclusion of this page is authorized by L.N. 28120031

THE SECURITLES (LICENSEVG Ah'D REGISTRATION) REGULATIONS, 1996 SWORN before me at ................................. In the parish of.. ....................................... ................................................... ) . m.. ............... day of. ............. ..20 .......... ) Signature of applicant ........................................................... 1 Justice of the Peece or Natary Public FOR OFFICIAL USE ONLY RegiMon Period ...................................................................................... Date Appliu$on received ............................................................................. Number of Attachments ................................................................................ Identifiution Verification .............................................................................. Application Fee paid S ................................................................................. Submitted to Commission on .......................................................................... Date ApprovedlRejected .............................................................................. Terrns and Conditions ofRegistrcrtlon (i) ....................................................................................................... (ii) ....................................................................................................... ... (111) ....................................................................................................... (iv) ....................................................................................................... Regiebation Fee $ ...................................................................................... Date Paid ........................................................................................ (10) certifyigmcer ...................................................................................... ChainnanlExecutive Director (1 1) Suppensions a Cancellatione ......................................................................... Adon Taken ................... .................................................................... Effedve Date .......................................................................................... Reawns .................................................................................................. ...................................................................................................... ...................................................................................................... pe hlwi011 of this page b authoriPd by LN. 135/2003 ]

THE SECURITIES (LICENSING AND REGISTRATION) REGULATIONS, 1996 FIRST SCHEDULE, contd. FORM H THE SECURITIES ACT The Securities (Licensing and Registration) Regulations, 1996 Application for Licence to Establish and Operate a Central Securities Depository

1. ?his Fom is to be used by every Applicant for licensing of a Central Securities Depository under the Securities Act.
2. All applicable questions must be answered. Failure to do so may cause delays in the processing of the Application.
3. If the space provided for answers is insufficient, then furnish required information on an attachment.
4. A11 documents pertaining to any question must be attached to the fonn and be clearly marked with the number of the relevant question. Name of Company ................................................................................. Address of Company ............................................................................... Business telephone number ....................................................................... Fax number .......................................................................................... Email address ...................................................................................... Address of principal place of business, if different hm No. 2 .............................. ......................................................................................................... Share Capital $ ...................................................................................... Date and place of launch of central security depository ....................................... ......................................................................................................... Name of directors ................................................................................... ................................................................................................................... ......................................................................................................... ......................................................................................................... ......................................................................................................... Names of principal officers of central securities depository .................................. .......................................................................................................... ......................................................................................................... ......................................................................................................... [The inclwion of this pee is authorized by L.N. 13512003 ]

THE SECURITIEY (LICENSWG AND REGISTRATION) REGULI TIONS, 1996 11: Names of shareholders holding 10% or more of share capital ................................ ......................................................................................................... ......................................................................................................... ....................................................................................................... ...................................................................................................... ..................................................................................................... ......................................................................................................... ......................................................................................................... 12. Names and shareholdings of directors holding less than 10% of share capital.. ........... .......................................................................................................... ......................................................................................................... ......................................................................................................... ......................................................................................................... ......................................................................................................... ......................................................................................................... 13. Name of ultimate parent company, if any ....................................................... ......................................................................................................... 14. Names of all subsidiaries and associated companies ...... .:. ................................. 15. Was the company previously registered by the Commission? Yes ........ No ........ 16. State all eligible securities .................................... 17. State name of Settling Bank ......................................................................

[The inclusion of this page is authorized by L.N. 135/2003 ]

Name of auditor (Finadd) ....................................................................... Wlsinw address of auditor (Financial) ......................................................... Name of system auditor ........................................................................... Ekeineta address of system auditor ............................................................... .......................................................................................................... Signature of Puthahed officer FORM I THE SECURITIES ACT The Socwities (Licensing and RegisIration) Regulations, 19% Licence to Establish and Operate Central Securities Depo~itory No. of Licence ................................... This Licence authorizes.. ................................................................................... of ..................................................................................................... in the parish of ................................................ to establish and operate a omtml securities depository in accordance with the Securities Ad and regulations made thereunder. This licence is issued subject to the tenns and conditions, if any, annexed hereto. This licence is not transferable. Dated this. ............................... ....day of. ............................................, 20.. ........ ................................................... Chairman, Financial Services Commission [The inclusion of this page is authorized by L.N. 135f2063 ]

THE SECURITIES (LICENSING AND REGISTRATION) REGULATIONS, 1996 SECOND SCHEDULE (Regulations 3,4,6(2), 8(2) and 9) Fees I. The fees in respect of a dealer's licence shall be- (a) in the case of an individual￾On application (non-refundable) ... $ 50,000 On the grant of a licence and, thereafter, annually. on or before the anniversary of the grant of the licence . . . . . . $120,000 (b) in the case of a company On application (non-refundable) ... $5,000 On the grant of a license and, thereafter, annually, on or before the anniversary of the grant of the license . . . . . . the greater of- (i) $500,000; or (ii) the aggregate of- (A) 5 basis points on the first $5 billion of total assets; (B) 1.5 basis points on the next $25 billion of total assets; and (C) 0.75 basis points on assets over $30 bil￾lion. Note: For the purposes of Item 1 (b)(ii); -assetsw means (a) the aggregate total of a dealer's balance sheet assets as at the 31st December of the year immediately prior to the anniversary of the grant of its licence, taken without the netting off of its liabilities plus the aggregate value, at that date, of securities or other investment instruments held or managed on behalf of clients, whether on a discretionary or a non-discretionary basis: or (b) in the case of a unit trust and overseas mutual funds, the net value of securities sold by or through the dealer during the year ending on the 3 1 st December immediately prior to the anniversary of the grant of its licence. 2. The fees payable in respect of an investment adviser's licence shall b+ (a) in the case of an individual￾On application (non-refundable) .. . $5,000 On the grant of a licence and, thereafter, annually, on or before the anniversary of the grant of the licence . . . . . . $90.000 [The inclusion of this page is authorized by L.N. 21R012)

THE SECURITIES (LICENSING AND REGISTRATION) REGULATIONS, I996 SECOND SCHEDULE, contd. Fees, contd. (b) in the case of a company-- On application (non-refindable) ... $ 5,000 On the grant of a licence and, thereafter, annually, on or before the anniversary of the grant of the licence ... $90.000 and $ 4.000 in respect of each branch 3. The fees payable in respect of registration as adealer's representative shall be￾On application (non-refindable) ... ... $ 5,000 On the grant of registration and, thereafter, annually, on or before the anniversary of the grant of the registration ... $ 16,000 4. The fees payable in respect of the registration as an investment adviser's representative shall be￾On application (non-refundable) ... ... On the grant of registration and, thereafter, annually, on or $ 5,000 before the anniversary of the grant of the registration ... $ 8.000 5. The fee payable by a recognized stock exchange shall be an annual fee calculated in accordance with the formula indicated hereunder and shall be paid 0n.a monthly basis, such payment to be made no later than the last day of the month following the month for which the fee is due 0.08% of the total value of all trading activities on the stock market for each day of the financial year of the Exchange 6. The fees payable in respect of a Responsible Officer shall be- (a) On application (non-refundable) ... ... ... $ 5,000 (b) On the grant of registration and, thereafter, annually, on or before the anniversary of the grant of the registration ... ... ... $50.000 7. The fees payable by a central securities depository shall be- (a) On application (non-refindable) ... ... ... S20.000 (b) On the grant of a licence , ... ... ... (c) An annual fee calculated in accordance $20,000 with the formula indicated hereunder and shall be paid on a monthly basis, such payment to be made no later than the last day of the month following the month for which the fee is due ... 5% of the transaction revenue mi inclusion bf this page is authorized by L.N. 2lROlZj