Applicant information

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Authorized Applicant

Please specify the contact information for the individual who should be contacted regardering any matter should any problems or concerns arise in regards to this application. The primary contact is not necessarily an Authorised Representative. To be an Authorized Representative, the primary contact should be listed in the "Authorised Representatives" section.

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LIST OF DIRECTORS


ULTIMATE BENEFICIAL OWNERS

Please specify those Shareholders with 10% or more of the Applicant company. If no Shareholder owns more than 10% the shares then provide information on the largest Shareholders that excercise control over the running of the Applicant's Company