APPENDIX
I
CHAPTER
7 – OFF-EXCHANGE TRADE VALIDATION
&
REPORTING SYSTEM
APPLICATION FOR DIRECT PARTICIPATION
IN THE
OFF-EXCHANGE TRADE VALIDATION
& REPORTING SYSTEM
How to use this
Application Form
1.
Applicants
must submit a completed Application Form together with any supporting documents
and fees to:
The General Manager
Garrison Chapel
2.
The
Application Form should be read in conjunction with the Financial Markets Act
[Chapter 345 of the Laws of Malta] and the Bye-laws of the Malta Stock Exchange
[available on www.borzamalta.com.mt].
3.
Applications
will only be considered provided all relevant Sections have been completed and
supporting documents and fees have been appended thereto.
4.
Should
space provided not be sufficient, additional information may be entered on
separate sheets with the heading “Continuation to Section __” duly signed and dated.
5.
Misleading
or incorrect information on any material point shall render the application
invalid.
6.
All
information submitted in the application is for the sole use of the Exchange
and shall not be divulged to third parties other than the Competent Authority
as deemed appropriate.
1.00 SECTION 1 – AUTHORISED
INTERMEDIARY
1.01
Applicant’s
Name : ___________________________________________
1.02
ISA
Licence Ref*: _____________________________________________
·
In
cases where the authorised intermediary is not licensed under the ISA but authorised
by the MFSA kindly attach a copy of such authorisation.
1.03
Registered
Address *
Address
:_________________________________________
__________________________________________
__________________________________________
Contact
Person :
__________________________________________
Design :
___________________________________________
No. :
___________________________________________
Tel No :
___________________________________________
Fax No : ___________________________________________
E-mail : ___________________________________________
·
The above information will appear on the
Exchange’s List of Direct and Indirect Participants and all communications will
be addressed accordingly.
1.04 Member of the Exchange YES NO
[Please tick as appropriate]
2.00 SECTION 2 –
PARTICIPATION
Application is being made with
respect to direct participation in
the Off-Exchange Trade Validation and Reporting System.
(i)
Access
from own premises
(ii)
Access
from Exchange premises
[Please delete as appropriate]
3.00 SECTION 3 – Persons
Nominated to access the system (Reporters)
(i)
Nominated Person
: ______________________________
ID Card No or
Equivalent identification:
_________________________
(ii)
Nominated Person :
______________________________
ID Card No or
Equivalent identification:
_________________________
4.00 SECTION 4 –
FEES
Attached please find :
Cheque No : __________________________
Bank : __________________________
Dated : __________________________
Amount : __________________________
in respect of applicable fees in terms of
Council Notice 1.
5.00 SECTION 5 –
DECLARATION BY APPLICANT
5.1 We/I declare that the information
contained in this application is complete and correct.
5.2 We/I declare that the Authorised
Intermediary, his officers and employees are aware of the provisions of the
Act, Statute and Bye-laws and any other rules that may be in force from time to
time and will comply with and be bound by all such relevant provisions.
5.3 We/I declare that the Authorised
Intermediary will be responsible for and be bound by all the actions and
omissions of its officers and employees in their activities in connection with
the Exchange.
5.4 We/I declare that the Authorised
Intermediary shall keep the Exchange notified of any significant changes in the
information supplied in this application which occur after the date of
submission of the application.
5.5 We/I declare that the applicant
has obtained all relevant regulatory approvals.
Signature :
_____________________ Signature :
_______________________
Designation :
___________________ Designation :
_____________________
Signed on
behalf of [name of applicant] _____________________ on [date] ___________