APPLICATION FOR REGISTRATION AS A BROKERAGE ENTITY

(To be completed in duplicate)

WHEN COMPLETING THIS FORM, PLEASE ENSURE THAT:

1. All sections are completed in full.

2. All attachments are submitted with the application.

To: The Director

ZAMACE

I/we apply to be a brokerage Entity on ZAMACE

  1. Applicant:

Please indicate category of Membership applying for by ticking in relevant box:

Corporate Business / ZMW 5,000
Farmer Association or Co-operative / ZMW 1250

Company Name (in Block letters):

Postal address:

Location of business:

Telephone No. (Business):

Email:

Details of individual members employed by the Company: (Management only)

Board Directors:

  1. Questions to be answered by applicant:

Has the company ever made an assignment to or arrangement or composition with its creditors? If so, give particulars:

Are there any unsatisfied judgments, in the Courts of Law, outstanding against the company? If so give particulars:

Has the companyever been convicted of any offence involving fraud or dishonesty? If so, state the court by which the company was convicted, the date of the conviction and full particulars of the offence:

  1. The following individuals are to be registered as brokers authorized to arrange trades on behalf of the Brokerage Entity:

1.Name:

Passport / NRC No.:

Physical Address:

Mobile Number:

Email Address:

Nationality:

Citizenship:

Relevant Experience:

Position in Broker Entity:

2.Name:

Passport / NRC No.:

Physical Address:

Mobile Number:

Email Address:

Nationality:

Citizenship:

Relevant Experience:

Position in Broker Entity:

3.Name:

Passport / NRC No.:

Physical Address:

Mobile Number:

Email Address:

Nationality:

Citizenship:

Relevant Experience:

Position in Broker Entity:

  1. Declaration by Directors/Individuals:

I/We hereby declare that:

  1. The information given in Section A is true;
  2. The answers given to the questions in Section B are true;

We acknowledge the right of the Board of Directors of ZAMACE to seek information additional to that provided above at any time hereafter and we undertake to provide the same promptly on request

Authorized Applicant’s Name:

Authorized Applicant’s Signature:

Date:

To be completed by the ZAMACE Executive Director:

Executive Director’s recommendation:

I have reviewed and considered the foregoing application and being satisfied that the applicant is a suitable company to conduct brokerage on ZAMACE, recommend to the Rules and Regulations Committee that the applicant be so admitted, subject to the payment of the applicable fees and fulfillment of all other conditions as may be stipulated by the Board of Directors of ZAMACE.

Date: Signature of ZAMACE Director:

To be completed by the Chairman of the Rules and Regulations (R & R) Committee:

R & R Chairman’s recommendation:

The Rules and Regulations Committee has reviewed and considered the foregoing application.

Conditional admittance is valid for not more than 21 working days.

Approved applicant to be so admitted, subject to the payment of the applicable fees.

The application is hereby, Recommend/ Deferred/ Conditional/ Rejected by the committee.

Date: Signature of Chairman R & R Committee:

To be completed by Chairman of ZAMACE Board of Directors

  1. Approved/not approvedby the ZAMACE Board of Directors.

Date. Signature ofBoardChairman

CHECK LIST OF DOCUMENTS TO BE SUBMITTED WITH APPLICATION:

  • Current Audited Financial Statements
  • Certificate of Incorporation
  • Latest PACRA Print out (Not more than 3 months old)
  • Board Resolution authorizing application

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ZAMBIAN COMMODITY EXCHANGE