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[接上页] Note: 1) Please '?' in the appropriate box. 2) *Delete as inappropriate. Section A Section A of this form has to be completed by a representative of the applicant company. The representative must be in effective control of the applicant company's estate agency business and he has to be a licensed estate agent. Validity Period of Licence applied for □ 12 months □ 24 months A-1 Particulars of Applicant Company Name of Applicant Company in English (As registered with Companies Registry) Licence No. Name of Applicant Company in Chinese (As registered with Companies Registry) Expiry Date (DD/MM/YYYY) Certificate of Incorporation No. Business Registration No. Expiry Date (DD/MM/YYYY) For the following particulars in sections A-1 and A-2, applicants only need to provide the information that is DIFFERENT from application last filed. Address of Registered Office ____________ Flat/Room ____________ Floor ____________ Block _______________________________ Name of Building/Estate __________________________ Number and Name of Street _________________________ District HK/KLN/NT* Telephone No. Fax No. Emal Address A-2 Particulars of Business (if DIFFERENT from above) Business Name in English (as shown in Business Registration Certificate) Business Name in Chinese (as shown in Business Registration Certificate) Place of Business ____________ Flat/Room ____________ Floor ____________ Block _______________________________ Name of Building/Estate ___________________________ Number and Name of Street _________________________ District HK/KLN/NT* Telephone No. Fax No. Emal Address A-3 List of Directors Note: 1) As registered with Companies Registry. Please use additional sheet if necessary. 2) Directors without a valid Estate Agent's Licence (Individual)/(Company) must complete Section B / Section C of this form. List of Directors Name in English (Surname first) Name in Chinese Licence Number Expiry Date (DD/MM/YYYY) (Individual) List of Directors (Company) A-4 Declaration Note: The questions below refer to factors which will be considered in the determination for the renewal of licence/Statement of Particulars of Business. They form an integral part of this form and must be answered. "You" in the questions means the company applying for the renewal of the Estate Agent's Licence (Company)/Statement of Particulars of Business. Yes No 1. Are you in liquidation or the subject of a winding-up order, or is there a receiver appointed in relation to you, or have you, within the 5 years immediately prior to the date of this application, entered into a composition or scheme of arrangement with your creditors? □ □ 2. Have you ever been convicted under the Estate Agents Ordinance (Cap 511)? □ □ If you have answered 'Yes' to any of the above questions, please give details using additional sheets. On behalf of the applicant company, I hereby declare that for each place at which and each business name under which the applicant company is to carry on an estate agency business, the applicant company has filed as part of this application an application for the grant or renewal of statement of particulars of business (Form 8 or 14), and that all the foregoing information is FULL, COMPLETE AND TRUE to the best of my knowledge and belief and I authorize the Estate Agents Authority to verify the foregoing information in any manner as it deems fit. _____________________________ Name of Representative (in BLOCK LETTERS) __________________________________ Estate Agent's (Individual) Licence number _____________________________ Position (in BLOCK LETTERS) ____________________ Date (DD/MM/YYYY) ________________________________ Authorized Signature and Company Chop Section B Particulars of Director (Directorship held by an Individual without a valid estate agent's individual licence) Form 12(Page 2) Section 55(1)(c) of the Estate Agents Ordinance (Cap 511) makes it an offence punishable by a fine at level 6 and/or imprisonment for 1 year on conviction upon indictment or by a fine at level 5 and/or imprisonment for 6 months on summary conviction if a person makes any false or misleading statement or furnishes any false or misleading information in connection with an application for the grant or renewal of a licence. Please obtain or copy sufficient copies of Section B of this form as necessary for completion by EACH director without a valid estate agent's individual licence. B-1 Particulars of Applicant Company Certificate of Incorporation No. Name of Applicant Company in English B-2 Particulars of Director Name in English (Surname |