P.U. 173/66
COMPANIES REGULATIONS, 1966
SECOND SCHEDULE (Regulation 3)



FORM 48C. Application For Renewal Of Company Secretary's Licence.

FORM 48C

Companies Act, 1965
(Section 139B (4) (5) )


Licence. No:



Licence Expired On:



APPLICATION FOR RENEWAL OF COMPANY
SECRETARY'S LICENCE

Application is made for renewal of Company Secretary's Licence No: .......................... issued on .......................... under the Companies Act 1965 and the following statements are made in respect thereof:

A. (a) Full name of licenses: ..........................

(b) Residential address: .......................... (c) Office address: ..........................
B. Declaration:
I .......................... do solemnly and sincerely declare that:


(a) I am not an undischarged bankrupt;

(b) I have not been convicted whether within or without Malaysia of any offence


(i) in connection with the promotion, formation or management of a corporation;

(ii) involving fraud or dishonesty punishable on conviction with imprisonment for three months or more; or

(iii) under section 132, 132A or 303, within a period of five years preceding the date of this declaration;


(c) all information given in this application and in the attached annexure(s) (if any) is true and correct.


Dated this .......................... day of .......................... 19 ..........................
..........................
Signature of Applicant


FOR THE REGISTRY'S USE ONLY

Remarks
Date
Approved
Date
Rejected
Licence
Number
Officer

(Ins.P.U.(A) 80 /1993:s.5)


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