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



FORM 48B. Application For Company Secretary's Licence.

FORM 48B
Photograph
of
Applicant


Companies Act, 1965
(Section 139B (1))


APPLICATION FOR COMPANY SECRETARY'S LICENCE

Application is made for Company Secretary's Licence under the Companies Act 1965 and the following statements are made in respect thereof.

If space is insufficient to provide details, please attach annexure (s). Any such annexure(s) should be identified in accordance with Regulation 6A.

A. (i) Name of applicant: ...................................... (In Block Letters)
(ii) Residential address: ......................................
(iii) Office address: ......................................
(iv) Date and place of birth: ......................................

(v) Male/Female: ......................................

B. Academic or professional qualification
___________________________________
(Please attach photocopy of certificate of qualification)

C. Years of experience in Secretarial Practice......................................

(Please attach relevant documentary / evidence relating to the experience. )

D. Details of one person with whom the applicant has had regular contact over the past five years and of whom the Registrar may enquire regarding the applicant's character.


E. Declaration:
I ......................................do solemnly and sincerely declare that:




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

FOR THE REGISTRY'S USE ONLY
Remarks
Date
Approved
Date
Rejected
Licence
Number
Officer



ANNEXURE A


LIST OF COMPANIES WHEREBY APPLICANT IS
APPOINTED AS SECRETARY

No.
Company
Number
Name of Company
Appointment
Date
Office
Use



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


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