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CMSA Form 1

Company application for a dealer licence

18 questions

Section 1

Applicant details

1Name of the applicant.Short text

2Registered office.Short text

3Place of incorporation.Short text

4Full address and telephone number of the principal place where business will be carried on.Phone number

5Address of the place where the applicant's register under section 52 of the Act will be kept.Long text

6Details of each director and company secretary.Table / multiple entries

Name / item

Details

Period / notes

Entry 1

Detailed answer

Supporting notes

Section 2

Business plan and controls

1Nature of the principal business of the applicant.Long text

2Activity and manner in which the applicant proposes to conduct the business requiring a dealer licence.Short text

3Type of clients with whom the applicant proposes to do business.Short text

4Organisational structure and internal control procedures adopted or proposed for the business.Long text

5Persons who directly or indirectly exercise controlling influence over management and policies.Short text

Section 3

Fitness and experience

1Whether the applicant has been licensed, registered or authorised in relation to securities dealing or another regulated trade, business or profession.Yes / No, attach details if Yes

YesNo

Attachment required when the answer is Yes

2Whether the applicant has been refused or restricted from carrying on a trade, business or profession requiring a licence, registration or authority.Yes / No, attach details if Yes

YesNo

Attachment required when the answer is Yes

3Whether directors, company secretary or management staff have had securities exchange membership, discipline, refusal, convictions, civil judgments, bankruptcy, other management roles, refused bonds, or director disqualification matters.Yes / No, attach details if Yes

YesNo

Attachment required when the answer is Yes

4Experience of directors or management staff in performing functions related to the proposed licensed activity.Long text

5Employment and business activities of each director and company secretary during the previous ten years.Table / multiple entries

Name / item

Details

Period / notes

Entry 1

Detailed answer

Supporting notes

6Additional qualifications, training, or information relevant to the application.Long text

7Two character referees for each director and company secretary.Table / multiple entries

Name / item

Details

Period / notes

Entry 1

Detailed answer

Supporting notes

THE UNITED REPUBLIC OF TANZANIA

CAPITAL MARKETS AND SECURITIES AUTHORITY

CMSA Form 1

Applicant details

Business plan and controls

Fitness and experience