Date of Birth* Business Occupation Service Address Please provide details of authorised signatory’s service address. Unit Number / Level Number Building Name Street / Area State / Province PO Box Number* Emirate Country* Fit & Proper This is required to ADGM Registration Authority to assess whether you are fit and proper for the purpose of your firm’s registration as a legal entity subject to ADGM Limited Liability Partnership and Commercial Licensing Regulations 2015. Have you ever been convicted of a crime involving dishonesty?* Yes No Details Have you ever served or been sentenced to a term of imprisonment?* Yes No Details Have you ever been convicted of any offence under any provision of the financial markets legislation or any offence under any provision of any foreign act governing auditors, financial markets or financial services, corporations, financial reporting, or requirements for preventing money laundering ?* Yes No Details
Unit Number / Level Number* Building Name* Street / Area* State / Province Emirate Country Fit & Proper This is required to allow ADGM Registration Authority to assess whether you are fit and proper for the purpose of your firm’s registration as a legal entity subject to ADGM Limited Liabilities Partnership and Commercial Licensing Regulations 2015. Have you ever been convicted of a crime involving dishonesty?* Yes No Details Have you ever served or been sentenced to a term of imprisonment?* Yes No Details Have you ever been convicted of any offence under any provision of the financial markets legislation or any offence under any provision of any foreign act governing auditors, financial markets or financial services, corporations, financial reporting, or requirements for preventing money laundering ?* Yes No Details Have you ever been banned from acting as a director of a company or other incorporated body, of from being involved in the management of any Yes No
Country Fit & Proper This is required to allow ADGM Registration Authority to assess whether you are fit and proper for the purpose of your firm’s registration as a legal entity subject to ADGM Limited Liabilities Partnership and Commercial Licensing Regulations 2015. Have you ever been convicted of a involving dishonesty?* Yes No Details Have you ever served or been sentenced to a term of imprisonment?* Yes No Details Have you ever been convicted of any offence under any provision of the financial markets legislation or any offence under any provision of any foreign act governing auditors, financial markets or financial services, corporations, financial reporting, or requirements for preventing money laundering ?* Yes No Details Have you ever been banned from acting as a director of a company or other incorporated body, of from being involved in the management of any class of incorporated or unincorporated entity?* Yes No Details Have you ever been subject to disciplinary action against them by Yes No
Limited Partner Title* Forenames* Surname* Former Names Name by which the individual was formerly known for business purposes. Country of Residence* Nationality* Date of Birth* Business Occupation Registered Office Physical Address Please provide details of Partner’s service address. Office Number* Floor* Building Name* Street Name of Cluster / Square / Area on the island* State / Province* Emirate Country* Residential Address Please provide details of Partner’s residential address. This information will not be visible to the public register. Unit Number / Number* Building Name* Street / Area* State / Province Emirate Country Fit & Proper This is required to allow ADGM Registration Authority to assess whether you are fit and proper for the purpose of your firm’s registration as a legal entity subject to ADGM Limited Liabilities Partnership and Commercial Licensing Regulations 2015. Have you ever been convicted of a involving dishonesty?* Yes No
Governing Law* Registered Office Physical Address Please provide details of Partner’s service address. Unit Number / Level Number* Building Name* Street / Area* State / Province Emirate Country Mailing Address Please provide details of Partner’s mailing address. Unit Number Level Number Building Name Street / Area / Province PO Box Number* Emirate Country Certificate Of Incorporation or Registration* Copy of Certificate Of Incorporation or Registration enclosed. Please enclose copy of Certificate Of Incorporation or Registration. Resolution Authorising Incorporation of ADGM Partnership * Copy of Resolution Authorising Incorporation of ADGM Partnership enclosed. Please enclose copy of Resolution Authorising Incorporation of ADGM Partnership. I consent to act as Partner of the named entity. I declare that the information in this application is true and complete as at the date of this form. Body Corporate (3) Please complete this section if Partner is a body corporate. Use continuation sheet if necessary. Type of Partner General Partner Limited Partner Company / Firm Name* Registration Number* Place of Registration / Incorporation*