Securities & Commodities Authority
REGISTRATION RENEWAL APPLICATION
FOR PJSCs
1 / Name of the Company
2 / Registration No.
3 / Address / Emirate
PO Box
Tel
Fax
4 / Contact person / Name
Tel
5 / Capital Data / Subscribed
Paid
No. of shares
Nominal value
Portion paid of the share value
6 / Equity capital distribution as per the AOA of the Company
Class / Value / Percentage %
Government
Emiratis
GCC nationals
Other nationalities
Total / 100%
Note: Renewal of the registration will save you from the delay penalty.
Company representativeCompany seal Executed on: …/…/20…
DATA OF BONDS OR SUKUK ISSUED UNTIL THE RENEWAL DATE
Company Name:
Issuance Data
1 / Issuance Type / ͏͏ Convertible Bonds / ͏ Convertible Sukuk
͏ Non - Convertible Bonds / ͏ Non - Convertible Sukuk
2 / General Assembly Meeting Date
3 / Countries of Placement
4 / Placement Type / Public / Private (Current Shareholders – strategic/ Qualified Investors)
5 / Issuance Currency
6 / Issuance Value
7 / Issuance Date
8 / Issuance Period
9 / Interest / Yield rate
10 / Periodical of yield payment(Annual, semi-annual, quarterly)
11 / Conversion Data
12 / Conversion Rate
13 / Listing exchange
14 / Listing Date
15 / Rating Company
16 / Rating Grade
** In case of multiple issues, a separate form should be completed and stamped for each issue.
Required documents to renew a PJS company registration with SCA1 / Original registration certification / renewal of registration
2 / Copy of the trade license + (Copy of the COCI membership for companies established in Sharjah)
3 / List of the board of directors members, their nationalities and capacities using the attached form.
4 / Payment of the prescribed renewal fees of AED 5,000 by the e-Dirham Card
5 / Completed form of debt instruments issued by the company, if any.
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/ هيئـــة الأوراق الماليــــة والسلــــعSecurities & Commodities Authority
DATA FORM FOR THE BOARD MEMBERS OF ……………………………… COMPANY
S/N / Name / Capacity / ID NO. / Nationality / Membership in other PJS companiesNo. of Memberships / Names of the companies and capacity in each company
1
2
3
4
5
6
7
8
9
10
11
12
13
14
I, …………………………….., the Chairman of the Board, acknowledge hereby that the above data is correct and identical to the facts on the company register as of todate.
Date: …/…/…Signature of the Chairman of the BoardCompany seal
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