DECLARATION FORM FOR KEY MANAGEMENT PERSONNEL
Name: | |
NRIC: | |
Position: |
I do hereby solemnly affirm and declare the following: -
(Please tick (✓) whichever applicable)
a. | I have not been the subject of any proceedings of a disciplinary or criminal nature, or have been notified of any impending proceedings or of any investigations, which might lead to such proceedings. | |
b. | I have not contravened any provision made by or under any written law designed to protect members of the public against financial loss due to dishonesty, incompetence of malpractice. | |
c. | I have not contravened any of the requirements and standards of a regulatory or professional body, government or its agencies. | |
d. | I, or any business in which I have a controlling interest or exercises significant influence, have not been investigated, disciplined, suspended or reprimanded by a regulatory or professional body, a court or tribunal, whether publicly or privately. | |
e. | I have not been engaged in any business practices which are deceitful, oppressive or otherwise improper (whether unlawful or not), or which otherwise reflect discredit on my professional conduct. | |
f. | I have not been dismissed, asked to resign or has resigned from employment or from a position of trust, fiduciary appointment or similar position due to any issue in relation to my honesty and integrity. | |
g. | I have not been associated, in ownership or management capacity, with a company, partnership or other business association that has been refused registration, authorisation, membership or a license to conduct any trade, business or profession, or has had that registration, authorisation, membership or license revoked, withdrawn or terminated. | |
h. | I have not held a position of responsibility in the management of a business that has gone into receivership, insolvency, or involuntary liquidation while I was connected with that business. | |
i. | I have not been a director of, or directly concerned in the management of, any corporation which is being or has been wound up by a court or other authority competent to do so within or outside Malaysia, or of any licensed institution, the license of which has been revoked under any written law. | |
j. | I have not in the past acted unfairly or dishonestly in the dealings with customers, employer, auditors and regulatory authorities. | |
k. | I have not at any time shown a strong objection or lack of willingness to co-operate with regulatory authorities, which in turn resulting in a failure or potential failure to comply with legal, regulatory and professional requirements and standards, including compliance with tax requirements and obligations. | |
l. | I have not at any time shown strong objection or lack of willingness to maintain effective internal control systems and risk management practices. | |
m. | I have not contributed significantly to the failure of an organisation or a business unit. | |
n. | I am not involved in any business or other relationship which could materially pose a conflict of interest or interfere with the exercise of my judgement when acting in the capacity of a Key Management Personnel which could be disadvantageous to the Company or the interest of the Company. |
a. | I have been and will be able to fulfil my financial obligations, whether within or outside Malaysia, as and when they fall due. | |
b. | I have not been the subject of a judgement debt which is unsatisfied, either in whole or in part, whether within or outside Malaysia. |