合格境外机构投资者托管人申请表

合格境外机构投资者托管人申请表

致：_________________________________

To: _________________________________

申请人：_____________________________

Applicant：__________________________

重要声明：本申请人董事会保证本申请所载材料不存在任何虚假记载、误导性陈述或者重大遗漏，并对内容的真实性、准确性和完整性承担法律责任。

ACKNOWLEDGEMENT： The applicant’s Board of Directors hereby represents and warrants that this Application contains no false representations, misleading statements or material omissions, and shall be liable for the authenticity, accuracy and completeness of the contents.

填表日期（Date）__________________

（说明：除非另有标明，请用中文填写本表。）（Please fill out this Form in Chinese, unless otherwise stated.）