??ࡱ?>?? _a????^??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? ?R?9bjbj$$=RF|F| ??????? ????????????8?L???1"?????%.Sg 1111111$?3?x6,51?s%%ss51????TJ1???sF????1?s1??2?,?C/?????@R?Rk??????^3..?0h1<?1a.??6??6\C/C/?6?W/?ss?sssss5151??sss?1ssss?????????????????????????????????????????????????????????????????????6sssssssss + K: TOKYO STOCK EXCHANGE, INC. - J-Qualified Specialist Application Form1. Trade name or name of an applicant of which the candidate belongs:2. Title and name of candidate for the J-Qualified Specialist status:TitleFirst nameSurname 3. Private address and Email address of the candidate: Postcode:Email address:4. Reasons for applying for the J-Qualified Specialist status (please add an additional sheet, if necessary):5. The position and role of the candidate in relation to business operations of the J-Adviser (please add an additional sheet and/or organization sheet, if necessary):6. A summary of the candidate?s employment history (please add an additional sheet, if necessary):Dates from/to:Name and address of organisation:Position held and description of responsibilities:7. A summary of the candidate?s practical experience in the provision of Corporate Finance Advice (please add an additional sheet, if necessary) coverings at least 3 years in the last 5 years and including experience in Japanese capital markets:Please include details of the applicant?s transactional experience, if appropriate:Description of Transaction:Details of work undertaken by applicant:Date of Transaction:8. Details (if applicable) of the regulatory status of the applicant (please provide supporting documentation confirming regulatory status if relevant), together with details of any sanctions, warnings, disciplinary actions or similar taken against the candidate:9. Other matters (please describe the details of other matters including any litigation which may affect approval as a J-QS status. Please add an additional sheet if necessary.)10. Declaration of the candidate:I declare that the information supplied is complete, true, accurate and not misleading.Signed:Print name:Job title:Date:11. Declaration of the J-Adviser:The applicant hereby applies for approval of the candidate as a J-QS in accordance with Special Regulations of Securities Listing Regulations Concerning Specified Listed Securities. 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