C - 監事的聲明、承諾及確認(適用於在中華人民共和國(「中國」)註冊成立的發行人)

過去的版本: 有效期自 2018年02月15日 至 2019年02月28日
查看其它版本請點擊右側的版本索引標籤。

Part 1
第一部分
DECLARATION
聲明
 
1
State:—
請填報:
 
(a) present surname and any former surname(s)*
現時姓氏及任何前度姓氏*
 
(b) alias, if any *
別名,如有*
 
(c) present forename(s) and any former forename(s)*
現時名字及任何前度名字*
 
(d) date of birth
出生日期
 
(e) residential address
住址
 
(f) nationality and former nationality, if any
國籍及前度國籍,如有
 
(g)
(i) Hong Kong ID card number
香港身份證號碼
 
(ii) in the case of a non-Hong Kong ID cardholder,
passport number or any identification document
number and name of issuing authority
如為非香港身份證持有人,請列明護照號碼或任何身份識別文件號碼,以及簽發機構名稱
 
(h) name of issuer (i.e. the new applicant/listed issuer)
發行人(新申請人╱上市發行人)名稱
 
in English
英文
 


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in Chinese
中文



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  * As set out in the Hong Kong ID card, or any relevant identification document referred to in  1(g) above
  * 香港身份證或上文1(g)所述的任何有關身份識別文件上所示者。
 
2. The relevant document that sets out my personal details in the manner described in paragraph 41 of Appendix 1A or rule 17.50(2), as the case may be, of the Rules Governing the Listing of Securities on the GEM of The Stock Exchange of Hong Kong Limited from time to time in force (the “GEM Listing Rules”) is:
按不時生效的《香港聯合交易所有限公司GEM證券上市規則》(《GEM上市規則》)附錄一A第41段第17.50(2)條所述方式(視屬何情況而定)載有本人個人資料的有關文件:
 
  (Tick as appropriate)
(請在適當方格內加上√號)
 
 
In the case of new applicant:
如屬新申請人:
 
the listing document dated......................which has been duly registered with the Companies Registry.
日期為 .................年.................. 月.................... 日並已正式在公司註冊處登記的上市文件。
 
 
In the case of listed issuer:
如屬上市發行人:
 
the announcement dated........................by the issuer as required under GEM Listing Rule 17.50(2) with regard to my appointment as a supervisor of the issuer.
發行人按《GEM上市規則》第17.50(2)條的規定,就委任本人為發行人監事的公告。公告日期為 ................年................ 月 ..................日。

Part 2
第二部分
UNDERTAKING AND ACKNOWLEDGEMENT
承諾及確認

 
The particulars referred to in this Part 2 are:—
此第二部分所述的資料為:

1 in the exercise of my powers and duties as a supervisor of............................(Insert the name of the issuer) I, the undersigned, shall:
在行使...............................(填入發行人名字)監事的權力及職責時,本人(簽署人)須:

(a) comply to the best of my ability with all applicable laws, rules, regulations and normative statements from time to time in force in the PRC relating to the responsibilities, duties and obligations of a supervisor in connection with the governing, operation, conduct or regulation of public companies in the PRC or elsewhere;
盡力遵守不時生效的所有關於監事對中國或其他地方的公眾公司的管轄、運作、行為或監管的責任、職責及義務的適用中國法律、規則、規例及規範聲明;
 
(b) comply to the best of my ability with the provisions of the issuer's articles of association (including all provisions regarding the duties of supervisors) and cause the issuer and its directors to act at all times in accordance with the issuer's articles of association;
盡力遵守發行人的公司章程的規定(包括有關監事職責的一切規定),並促使發行人及其董事在任何時候均按照發行人的公司章程而行事;
 
(c) use my best endeavours to cause the issuer and its directors to comply with the Rules Governing the Listing of Securities on the GEM of The Stock Exchange of Hong Kong Limited from time to time in force (the “GEM Listing Rules”), the Code on Takeovers and Mergers, the Code on Share Buy-backs and all other relevant securities laws and regulations from time to time in force in Hong Kong;
盡力促使發行人及其董事遵守不時生效的《香港聯合交易所有限公司GEM證券上巿規則》(《GEM上巿規則》)、《公司收購及合併守則》、《公司股份回購守則》及香港所有其他不時生效的有關證券的法例及規例;
 
(d) inform The Stock Exchange of Hong Kong Limited forthwith and in writing, at any time while I am a supervisor of the issuer, of the initiation by the issuer's supervisory committee of legal proceedings against any director of the issuer;
在本人擔任發行人的監事的任何期間,如發行人的監事會對發行人的任何董事提出法律程序,立即通知及以書面通知香港聯合交易所有限公司;
 
(e) comply to the best of my ability, as if the same applied to me to the same extent as it does to directors of the issuer, with: (a) Parts XIVA and XV of the Securities and Futures  Ordinance; (b) rules 5.46 to 5.67 of the GEM Listing Rules relating to securities transactions by directors; (c) the Code on Takeovers and Mergers; (d) the Code on Share Buy-backs; and (e) all other relevant securities laws and regulations from time to time in force in Hong Kong;
盡力遵守下列條例及規則,猶如該條例適用於本人,程度上如同其適用於公司董事般:(a)《證券及期貨條例》第XIVA及XV部;(b)《GEM上巿規則》第5.465.67條有關董事進行證券交易的規定;(c)《公司收購及合併守則》;(d)《公司股份回購守則》;以及(e)香港所有其他不時生效的有關證券法例與規例;
 
(f) use my best endeavours to procure that any alternate of mine shall so comply;
盡力促使本人的任何替任人遵守上述各項;
 
(g) I hereby give my irrevocable authority to the Executive Director of the Listing Division (as such term is defined in rule 1.01 of the GEM Listing Rules), or to any person uthorized by him, to disclose any of the foregoing particulars given by me to members of the GEM Listing Committee (as such term is defined in rule 1.01 of the GEM Listing Rules) and, with the approval of the Chairman or a Deputy Chairman of The Stock Exchange of Hong Kong Limited, to such other persons, as the said Executive Director of the Listing Division may from time to time think fit; and
本人茲授予上市科主管(按《GEM上市規則》第1.01條界定)(或獲其授權的任何人士)不可撤回的權力,讓他將本人提供的上述資料向GEM上巿委員會(按《GEM上市規則》第1.01條界定)委員披露;並在香港聯合交易所有限公司主席或一位副主席批准的情況下,向上巿科主管不時認為適當的其他人士披露;及
 
(h) I will, for  so long as I remain a supervisor of the issuer and for the further period of 3 years from the date on which I cease to be a supervisor of the issuer, inform the Stock Exchange of Hong Kong Limited, by notice in writing to the Executive Director of the Listing Division, of any change to my residential address as set out in Part 1 of this Form as soon as reasonably practicable and in any event within 1 month of my so changing residence for the purpose of facilitating correspondence with the Exchange; and
在本人擔任發行人監事期間及本人不再擔任發行人監事之日起計三年內,如本人於本表格第一部分所填報的住址有任何更改,本人會在合理可行的情況下盡快而無論如何於本人更改住址後一個月內,以書面通告形式通知上市科主管,以便與交易所進行函件往來;及
 
2 I acknowledge and agree that:—
本人承認及同意:

(a) a document or notice shall be deemed to have been served on me by The Stock Exchange of  Hong Kong Limited:—
由香港聯合交易所有限公司送交本人的文件或通告在以下情況被視作送達:

(i) when it is served personally on me; or
專人送遞予本人;或
 
(ii) by sending a copy of it by post or by facsimile to me at my usual or last  known residential or business address or at the address notified by me in Part 1 of this Form or at the address notified by me in accordance with paragraph 1 (h) of Part 2 of this  Form; or
以郵遞或傳真方式送交本人的慣敘或最後為香港聯合交易所所知的住宅或營業地址,或由本人於本表格第一部分通知的地址,或由本人根據本表格第二部分1(h)段通知的地址;或
 
(iii) if there is a letter box for the address in question, by inserting through the letter box a copy of the document or notice enclosed in a sealed envelope addressed to me;
如有關地址設有信箱,把內附該文件或通告的密封信封(而信封上又註明是致本人的)投入信箱內;
 
(b) the date of service shall be deemed to be the second business day (or, in the case of an overseas address, the tenth business day) after the date on which the copy was sent to or, as the case may be, inserted through the letter box for the address in question; and
上述文件或通告被寄往該地址或(視乎情況而定)被投入該地址的信箱內的日期後的第二個營業日(或如屬海外地址,則第十個營業日)將被視為送達日期;及
 
(c) as the case may be, in proving service it shall be sufficient to show that the envelope containing the notice was addressed to me at the address in question and had stamps or postage of sufficient value thereon to ensure that the same could be sent by post; and
要證明文件已被送達,只須證明載有該通告的信封乃寄致本人收啟,且被寄往有關地址及貼有足夠郵票或已付上足夠郵資以確保可用郵遞寄出;及
 
(d) for the avoidance of doubt, in the event I change my residential or business address and fail to inform The Stock Exchange of Hong Kong Limited of any new address pursuant to paragraph 1 (h) of Part 2 of this Form, any document or notice served upon me at my former residential address or business address in accordance with this paragraph shall nevertheless be deemed to have been validly served upon me for all purposes.
為釋疑起見,倘若本人更改本人的住宅或營業地址而並未根據本表格第二部分1(h)段通知香港聯合交易所有限公司本人的新地址,則根據本段送往本人前度住址或營業地址的任何文件或通告,就各方面而言仍將被視作有效送達本人論。
 
I hereby submit to the jurisdiction of The Stock Exchange of Hong Kong Limited in respect of all matters relevant to the GEM Listing Rules.
本人在此接受香港聯合交易所有限公司就有關《GEM上市規則》各方面的管轄。
 
I,.............................................................. [Insert Chinese name, if any]:
本人............................................................... [請填上中文姓名(如有)]:

 
(i) solemnly and sincerely declare that all particulars about me that appear in Part 1(1) of this Form C and in the document referred to in Part 1(2) of this Form C are true, complete and accurate, that I accept responsibility for the truthfulness, accuracy and completeness of the foregoing particulars, that I have not made any statements or omissions which would render such particulars untrue or misleading, that I understand the possible consequences of giving information which is false or misleading in a material particular including those as set forth in Note hereto, and that I understand that The Stock Exchange of Hong Kong Limited may rely upon the foregoing particulars in assessing my suitability to act as a supervisor of the issuer; and
謹以至誠鄭重聲明,在本C表格第一部分(1)及本C表格第一部分(2)所述文件所示有關本人的所有詳細資料均為真實、完整及準確,且本人對上述資料的真實性、準確性及完整性承擔責任,而本人亦無作出任何聲明或遺漏,致使有關資料不真實或具誤導性,本人亦明白在要項上提供虛假或具誤導性的資料可能引致的後果(包括本表格附註所載內容);本人並明白,香港聯合交易所有限公司或會倚賴上述資料來評估本人是否適合出任發行人監事;及
 
(ii) undertake and acknowledge with The Stock Exchange of Hong Kong Limited in the terms set out in Part 2 of this Form C.
按本C表格第二部分所載的條款向香港聯合交易所有限公司作出承諾及確認。

                                                                 Signature簽署:....................................

Name of supervisor監事姓名:........................

Hong Kong ID Card Number*                                      
香港身份證號碼*:...................................

Dated日期:.

Certified as the true signature of..................................
由以下人士證明上述簽署為....................... 的真實簽署
By:

ignature (Secretary/Director)                                    
簽署(秘書╱董事):...................................

Name (Secretary/Director)                                          
姓名(秘書╱董事):...................................
 
* In the case of a non-Hong Kong ID cardholder, state the passport number or any identification document number and name of issuing authority.
如為非香港身份證持有人,請列明護照號碼或任何身份識別文件號碼,以及簽發機構名稱。

 
Note:
附註:
The failure of any person required to lodge this Form C to complete Part 1 of this Form C truthfully, completely and accurately, or the failure to execute Part 2 of this Form C or to observe any of the undertakings made under that Part, constitutes a breach of the GEM Listing Rules. In addition, every supervisor of the issuer supplying information sought or referred to in this Form C, should note that such information constitutes information which is provided to the Exchange in purported compliance with a requirement to provide information under the “relevant provisions”(as defined in Part 1 of Schedule 1 to the Securities and Futures Ordinance, Cap. 571) and is likely to be relied upon by the Exchange. In relation to this, you should be aware that giving to the Exchange any information which is false or misleading in a material particular will render the relevant person liable for prosecution for an offence under section 384 of the Securities and Futures Ordinance. If you have any queries you should consult the Exchange or your professional adviser immediately.
按規定須呈交本表格的任何人士,若未能真實、完整及準確地填妥本C表格第一部分,或未能簽立本C表格第二部分又或未能遵守該部分所作的任何承諾,均構成違反《
GEM上市規則》。此外,凡提供本C表格所要求或所述資料的發行人監事均應注意,該等資料構成本意是為遵守「有關條文」(定義見香港法例第 571章《證券及期貨條例》附表1第1部)項下關於提供資料的規定而向本交易所提供的資料,本交易所或會依賴該等資料。就此, 閣下應注意,根據《證券及期貨條例》第384條,在要項上向本交易所提供虛假或具誤導性的資料,有關人士即屬犯法,會遭檢控。若 閣下有任何疑問,應立即諮詢本交易所或 閣下的專業顧問。