Management and Directors Questionnaire

MDQ | Management and Directors Questionnaire

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Main Principal Applicant

Name of Corporation/Applicant *

Reference number (if you have one)

Your position within the applicant *

Position held since *

Shareholder?

Yes

No

If 'Yes', percentage? *

If you are human, leave this field blank.

IntaCapital Swiss SA,
Rue du Rhône 80 - 84,
CH - 1204 Genève,
Switzerland