Listing Rules and Guidance: Contents


 
 

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Form I Declaration and Undertaking with regard to Supervisors of an Issuer incorporated in the People's Republic of China ("PRC")
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Appendix 5
附錄五

Declaration and Undertaking with regard to Supervisors of an Issuer incorporated in the People's Republic of China ("PRC")
在中華人民共和國(「中國」)註冊成立的發行人的監事的聲明及承諾

Form I
I表格

Part 1
第一部分

Declaration
聲明

1. State:-
請填報:
  in English
英文
in Chinese
中文
(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
..................... .....................


* 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(1) of Appendix 1A or rule 13.51(2), as the case may be, of the Rules Governing the Listing of Securities on The Stock Exchange of Hong Kong Limited from time to time in force (the "Listing Rules") is:
按不時生效的《香港聯合交易所有限公司證券上市規則》(《上市規則》)附錄一A第41(1)段或第13.51(2)條所述方式(視屬何情況而定)載有本人的個人資料的有關文件為:

(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 Listing Rule 13.51(2) with regard to my appointment as a supervisor of the issuer.
發行人按《上市規則》第13.51(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
承諾

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

(a) 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:
(i) 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;
(ii) 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;
(iii) use my best endeavours to cause the issuer and its directors to comply with the Rules Governing the Listing of Securities on The Stock Exchange of Hong Kong Limited from time to time in force (the "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證券上巿規則》(《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;
(iv) 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;
(v) 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) the Model Code for Securities Transactions by Directors of Listed Issuers set out in Appendix 10 of the Listing Rules; (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,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)《上巿規則》附錄十列出的《上巿發行人董事進行證券交易的標準守則》;(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;
(vi) 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;
(b) I hereby irrevocably appoint the issuer as my agent, for so long as I remain a supervisor of the issuer, for receiving on my behalf any correspondence from and/or service of notices and other documents by The Stock Exchange of Hong Kong Limited;
本人茲不可撤回地委任發行人為本人的代理人,在本人留任發行人監事期間,代表本人接收香港聯合交易所有限公司發出的任何書信及 / 或送達的通知書及其他文件;
(c) I shall provide to The Stock Exchange of Hong Kong Limited, immediately upon my resignation as a supervisor of the issuer, my up-to-date contact information, including my address for correspondence from and service of notices and other documents by The Stock Exchange of Hong Kong Limited and telephone number; and
本人將在辭去發行人監事職務後,立即向香港聯合交易所有限公司提供本人最新的聯絡資料,包括供本人接收香港聯合交易所有限公司發出的書信、送達的通知書及其他文件的地址和電話號碼;以及
(d) I hereby give my authority to the Head of the Listing Division of The Stock Exchange of Hong Kong Limited, or to any person authorised by him, to disclose any of the foregoing particulars given by me to members of the Listing Committee 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 Head of the Listing Division may from time to time think fit.
本人茲授權香港聯合交易所有限公司上巿科主管、或其授權的任何人士,將本人提供的上述資料向上巿委員會委員披露;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。

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 I and in the document referred to in Part 1(2) of this Form I 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 the 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I表格第一部分(1)及本I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 with The Stock Exchange of Hong Kong Limited in the terms set out in Part 2 of this Form I.
按本 I 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。

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:

Signature (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 I to complete Part 1 of this Form I truthfully, completely and accurately, or the failure to execute Part 2 of this Form I or to observe any of the undertakings made under that Part, constitutes a breach of the Listing Rules. In addition, every supervisor of the issuer supplying information sought or referred to in this Form I, 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I表格的任何人士,若未能真實、完整及準確地填妥本I表格第一部分,或未能簽立本I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《上市規則》。此外,凡提供本I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。