Form 2 Application for Eligibility Certificate by a Corporation (PDF ...
Form 2 Application for Eligibility Certificate by a Corporation (PDF ... Form 2 Application for Eligibility Certificate by a Corporation (PDF ...
Office of Liquor, Gaming and Racing COMPANY PROBITY FORM (xxi) To your knowledge while engaged by the company did such auditors or external accountants become subject to investigation for any reason? * YES / NO If YES, provide full details: ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ (xxii) List the following details of any legal advisers, solicitors and/or consultants engaged over the last five (5) years: Firm/Company Address Period and Capacity of Engagement (xxiii) Commencing with the current state and country and working backwards, list all the states and countries in which the company has conducted business over the last 20 years. State and Country Dates Business Conducted From To Signature: ___________________________________ 14
Office of Liquor, Gaming and Racing COMPANY PROBITY FORM B. ARRESTS, DETENTIONS AND LITIGATION Please note that disclosure of these matters in respect to a conviction or charge under a Queensland law for both the company and the individual is not limited by any time frame. (i) Has the company, or any holding or subsidiary company, in Australia or elsewhere: (a) been convicted of an offence? * YES / NO (b) been investigated by a law enforcement agency? * YES / NO (c) been summoned before a court to answer any offence? * YES / NO If YES, provide full details: ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ (ii) Has any office holder or employee of the company, acting in that capacity, in Australia or elsewhere: (a) been convicted of an offence? * YES / NO (b) been investigated by a law enforcement agency? * YES / NO (c) been charged by a law enforcement agency? * YES / NO (d) (e) been summoned before a court to answer any offence whatsoever? * YES / NO had any charge proven without the recording of a conviction? * YES / NO (f) had civil proceedings instituted against them? * YES / NO If YES, provide full details: _________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ Signature: ___________________________________ 15
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Office of Liquor, Gaming and Racing<br />
COMPANY PROBITY FORM<br />
(xxi) To your knowledge while engaged <strong>by</strong> the company did such auditors or external<br />
accountants become subject to investigation <strong>for</strong> any reason?<br />
* YES / NO<br />
If YES, provide full details:<br />
________________________________________________________________<br />
________________________________________________________________<br />
________________________________________________________________<br />
________________________________________________________________<br />
________________________________________________________________<br />
(xxii) List the following details of any legal advisers, solicitors and/or consultants<br />
engaged over the last five (5) years:<br />
Firm/Company<br />
Address<br />
Period and Capacity<br />
of Engagement<br />
(xxiii) Commencing with the current state and country and working backwards, list all<br />
the states and countries in which the company has conducted business over the<br />
last 20 years.<br />
State and Country<br />
Dates Business Conducted<br />
From<br />
To<br />
Signature: ___________________________________ 14
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