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1、DU003M Page 1 of 10 第 1 頁，共 10 頁 A5b 01/09 Declaration and Undertaking with regard to Directors 董事的聲明及承 董事的聲明及承 Form B B表格 B表格 Part 1 第一部分 第一部分 DECLARATION 聲明 聲明 1. State:- inin 請填報： English Chinese英文 中文 (a) present surname and any former surname(s)* 現時姓氏及任何前姓氏* . .(b) alias, if any * 別名，如有* . .(c)
2、present forename(s) and any former forename(s) * 現時名字及任何前名字* . .(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
3、 identification documentnumber and name of issuing authority如為非香港身份證持有人，請明護照號碼或 任何身份別文件號碼，以及簽發機構名稱 . .(h) name of issuer (i.e. the new applicant / listed issuer) 發 人（新申請 人 上市發人）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
4、(g) 所述的任何有關身份別文件上所示者。 DU003M Page 2 of 10 第 2 頁，共 10 頁 A5b 01/09 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 K
5、ong Limited from time to time in force (the “Listing Rules”) is: 按時生效的香港合交所有限公司證券上市規則（上市規則）附一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 Regist
6、ry. 日期為 .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: 如屬上市發人： the announcement dated .by the issuer as required under Listing Rule 13.51(2) with regard to my appointment as a director of the issuer. 發人按上市規則第13.51(2)條的規定，就委任本人為發人董事的公告。公告日期為.月日。 DU003M Page 3 of 10 第 3 頁，共 10 頁 A5b 01/09 Part 2
7、第二部分第二部分 UNDERTAKING 承 承 The particulars referred to in this Part 2 are:- 此第二部分所述的資為： (a) in the exercise of my powers and duties as a director of (Insert the name of the issuer) I, the undersigned, shall:- 在使 (填入發人名字)董事的權及職責時 ，本人 （簽署人）須： (i) comply to the best of my ability with the Rules Governing
8、 the Listing of Securities on The Stock Exchange of Hong Kong Limited from time to time in force (the “Listing Rules”); 盡遵守時生效的香港合交所有限公司證券上巿規則（上巿規則）； (ii) use my best endeavours to procure that the issuer and, in the case of depositary receipts, the depositary, shall so comply; and 盡促使發人及（如屬預託證券）存管人
9、遵守上巿規則；及 (iii) use my best endeavours to procure that any alternate of mine shall so comply; 盡促使本人的任何替任人遵守上巿規則； (b) I shall, in the exercise of my powers and duties as a director of the issuer, comply to the best of my ability with Part XV of the Securities and Futures Ordinance, the Code on Takeove
10、rs and Mergers, the Code on Share Repurchases and all other securities laws and regulations from time to time in force in Hong Kong, and I shall use my best endeavours to procure that the issuer shall so comply; 本人在使發人董事的權及職責時，將盡遵守證券及期貨條第XV部、公司收購及合併守則、股份購回守則及香港所有其他時生效的有關證券的法及規，本人並會盡促使發人遵守上述各項； DU003
11、M Page 4 of 10 第 4 頁，共 10 頁 A5b 01/09 (c) I shall: 本人將: (i) provide to the Exchange as soon as possible, or otherwise in accordance with time limits imposed by the Exchange: 盡快或根據本交所設定的時限向本交所提供以下資及文件： (1) any information and documents that the Exchange reasonably considers appropriate to protect inv
12、estors or ensure the smooth operation of the market; and 本交所合地認為可保障投資者或確保市場運作暢順的任何資及文件；及 (2) any other information and documents or explanation that the Exchange may reasonably require for the purpose of verifying compliance with the Listing Rules; and 本交所可為核實是否有遵守上市規則事宜而合地要求的任何其他資及文件或解釋；及 (ii) cooperate in any investigation conducted by the Listing Division and/or the Listing Committee of The Stock Exchange of Hong Kong Li
