SYDNEY STOCK EXCHANGE LIMITED
SPONSOR APPLICATION FORM
Sponsor Application Form
How to Complete this Application Form
Applicants seeking to become sponsors approved by the Sydney Stock Exchange Limited (SSX) must
complete this application form.
It is essential that you read this application form in conjunction with the SSX Listing Rules as published by
SSX from time to time.
If you would like to discuss the application process or the Listing Rules in more detail please contact SSX
Business Development on +61 2 9217 2705.
You must submit a completed application form together with appropriate supporting documents.
Answers must be printed or typed in black.
SSX will keep confidential all information provided by the applicant, except to the extent that disclosure is
necessary for the exercise of its supervisory functions, is permitted by the operating rules (including
Procedures and Appendix) or is otherwise required by law.
Please return the completed application form to
SSX Business Development
Level 16, Central Square
323 Castlereagh Street
Sydney NSW 2000 Australia
Tel: +61 2 9217 2705
December 2015
Sponsor Application Form
1.
Name of applicant (the “applicant” or “you” or “we”)
_____________________________________________________________________________________
The applicant hereby applies to Sydney Stock Exchange Limited (SSX) (ACN 080 399 220) to become a
sponsor pursuant to the SSX Listing Rules.
2.
Trading name (if different)
_____________________________________________________________________________________
Business Address
_____________________________________________________________________________________
_____________________________________________________________________________________
________________________________________________________ Postcode __________________
Tel: __________________ Fax: __________________ Website: ______________________________
Registered Address (if the same as Business Address please insert “as above”)
_____________________________________________________________________________________
_____________________________________________________________________________________
________________________________________________________ Postcode __________________
Tel: __________________ Fax: __________________ Website: ______________________________
December 2015
Sponsor Application Form
3.
4.
Nature of entity
(a)
Sole trader
Yes
No
(b)
Company
Yes
No
(c)
Partnership
Yes
No
(d)
Other (specify)
_________________________
Australian Business Number (ABN, ACN)
_____________________________________________________________________________________
5.
Name of contact
_____________________________________________________________________________________
Tel: __________________ Fax: __________________ Email: ________________________________
6.
Are you:
(a)
A financial services licensee as defined under
the Corporations Act (Cth) 2011 or an Authorised
Representative of a financial services licensee?
Yes
No
If a financial services licensee, please attach a copy of the Australian financial services
license. If an Authorised Representative of a financial services licensee please attach a
copy of the Australian financial services license and a written acknowledgement from the
financial services licensee that you have applied to become, and if accepted may act in
the capacity of, a sponsor under the SSX Listing Rules and that, in making the
application, you are relying upon being a corporate authorized representative of the
financial services licensee.
(b)
An Legal Practice under the law of
a State or Territory of Australia?
Yes
No
If yes, specify which State or Territory
_______________________________________________________________________
December 2015
Sponsor Application Form
(c)
A public accounting practice practising as
a sole practitioner or practising in any other
form whose principal belongs to one of the
following professional bodies at the declared
membership classification, and complies with
the body’s continuing professional education
requirements.
Professional bodies
The institute of Chartered Accountant in
Australia
CPA Australia
Institute of Public Accountants
Yes
No
Declared membership classifications
CA, ACA and FCA
CPA and FCPA
AIPA, MIPA and FIPA
If yes, specify which professional body and classification
_______________________________________________________________________
Note: Please provide documentary evidence to support your assertions if your answer to any of the above questions in Section 6
is Yes. Refer SSX Listing Rule 3.7
7.
Please provide an outline of your history and corporate profile.
Note: Please include a separate sheet setting out such information
8.
Provide specific details of your recent corporate finance experience. In particular, provide
details of your client, the date of the transactions, the stock markets (if any) on which the
transactions took place, and your involvement with your client since the transaction.
Please provide copies of public document for each transaction to support your assertion.
Please provide contact details of three clients whom you have given corporate finance
advice to in the last two years.
Note: Please include a separate sheet setting out such information. Refer Listing Rule 3.7
9.
Provide details of your recent experience in advising listed companies of their compliance
responsibilities and obligations pursuant to the listing rules of any Australian financial
market.
Note: Please include a separate sheet setting out such information. Refer Listing Rule 3.21(b) and (d)
10.
Provide details of your specific expertise in relation to providing advice to listed
companies in overseas financial markets (particularly in relation to China or other Asian
markets).
Note: Please include a separate sheet setting out the details.
December 2015
Sponsor Application Form
11.
Please provide name and address of:
a)
b)
c)
d)
Principal if you are a sole practitioner; or
All directors of your practice if you are an incorporated practice; or
The managing director if you are a practice with more than 20 partners; or
All partners of your practice if you are a partnership.
Note: Please include a separate sheet setting out the details
12.
Please provide details of any adverse matters which have been brought by, or to the
attention of, any regulatory agency in relation to your business in the previous 5 years.
Note: The time required by SSX to assess on application will be shortened by the provision of all relevant
correspondence with the regulatory agency.
13.
Please provide a summary of the controls you have in place to ensure that you can satisfy
the general obligations of a Sponsor.
(Please refer to listing rules 3.15 to 3.17.)
Note: Please include a separate sheet setting out the summary.
14.
Give details of executive staff who will be involved in your sponsor activities.
(Continue on a separate sheet where necessary)
Title
December 2015
First Name(s)
Surname
Sponsor Application Form
15.
Have you (or your executive officers or principals):
(a)
Been convicted for any offence (other than
a traffic offence)?
Yes
No
(b)
Been charged with any offence (other than
a traffic offence) at any time?
Yes
No
(c)
Been adversely mentioned in a report made
by or at the request of any government,
governmental authority or agency?
Yes
No
(d)
Been subject to a banning order under section
920A of the Corporations Act?
Yes
No
If your answer to any of the above questions is yes, please include a separate sheet and provide the relevant details.
Refer Listing Rule 3.9
16.
Provide a copy of a certificate of currency for your professional indemnity insurance.
Note: Please include a separate sheet and provide the relevant details.
17.
Provide details of any other information which you think may be relevant to SSX’s
consideration of your application.
Note: Please include a separate sheet and provide the relevant details.
18.
Provide SSX with a copy of your company logo in JPEG format for inclusion on the SSX
website if your application is accepted.
19.
Please enclose with this application your cheque payable to Sydney Stock Exchange
Limited or date and amount of electronic transfer being the initial fee, details of which are
set out in the SSX Fee Schedule.
Refer Listing Rule 3.7 and schedule 2 of SSX Fee Schedule
20.
Please provide the principal contact in relation to future payments:



December 2015
Name
Phone number
Email address
Sponsor Application Form
21.
Please provide the entity to which invoices are to be directed (if different to the Applicant)



22.
23.
Name
Phone number
ACN
The applicant hereby:
22.1.
Acknowledges that SSX may use the applicant’s company logo provided in accordance
with point 16 of this application for the purpose of promoting the SSX market and agrees
that it will not object to the use by SSX for the purpose.
22.2.
Acknowledges that SSX has absolute discretion in determining whether to accept or
refuse my application and in the event that my application is refused by SSX I have no
right to appeal against the refusal.
22.3.
Agrees and undertakes it will not do any act or make any statement which would bring
SSX into disrepute or damage the goodwill or reputation of SSX in any circumstances
including but not limited to circumstances if its application to SSX is refused by SSX.
22.4.
Acknowledges that SSX may contact the applicant’s clients whose contact details have
been provided to SSX and agrees and consents to SSX contacting those clients in
relation to this application.
The applicant hereby:
23.1.
Warrants that there is no reason why we should not be accepted as a sponsor and
warrant and represent that we are competent to discharge the responsibility of a
sponsor.
23.2.
Agrees that SSX may accept or refuse our application for admission as a sponsor in its
absolute discretion and agree that if admitted as a sponsor, SSX may terminate the
admission as a sponsor as contemplated by the Listing Rules.
23.3.
Consents to inclusion of information concerning us on a register of sponsors
maintained by SSX in SSX's absolute discretion.
23.4.
Agrees that the SSX Listing Rules and the SSX Business Rules and this application
and Undertaking to SSX should be construed and interpreted having regard to their
purpose and intent and not just their form.
23.5.
Agrees to indemnify SSX to the fullest extent permitted by law from and against any
claim, action, interest, costs and expenses arising from the negligence, wilful default or
fraud on our part and in relation to this Undertaking to SSX.
December 2015
Sponsor Application Form
23.6.
Agrees and acknowledges that SSX may publicise as it, in its absolute discretion, sees
fit any information about us which relates to or concerns any subject matter referred to
in this application and Undertaking to SSX or us being a sponsor.
23.7.
Agrees and undertakes to promptly provide all such information and documents as
SSX may require for the purposes of the SSX Listing Rules or the SSX Business Rules
and this application and Undertaking to SSX.
23.8.
Agrees that SSX has a discretion as to whether or not to take any action for a breach of
the SSX Listing Rules or the SSX Business Rules and this Undertaking to SSX and
may vary or revoke, at any time any decision as to the exercise of that discretion of its
own accord or upon request by us.
23.9.
Agrees and undertakes to promptly advise SSX in writing if we resign from or are
dismissed or expelled from any professional association of which we (or of which one
of our directors or partners) is a member or to which we otherwise belong and to
provide SSX with written detailed reasons for such resignation, dismissal or expulsion.
23.10. Agrees and undertakes that we will comply with and properly discharge all of our
duties and obligations as a sponsor prescribed by the SSX Listing Rules and the SSX
Business Rules that are in force from time to time
23.11. Agrees that, if we are admitted as a sponsor, we are bound by the SSX Listing Rules
and SSX Business Rules and any decisions by SSX or a Review Panel under the SSX
Listing Rules or the SSX Business Rules applicable to it.
23.12. Acknowledges and agrees that if SSX or a Review Panel considers that we have
breached any obligation under the SSX Listing Rules or this Undertaking to SSX, then
SSX or the Review Panel may censure the Applicant and take any enforcement
proceedings in accordance with the SSX Listing Rules. We acknowledge and agree that
SSX may publicly announce any enforcement proceedings taken against us in
accordance with the SSX Listing Rules.
23.13. Agrees and undertakes to promptly advise SSX in writing if we are the subject of any
form of investigation or disciplinary procedure or of any judicial or administrative
hearing or action taken by or recommended by ASIC.
.
December 2015
Sponsor Application Form
We declare that the information supplied is complete and correct.
Signature _____________________________________ Date ________________________________
Name of signatory in block capitals ________________________________________________________
Position _____________________________________________________________________________
Signature _____________________________________ Date ________________________________
Name of signatory in block capitals ________________________________________________________
Position _____________________________________________________________________________
This undertaking must be signed by two directors of the applicant if the applicant is incorporated,
or, in the case of a partnership, by two partners.
December 2015