Schedule
Form No. 1.
FORM OF APPLICATION MADE UNDER SECTION 11 OF THE ABOVE-MENTIONED ACT FOR AN ASSURANCE LICENCE.
PARTICULARS TO BE FURNISHED BY APPLICANT FOR ASSURANCE LICENCE.
1. Name of applicant *............................................................ .................................................
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2. Registered or principal office within the State............................................................ .......................................
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3. State whether applicant is an Irish company, a foreign company, or a syndicate