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COMMON APPLICATION Formal. CA Date: DD / MM / YYYYDistributors ARNARNSubBrokers ARNSubBrokers Couperin (Mandatory)127041E206367SIGNATURE(S) (To be signed by All Applicants)I/We hereby confirm that

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1 brokerage to be refers to the report that discloses information about a brokerage firm's activities and financial status.

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