MDPPACPB Regulations

Page 88 of 127
88 
 
 
SCHEDULES: 
SCHEDULE 1 
Regulation 50(3) 
MERGER/ACQUISITION 
NOTIFICATION 
FORM 
(To 
be 
submitted 
under 
Regulations 50(3) of these Regulations) 
 
SECTION A: GENERAL INFORMATION 
 
A1. Name of Filing Party: 
    •    Legal Name: 
    •    Address of Registered Office: 
    •    Country of Incorporation: 
    •    Contact Person (Name, Title): 
    •    Phone: 
    •    Email: 
    •    Company Registration Number: 
 
A2. Nature of Filing: 
☐ Initial Notification 
☐ Corrected Notification 
☐ Supplementary Information Submission 
☐ Notification of Change in Transaction Structure 
 
A3. Type of Transaction: 
☐ Merger 
☐ Acquisition of Control (Majority/Minority) 
☐ Joint Venture 
☐ Asset Acquisition 
☐ Restructuring/Integration 
☐ Others (specify): 
 
A4. Date of Intended or Actual Transaction Execution: 
 
A5. Date of Notification Submission: 
 
SECTION B: PARTIES TO THE TRANSACTION 
 
B1. Acquiring Party (Party Gaining Control): 
    •    Legal Name: 
    •    Business Address: 
    •    Company Profile: 
    •    Parent Companies and Ultimate Beneficial Owners: 
    •    Principal Activities in the Petroleum Sector (Midstream/Downstream): 
    •    Group Structure (Attach organizational chart):