m~u hoi chu nghia viet nam . . doc hip - ttl' sa y lichtienlengroup.com.vn/upload/dai hoi...
TRANSCRIPT
M~u Iy lich O1l2020-DHCD
CONG HOA. xA HOI CHU NGHiA VIET NAM. . .Doc Hip - Ttl' do - Hanh phuc
saYEU L Y LICH•(Dung cho cdc thanh vien H6i d6ng quan tri, Ban Tong giam d6c, Ban Ki€m soat;
1. HQ va ten:NGUYEN M4-NH HA.
2. Gioi tinh: Nam
3. sf> CMND: 270883258 Ngay c~p:10105/2006 Nai cap: tai D6ng Nai
4. Ngay thangnamsinh: 27112/1962
5. Quoc tich: Viet Nam
6. Dan toe: Kinh
7. Quequan:Hai Duong
8. Dia chi thuong tru: G lA, Duong D6ng Khoi, Phuong Tan Hiep, Tp Bien
Hoa, D6ng Nai.
9. sf> dien thoai lien lac: 061 8878002
10. Trinh de>van hoa:10/10
11. Trinh de>chuyen mon: Quan tri kinh doanh
12. Qua trinh cong tac (neu tom tlitnoi cong tac, chuc v~,nghJ nghiepali qua):
Tir thang nam den Dan vi cong tac Clnrc vuthang nam
Tu 1993 - 2001 DNTN Tien Len Chu doanh nghiep
Tir 2002 - 9/2009 Cong ty TNHH Tien Len Thanh vien HDQT
Tir 10/2009 den nay Cong ty CP T~p Doan Thep Tien Len Chu tich HDQT
13.Chuc vu dang nam gift tai Cong ty: Chu tich HDQT
14. Chirc vu dang nam giu tai t6 chirc khac: Chu tich HDQT kiern Giam Df>c
Cty CP San Xudt va Thuong Mai Phuc Ti~n
15. sf> c6 phan dang nam gitt: 19.995.782 c6 phAn (chiem 19,87% c6 phanhru
hanh cua cong ty)
16.Trong do:
+ So' hiru ca nhan: 19.995.782 c6 phAn (chiem 19,87% c6 phanhru
hanh cua cong ty)
+ Dai dien So'hiru phan ( t6 chirc ) : khong co
17. Nhtrng nguoi co lien quan (xemphu luc ):
18. Hanh vi vi pham phap lu~t(niu co): khong co
19. Quyen loi mau thu~n voi loi ich cong ty: khong co
Toi xin cam doan nhtrng loi khai tren la hoan toan dung su that, neu sai
t6i xin chiu trach nhiem tnroc phap luat,
Bien Hoa, ngay r1:Gh6ng 05ndm2020
Ngum khai
(10/, ghi rii ho ten)
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M~u 1y lich 01l2020-DHCD
CONG HOA xA HOI CHiJ NGHiA VIET NAM. . .Doc Uip - TIT do - Hanh phuc
saYEU LY LICH•(Dung cho cae thann vien Hoi d6ng quan tri, Ban rimg giam d6c, Ban Kidm soat)
1. HQva ten: Nguy~nVfi Hong Anh
2. Gioi tinh: Nam
3. S6CMND: 025546615Ngay cftp:23/1112011 ; NO'icftp: CA. TPHCM
4. Ngay thang nam sinh:25/03/1997
5. Quoc tich: Vi~t Nam
6. Dan toe: Kinh
7. Que quan: Ha NQi
8. Dia chi thuong tru: 59b, Nguy~n Ki~m, Phuong 3, quanGo Vftp, TP. HCM
9. S6dien thoai lien lac: 0376457494
10. Trinh dQvan hoa:12/12
11. Trinh dQchuyen man: Cao D&ng
12. Qua trinh cong tac(neu tom tilt noi cong tac,chuc v~, nghJ nghiepaaqua):
Tir thangnam d~n Dan vi cong tac Chirc vu
thang nam
04/2017- The Home Depot - Kent, WA, USA Nhan Vien
02/2018
06/2018- BitBox - HCM, Vi~t NamChuyen Vien
02/2019
04/2019- Ubiquest - HCM, Viet NamQuan Li
03/2020
13.Chuc vu dang nam gitr tai Cong ty: Khong C6
14. Chirc vu dang nam gifr tai t6 chirc khac: Kheng C6
1
15. S6c6 phan dang nam giu: 2.985.500 C6 Ph~n - Chiem 2.966%
+ Sahfru ca nhan: 2.985.500 C6 Ph~n - Chiem 2.966%
+ Dai dien sahtru phan (t6 chirc ): Khong C6
17. Nhtrng nguoi co lien quan ( xem phu luc ):
16. Trang do:
18. Hanh vi vi pham phap luat(niu co): Khong C6
19. Quyen loi mau thufrn voi loi ich cong ty: Khong C6
T6i xin cam doan nhtrng loi khaitren la hoan toan dung sir that, n€u sai
t6i xin chiu trach nhiem tnroc phap luat,
Bien Hoa, ngay25 thdng05 nam2020
N g1firi khai
(10/, ghi ro ho ten)
Chu Tich HE>QT?I: • ..
NGUYEN MANH HA
Nguyen Vii H6ng Anh
2
DANH SACH NGuffi CO LIEN QUAN
Stt Ten t6 chirc/ca nhan Hi khoan giaodich Chirc vu tai cong s6 CMNDI Ngay cap NO'idp Dia chi M6i lien h~ s6 e6phieu Ghi
chimg khoan(neu e6) ty (neu e6) DKKD CMND/ CMND/DKKD voi thanh sahfrueu6i eM
DKKD vien chu 1<:)1
eh6t
Cl}cDKQLCu59b Nguyen 4.870.980 ep
1 Nguy~n Vii te 026CI0429061 Khong Co 027060000242 03110/2018 Tru vaDLQG B6v~ dan cu
Ki~m Ti L~: 4,83%
2 PhamThj Thu Ha 026CI042911 Khong Co 024505005 16103/2006 CA. TPHCM59b Nguyen My
2.267.680
Kiem Ti l~: 2,25%
.59b Nguyen
3 Nguy~n Vi1 Lam Khong Co Khong Co 024204250 04/03/2015 CA. TPHCM Anh Trai 0Kiem
Nguirikhai
(ky, ghtrohe; tel.l) . /'../'?:/n/" .
,/'
I'f
Nguy~n Vii HBng Anh
3
I
... M~u ly lich Ol/2020-DHCD
CONG HoA xA HOI cau NGIDA VI¥T NAMDoc Hip - Tn' do - Hanh phuc
saYEU LY LICH•(Dung cho cae thanh vien Ht5id6ng quan tri, Ban Tong giam d6c, Ban Kiim soat)
1. H9 va ten: Nguy~nThi Tam
2. Gi6i tinh: Dnam ontr
3. S6 CCCD: 040186000627; NgaycAp: 19/09/2016; NO'icAp:CA Hai Duong
4. Ngay thang nam sinh:09/05/1986
5. Quoc tich: Vi~t Nam
6. Dan toe: Kinh
7. Que quan: Xii Dong San, Huyen Do Luang, Tinh NgheAn
8. Dia chi thuong tru:A14.01 Khu Chung cu cao tAng va dich vu thirong mai,
PhuongBinh Tri Dong B, Quan Binh Tan, Tp. HCM
9. S6 dien thoailien II;lC: 0985 287 566
10. Trinh d<)van hoa: Dai h9C
11. Trinh d<)chuyen mon: K~ toan Doanh nghiep
12. Qua trinh cong tac (neutom tcitnoi cong tac, chiecv¥, nghJ nghiepail qua):
Til thangnam d~n Don vi cong tac Clnrc vu
thang nam
02/2008 d~n Cong ty TNHH San xu11tva Thuong mai Dai Phuc K~ toan
02/2010
03/2010 d~n Cong ty TNHH San xu~t va Thuong mai Dai Phuc K~ toan t6ng hop
nay
13.Chuc V\l dang n~m gift tl;liCong ty: Thanh vien ban ki8m soat
14. ChucV\l dang n~m gift tl;lit6 chuc khac: kh6ng co
1
-, I.. ..
15. sa c6 phan dang n~m gift: 0
16. Trong do: + Sa hfru ca nhan: 0
+ f)~i dien sahiru phdn ( t6 clnrc )
17. Nhirng nguoi co lien quan (xem phu luc ):
18. Hanh vi vi pham phap lu~t(niu co): Khong
19. Quyen 19i mau thu~n voi 19i ich cong ty: Khong
Toi xin cam doan nhiing Ioi khai tren la hoan toan dung sir th~t, nSu saitoi xin chiu trach nhiem tnroc phap Iuat,
Bien Hoa, ngay 25 thdng05 ndm 2020
NgU'Oi khai
2
Stt Ten t6 chirc/ca Tai khoan giao Chirc vu S6CMNDI Ngay cap Nai cftp Dia chi M6i lien se c6 Ghinhan dich chirng tai cong ty DKKD CMNDI CMNDI h~ voi phieu So' cM
khoan (nSu co) (neu co) DKKD DKKD thanh vien hiru cu6ichu chot ky
N guy~n QuangA14.01 Khu Chung ctr cao tang
1 142093559 08/10/2014CAHlii va dich VI) thirong mai Phuong
Chong 0Huy Duong Binh Trj Dong B, Q. Binh Tan,Tp.HCM
Nguyen TrfutA14.01 Khu Chung cu cao tang
2 va dich vu thirong mai Phuong Con trai0Quang Minh Binh Tri Dong B, Q. Binh Tan, mot
Tp.HCM
N guy~n ThanhA14.01 Khu Chungcir cao tAng
3 va dich vu thirong mai Phuong Con gai0Huang Binh Tri Dong B, Q. Binh Tan, mot
Tp.HCM
Nguyen Khanh CANgh~Xom Th6ng Nhfrt,xa Dong
4Thfu1g
181391554 29/02/2012An
San, Huyen Do Luang, Tinh Cha mot 0NgMAn
N guy~n Thi D~n CANgh~Xom Th6ng Nhfrt,xsDong
5 180815554 29/02/2012 San, Huyen Do Luang, Tinh Mit mot 0An
Ngh~An
N guy~n Khanh CANgh~Than Khe Giao 1,xsN goc
6 186071762 15/10/2015 San, Huyen Th~ch Ha, Tinh Ha Anh mot 0Toan AnTInh
CANgMXom Nha Nghi, xsDi~n
Em gai7 Nguyen Thi Ly 186734048 17/0112006 Phong, Huyen Di~n Chau, Tinh 0An
NgMAn mot
Nguy~n Khanh CANgh~Xom Th6ng Nhfrt, Xa Dong
Em trai8Thanh
186959086 30103/2012An
San, Huy~n Do Luang, Tinhmot
0NgMAn
3
• _,. 'II
M~u ly ljch 01l2020-DHCD
CONG HOA.xA HOI CHU NGHiA VI:¢T NAMDoc Hip - TU'do -Hanh phuc
saYEU LY LICH•(Dung cho cac thanh vien H(Jid6ng quan tri, Ban Tong giam d6c, Ban Kiim soat)
1. H9 va ten:PH~M THI HONG
2. Gioi tinh: Nir
3. S6 CMND: 271432411 Ngaycftp: 31105/2011 Nai cftp: tai Dong Nai
4. Ngaythang nam sinh:20/10/1968
5. Quoc tich: VietNam
6. Dan toe: Kinh
7. Que quan: Nam Dinh
8. Dia chi thuong tru: GlA, DuongD6ng Khai, PhuongTan Hi~p, Tp Bien
Hoa, D6ng Nai.
9. S6 dien thoailien lac: 061 8878002
10. Trinh dQvan hoa:12/12
11. Trinh dQ chuyen mon: Quan tri kinh doanh
12. Qua trinh cong tac (neutom t!it noi cong tac, chuc v~, nghe nghiepetaqua):
Tir thangnam d€n Dan vi cong tac Clnrc vuthang nam
Tu 1993 - 2001 DNTN Tien Len Tnlly
Tu 2002 - 9/2009 Cong ty TNHH Tien Len Giam doc
Til 10/2009 den nay Cong ty CP T~p Doan Thep Tien Len Tong Giam doc
13. Chirc vu dang nam gitr tai Cong ty: Tong giam d6c
14. Chirc vu dang nam gitr t~i t6 chilc khac: khong c6
15. sf> c6 phan dang nam gitr: 11.603.706 c6 phan (chiem 11,53% CPhru hanh
cua cong ty
16.Trong d6:
+ Sahfru ca nhan: 11.603.706 c6 phan (chiem 11,53% CPhru hanh cua
cong ty)
+ Dai dien sahfru phan (t6 chirc ) : khong c6
17. Nhtrng nguoi c6 lien quan (xem phu luc ):
18. Hanh vi vi pham phap luat(niu co): khong c6
19. Quyen 19imau thufinvoi 19iich cong ty: khong c6
Toi xin cam doan nhtrng loi khai tren la hoan toan dung sir that, neu sai
toi xin chiu trach nhiem tnroc phap luat.
Bien tto« ngayJ.r.thang 05 nam 2020
NgU'O'i khai
(kj, ghi ro ho ten)
~
'.
-'1t!i;.~~I ..... ;/.....;l ~-;P-> ,.... '"
DANH SACH NGUOI CO LIEN QUAN
Stt Ten t6 chm/ea nhan Taikhoan Chtrc v\I,t~i SBCMNDI Ngay cip Noidp MBi lien h~ s6 c6 phiiugiao dich cong ty (neu co) DKKD CMNDI CMNDI Dia chi vo-ithanh sO-hfru cuBi
chung khoan DKKD DKKD vien chit ky(niu co) chBt
001C599888Cbu tich CA D6ng D21A, KP.5, Tan Hi~p,
1 Nguy~n Manh Ha 005C531888 270883258 10105/2006 Chong 19.995.782075C223366
HE>QT Nai Bien Hoa, D6ng Nai
2 Nguyen Dire Phuc 272039042 05/07/2006CA Dong D21A, KP.5, Tan Hi~p,
ConNai Bien Hoa, D6ng Nai
Nguyen NgocCue D21A, KP.5, Tan Hi~p,
3 PhuQ1lgB1279060 22/06/2007 QLXNC Bien Hoa, D6ng Nai
ConD6ng Nai
Cue D21A, KP.5, Tan Hi~p,4 Nguyen Anh Dai B1279061 22/06/2007 QLXNC Con
D6ngNaiBien Hoa, D6ng Nai
5 Pham Thi Ti~mAlO, KPo4, Tan Hi~p,
M~Bien Hoa, D6ng Nai
6 Pham Thi Mai 272272633 14/08/2008CA D6ng H12, KPo4, Tan Hi~p,
Chi gaiNai Bien Hoa, D6ng Nai
CA D6ng12016B, KP.5, Tam
7 Pham MinhDuc 271712076 17/08/2004 Hi~p, Bien Hoa, D6ng Anh trai 250444Nai
Nai
8 Pham Thi HU01lg 272179980 13/09/2007CA D6ng H12, KPo4, Tan Hi~p, Chi gai
Nai Bien Hoa, D6ng Nai
9 Pham Thanh Phong 020C109257 272039041 05/07/2006CA Dong D20F, KP.5, Tan Hi~p,
Em trai 14.539Nai Bien Hoa, D6ng Nai
10 Pham Minh TuAn 005C531666 271593812 22/1112011CA Dong A10, KPo4, Tan Hi~p, Em trai 1.218.797
Nai . Bien Hoa, D6ng Nai
11 Pham Duy Quang 271788867 18/02/2003CA Dong AlO, KPo4, Tan Hi~p,
Em traiNai Bien Hoa, D6ng Nai
Nguai khai
M~u 1y lich OI/2020-DReD
CONG HoA xA HOI CHU NGHiA VIET NAM. . .Doc Hip - Ttl' do -Hanh phuc
saYEU LV LICH•(Dung cho cac thanh vien H9i iJ6ngquem tri, Ban T6ng giam iJ6c,Ban Kdm soat)
1. HQva ten: D!NG TuAN D~I
2. Giai tinh: Nam.
3. S6 CMND: 272782560 Ngay cAp:17/09/2015 ; NO'icAp: CA B6ng Nai.
4. Ngay thang nam sinh: 02/09/1977.
5. QU6c tich: Vi~t Nam.
6. Dan toe: Kinh.
7. Que quan:xaTrung LQCHuyen Can LQc Tinh Ha TInh.
8. Dia chi thirong tru: Khu Ph6 Long Dire 3 Phuong Tam Phuoc Thanh Ph6
Bien Hoa Tinh B6ng Nai.
9. S6 di~n thoai lien IC;lC:0913138387.
10. Trinh dQvan hoa: 12/12.
11. Trinh dQ chuyen mon: CUNHAN CAO BANG.
12. Qua trinh cong tac (neu tom tilt nai cong tac, chtrc v¥, ngh€ nghi?p dli qua):
Tir thang nam d~nDan vi congtac Clnrc Vl}
thang nam
TiT2002 den 2005 CONG TY THEP TAY NGUYEN Tnrong ca
Til 2005 den 2009 CONG TY THEP TAY NGUYEN Quan doc xirong can
Til 2009 den 2012 CONG TY THEP TAY NGUYEN PiGiam doc dieu hanh
Til 2012 den 2019 CONG TY THEPBAc NAM P.Giam doc dieu hanh
Til T1I2020 den nay Kinh doanh tai nha rieng
13.Chuc vu dang nam gift tai Cong ty: thanh vien hQi d6ng quan tri
14. Chirc vu dang n~m gift tai t6 chirc khac: Khong co
1
15. S6 c6 phan dang nam gitr: 21.809 c6 phieu tuong irng voi: 0.02%.
+ Sa hfru ca nhan: 21.809 c6 phieu .
+ Dai dien sahfru phan ( t6 clnrc ) . khong co.
17. Nhfmg nguoi co lien quan ( xem phu luc ):
16. Trong do:
18. Hanh vi vi pham phap luat(niu co): khong co.
19. Quyen loi mau thu~n voi loi ich cong ty: khong co.
Toi xin cam doan nhirngIoi khai tren la hoan toan dung sir that, nSu sai
toi xin chiu trach nhiem tnroc phap Iuat,
Bien Haa, ngay25 thang 05 ndm 2020
N gU'o-i khai
(leY, ghi ro ho ten).:«.> :~(j ,-wI)
Chii Tich HDQTNGUYEN MANH HA
2
· '1
DANH SACH NGUOI CO LIEN QUAN
Stt Ten t6 chirc/ca nhan Tiiikhoan Clnrc vu tai S6CMNOI Ngay cap Noi cap Diaehi M6i lien h~ voi s6 e6 Ghigiao dich cong ty DKKD CMNDI CMNDI thanh vien chu chot phieusa chu
chirng (neu co) DKKD DKKD hfru cuoikhoan (neu ky
co)
T~iCATo 7B KP LONG orrc
1 Nguyen Thi Khuyen 183186645 13/03/2014 3 PHVONGTAM VO 0Ha TInh pHV6cBH-DN
T~i CAT6 7B KP LONG mrc
2 Dang Nguyen Tu§.n 276079113 3010112020 3PHVONGTAM CON 0D6ngNai PHH6cBH-DN
T6 7B KP LONG mrc3 Dang NgocAnh 3 PHVONGTAM CON 0
pHV6cBH-DN
T~i CA xA TRUNG r.oc4 Dang Van Ihrng 183425465 26/1112009 IWYI;:N CAN LQC BORUQr 0Ha TInh
TiNHHA TfNH
T~iCAxA TRUNGLQC
5 Phan Thi Y 183927141 08/0112009 IWYI;:N CAN LQC ME RUQr 0Ha TInhTiNHHA TfNH
T~iCAxA TRUNGLQC
6 Dang Di~u Thuy 183794379 25/07/2007 IWYI;:N CAN LQC EM RUQr 0Ha TInh TiNHHA TINH
, i
.1'Mftu ly ljch 01l2020-DHCD
CONG HoA xA HOI CHU NGHiA VIET NAM. . .Doc lap - TO'do -Hanh phuc
saYEU LY LICH•(Dung eho eae thanh vien H(3i d6ngquantri, Ban Tong giam dr5e, BanKdm soat)
1. H9 va ten:DUONG QUANG BINH
2. Gioi tinh: Nam
3. S6CMND: 270839861 Ngay cap:2111011996 ;Noi cAp:tai D6ng Nai
4. Ngay thang nam sinh:07-0S-1964
5. QU6c tich: Vi~t Nam
6. Dan toe: Kinh
7. Que quan: Ph6 Thuan, Duc Ph6, Quang Ngai
8. Dia chi thuong tru:03 Cir xa Be tong, Khu Ph6 10, Phuong An Binh, TP
Bien Hoa, D6ngNai.
9. S6dien thoai lien lac: 0613 83170S
10.Trinh dOvan hoa:12/12
11. Trinh dO chuyen mon: Cir nhan kinh t~, Cir nhan luat
12.Qua trinh cong tac (neu tomtlit noi cong tac, chirc v~, nghJ nghi¢pali qua):
Ttl' thang nam d~n thang Don vi cong tac Chirc vunam
Til'T211987->T4/1989 Cty Cung irng dich vu Vinh An -Ke toan twang
Til'TS/1989->T4/1990 Cty Cung img dich vu Vinh An -Ke toan twang
Til'TS/1990->T3/199S Cty Thuong nghiep Vinh An -Ph6 phong ke toan
-Ph6 phong kinh doanh
Til'T4/199S->T4/1999 Cty Thirong mai dich vu Bien Hoa -Ke toan twang
-Ph6 phong k~ toan
-Ph6 phong k~ ho~ch d:1utu
-Giam d6c trung tam kinh doanh
XNK hfmg thli cong my ngh~.
Til' TS/1999 den nay DNTN Tien Len -Ke toan twang
Cty TNHH Ti~n Len -K~ toan twang
'.-Ph6 giam doc
Cty CP t~p doan thep Ti~n Len -Ph6 tong giam d6c
13.Chuc vu dang nam giu tai Cong ty: Ph6 tong giam d6c
14. Chirc vu dang n~m gitr tai t6 chirc khac: khong c6
15. S6 c6 phan dang nam gitr: 29.080 c6 phan ; chiem 0.029% tren s6 c6 phan
hru hanh cua cong ty.
+ So' huu ca nhan: 29.080 c6 phan
+ Dai dien So'hiru phan ( t6 clnrc ) : khong c6
17. Nhtrng ngiroi c6 lien quan (xem phu luc ):
16. Trang do:
18. Hanh vi vi pham phap luat(niu co): khong co
19. Quyen loi mau thul1n voi Ioi ich cong ty: khong c6
Toi xin cam doan nhtrng loi khai tren la hoan toan dung sir th~t, neu sai toi
xin chiu trach nhiemtruce phap luat,
Bien tto« ngay J.3..thang05 nam 2020
Ngm)'i khai
(k-y, ghi ro ho ten)
Chu Tich HBQTNGUYEN MANH HA
DANH SACH NGUOI CO LIEN QUAN
Stt Ten t~ chirc/ca nhan Tai khoan Chirc vI} S6CMNDI Ngaydp Noicap Dia chi M6i S6 c~ Ghi chu
giao djch t~i cong ty DKKD CMNDI CMNDI lien h~ phi~u
chtrng (n~u co) DKKD DKKD vo; sO'hfru
khoan (n~u thanh cu6i kyco) vieu
chiich6t
I Bui Thi Hanh 271362540 09/0811995 CA 86ngNai676 K4, Ap 2, An Hoa, Bien Vq 0
Hoa, 86ng Nai
2 Duong Thi Anh Tuy~t 272329950 07/03/2009 CA Dong Nai676 K4, Ap 2, An Hoa, Bien Con 0
Hoa, 86ng Nai
" Duong Quang Long676 K4, Ap 2, An Hoa, Bien Con 0
.) Hoa, Dong Nai
4 Duong Luong 270040387 15/0411978 CA 86ngNai3 euxi Be Tong, Kp.10, An Cha 0Binh, Bien Hoa, 86ng Nai
5 VG Thi Phuong 270022981 07/0411978 CA 86ngNai3 euxi Be Tong, Kp.l0, An
Mit 0Binh, Bien Hoa, 86ng Nai
6 Duong Thi Thu An 271241832 15/0811994 CA Dong NaiC3/18, KP.l, Long Binh, Em 0
Bien Hoa, 86ng Nai
7 CA Dong NaiB2-15 Ce An LQe,Nguyen
Duong Thi T(J Anh 270891378 16/03/2006 Oanh, P.17, Q.Go Vfrp, Em 0TPHCM
8Duong Anh Tra 271327905 13/05/2009 CA Dong Nai
C3/19, KP.l, Long Binh, Em 0Bien Hoa, 86ng Nai
9 Duong H6ng Hoang 271437367 24/0111997 CA 86ng Nai3 elf xi Be Tong, Kp.l 0, An Em 0Binh, Bien Hoa, 86ng Nai
Ngiroi khai
M~u Iy ljch Ol/2020-DHCD
CQNG HoA xA HQI CHU NGHiA VI:¢T NAMDoc Hip - TO'do -Hanh phuc
saYEU LV LIeH•
(Dung cho cac thanh vien Hoi d6ng quan tri, Ban Tong giam d6c, Ban K;¬ msoat)
1. Ho va ten:NGUYEN NGOC pHlfONG. ..2. Gi6i tinh: Nfr
3. S6 CMND: 272479546 Ngay d.p: 11111/2011; Nai c~p: CA B6ng Nai
4. Ngaythang namsinh: 22/08/1997
5. Quoc tich: Vi~t Nam
6. Dan toe: Kinh
7. Que quan: Hai Duong
8. Bia chi thirong tru: GlA, Duong B6ng Kh6i, Phuong Tan Hi~p, TP BienHoa, Tinh B6ngNai.
9. S6dien thoai lien lac: 083 541 6363
10. Trinh dQvan hoa: 12/12
11. Trinh dQchuyen mon:Dai HQc- Chuyen nganh : Tam ly Kinh t€& Chinhtri
12. Qua trinh cong tac(neutom tlit noi cong tac, chiecv~, nghJ nghiepaaqua):
Tir thang nam d~n thangDon vi cong tic Clnrc vunam
Truong Quocre TP HCM ( International
Til 2003-2013 School Ho Chi Minh - ISHCMC)
Til 2013-2015 Truong Quoc Te Canadian Academy,
Thanh Ph6 Kobe, Tinh Hyogo Nh~t Ban
Til 2015-2020 Dai hoc Quoc gia Osaka, Nhat Ban
Til 2016 Thirc t~p tai Van phong chinh phil thanh
ph6 Itami, Nhat Ban
Til 2019 den nay Cty CP T~p Doan Thep Tien Len TrQ'ly HQiBongQuan Trj
13.Chuc vu dang n~m giu tai Congty: Tro ly Hci D6ng Quan Tri
14. Chirc vu dang n~m giu tai t6 chirc khac: khong co
15. S6c6 phan dang nam giu:
16. Trong do: + So' hiiu ca nhan: khongco
+ Dai dien So'htru phan ( t6 chirc ) : khong co
17. Nhtrng nguoi co lien quan (xem phu Iuc ):
18. Hanh vi vi pham phap lu~t(niuco): khong co
19. Quyen leimau thudn voi loi ich congty: khong co
Toi xin cam doan nhtrng loi khai tren la hoan toan dung str th~t, n~u sai
toi xin chiu trach nhiem tnroc phapIuat,
OQ~
ONGT1
Q'PHA'I
DOANTJA/ A
ENLE~
BienHOG, ngayJ.fthimg 05 nom 2020
NglfOi khai
(kj, ghi ro ho ten)
DANH SACH NGUm coLIEN QUAN
8tt Ten t6 chirc/canhan Taikhmin Chirc vu tai 86cMNDI Ngay cap Noi dp Dia chi M6i lien 86 c6 phieu Ghigiao dich cong ty (neu DKKD CMNDI CMNDI h~v6i sahftu cu6i cM
chirng khoan co) DKKD DKKD thanh ky(neu co) vien chu
ch6tThanh vien 54/62 Dtrong 518, Xa 1(1Ha
1 Pham Thj H6ng 001C566888 HDQTkiem 271432411 31/05/2011 CA D6ngNai Nl)i, KP5, P. Tan Hi~p, TP. M~ 11.603.706TOD Bien Hoa, Dbng Nai
001C599888 Chu tich hQi 54/62 Duong 518, Xa II)Ha2 Nguysn Manh Ha 005C531888 d6ng quan tri
270883258 10105/2006 CA D6ngNai Nl)i, KP5, P. Tan Hi~p, TP. B6 19.995.782075C223366 Bien Hoa, Dbng Nai
CA D6ngNai54/62 Duong 518, Xa II)Ha
3 Nguyen Duc Phuc 272039042 05/07/2006 Nl)i, KP5, P. Tan Hi~p, TP. Anh TraiBien Hoa, Dbng Nai
CA D6ngNai54/62 Duong 518, Xa II)Ha
4 Nguyen Anh D~i 272479547 11/11/2011 NQi,KP5, P. Tan Hi~p, TP. Em TraiBien Hoa, D6ng Nai
Ngiroi khai
(Ky, ghi fa ho ten)
M~u ly lich Ol/2020-DHCI:)
CONG HoA xA HOI CHU NGIDA VIET NAM. . .Doc Hip - Ttl' do - Hanh phuc
saYEU LY LICH•(Dung cho caethanhvien Hri t16ngquemtri, Ban T6ng gidm t16c,Ban Ki€m soat)
1. HQva ten:DAo TIq KIM LOAN
2. Gi&i tinh: Nft
3. 86 CMND: 271289057 Ngay cdp:15/05/2008 ;Noi cdp: tai D6ng Nai
4. Ngay thang nam sinh: 19-02-1977
5. QU6c tich: Viet Nam
6. Dan t(>c: Kinh
7. Que quan: Ha Nam Ninh
8. Dia chi thuong tru: D20F, Khu Ph6 5, Phuong Tan Hi~p, TP Bien Hna,
D6ngNai.
9. 86 dien thoai lien lac: 0613 895 192
10. Trinh d(>van hoa: 12112
11. Trinh d(>chuyen mon: Cir nhan kinh t~
12. Qua trinh cong tac(neu tom tdt noi cong tdc, chucV{l, nghJ nghiepail qua):
Til' thing nam d€n thangDon vi cong tac Chirc vu
nam
Til' 2002-2007 Cty TNHH Tien Len -Ke tom tong hop
Til' 2007-T09/2009 Cty TNHH Tien Len -Ke toan tnrong
Til' Tl 0/2009 - Cty CP T~p Doan Thep Tien Len -Ke toan tnrong
29/02/2020
Til' 113/2020den nay Cty CP Thep Bac Nam Tong Giam Doc
13.Chuc vu dang n~m gift tai Cong ty: Khong co
14. Clnrc vu dang n~m gift tai t6 chirc khac: Khong co
'.
15. S6 c6 phan dang n~m gitt: 74.676 c6 phan, chiem 0.07% tren c6 phieu luu
hanh cua cong ty
16. Trong do: + Sa hiru ca nhan: 74.676 c6 phfin
+ Dai dien sahfru phan ( t6 chirc ) : khong co
17. Nhtrng ngiroi co lien quan ( xem phu luc ):
18. Hanh vi vi pham phap luat(niu co): khong co
19. Quyen IQ'imau thudn voi IQ'iich cong ty: khong co
T6i xin cam doan nhtrng loi khai tren la hoan toan dung sir th~t, n€u sai t6i
xin chiu trach nhiem tnroc phap lu~t.
BienHOG, ngayl.-~.thang 05 nam 2020
NglfOi khai
(k)!, ghi ro ho ten)
Chi! Tich HE>QTNGUrtN M~NHHA
DANH SACH NGUOI CO LIEN QUAN
Stt Ten ta Chll'c/canhan Taikhoan Clurc VI} t~i s6 CMNDI Ngay dp NO'idp Dja chi M6i s6 ca Ghi chu
giao djch cong ty DKKD CMNDI CMND/DKKD lien h~ phi~u
chirng khoan (n~u co) DKKD vO'i so'hfru
(n~u co)thanh cu6i kyvienchiich6t
1 Pham Thanh Phong 020C109257Cua hang 272039041 14/03/2019 CA Dong Nai
020F, KP.5, Tan Hi~p, Bien Chong 14.539tnrong Hoa, D6ng Nai
2 Pham Anh ThuD20F, KP.5, ,\an Hi~p, Bien Con
Hoa, Dong Nai0
3 Pham Phuong ThaoD20F, KP.5, Tan Hi~p, Bien Con 0
Hoa, D6ng Nai
4 £>ao Van TIJ 270088585 09112/2004 CA £>6ng Nai14012,KPA, Tam Hi~p, B6 0
Bien Hoa, D6ng Nai
5 Dao Thi Kim Hoa 271183182 19/12/1996 CA Dong Nai140/2, KPA, Tam Hi~p, Chi 0
Bien Hoa, D6ng Nai
6 Dao Thi Kim Y~n 270781223 10107/2007 CA D6ng Nai140/2, KPA, Tam Hi~p, Chi 0
Bien Hoa, D6ng Nai
7 Dao Thi Kim NhungDinh cu oMy Chi 0
8 Dao Thi Kim Phuong 271435040 19112/1996 CA Dong Nai140/2, KPA, Tam Hi~p, Em 0
Bien Hoa, D6ng Nai
9 Dao Cao CUCmg 020CI04021 271471192 27/0811997 CA D6ngNai140/2, KPA, Tam Hi~p, Em
Bien Hoa, £>6ng Nai0
10 Dao Trung Hieu 271981526 03/08/2005 CA Dong Nai140/2, KPA, Tam Hi~p, Em
Bien Hoa, £>6ng Nai0
Nguoi Khai
~
M~u ly lich 01l2020-DHCD
CONG HOA.xA HOI CHU NGHiA VIET NAM. . .Doc Hip - TO' do - Hanb pbue
saYEU LY LIeH•
(Dung eho cdc thanh vien Hoi tl6ng quan tri, Ban T6nggiam tl6e, Ban Kiim soat)
1. HQva ten:
2. Gi6i tinh:
LE THJ HONG LIEU
Dnam llInu
3. S6CCCD: 083166000314 Ngay c~p:02/03/2020 Nai c~p: C\lCCanh satQLHCvSTIXH
4. Ngay thang nam sinh:06106/1966
5. Quoc tich: Vi~t Nam
6. Dan toe: Kinh
7. Que quan: BSn Tre
8. Dia chi thuong tru: 51 E Duong s6 6, P4, Quan 4, TpHi) Chi Minh
9. S6di~n thoai lien lac: 0908 27 98 27
10. Trinh dQvan hoa: Dai hoc
11. Trinh dQ chuyen mon: CU nhankS toan
12. Qua trinh cong tac(neu tom tlit nai cong tdc, chtrcV{l, nghJ nghiepali qua):
Tir thangnam d~n Dan vi cong tac Clnrc vu
thang namTil T0911988 Cong ty XNK Chq Lach, Ben Tre Ke toan
dSnTl211989
Til T01l1990 HTX mua ban huyen Chq Lach, tinh Ben Tre Ke toan tong hQ'P
dSnT0911996
Til TlOl1996 Cong ty Lien Doanh Dai Thanh Ke toan tong hQ'P
dSn03/1997
Til TOSI1997 DNTN Tien Len, Bien Hoa, Dong Nai Ke toan
dSnTl 2/200 1
Til TO112002 Cong ty TNHH Tien Len, Bien Hoa, Dong Nai Ke toan
dSnT06/2002
1
OPHA'iDOANTlW A
ENLEJ
Tir T07/2002Cong Ty TNHH Thep Tay Nguyen, KCN Tan T~o,Q. Ke toan tnrong
dSn T10/20 12 Binh Tan
Tir T11120 12Cong Ty TNHH Thep Tay Nguyen, KCN Tan T~o,Q. Tnrong phong kiem
dSn T12/20 13 Binh Tan scat n(>ib(>
Tir TO112014 Cong ty CP Thep BaeNam, Long Thanh, Dong Nai Ke toan tnrongdSn T12/201S
reT01l2016 Cong Ty TNHH Thep Tay Nguyen, KCN Tan T~o,Q.Truong phong kiem
dSn nay Binh Tansoat n(>ib(>kiem
tnrong phong hanh
ehinh
13. Chirc vu dang nam gift tai C6ng ty: Truong ban kiSm soat C6ng Ty C6
Ph~n T~p Doan Thep TiSn Len
14. Chirc vu dang nam gift tai t6 chirc khac: kh6ng co
15. S6 c6 phan dang nam gift: 21.809 c6 phan chiem 0.02% tren s6 c6 phieu
luu hanh cua c6ng ty
16. Trong do: + So' hiru ca nhan: 21.809 c6 ph~n chiem 0.02% tren s6 c6
phieu luu hanh cua c6ng ty
+ Dai dien So'htru phan ( t6 chirc ) : kh6ng co
17. Nhfrng nguai co lien quan (xem ph\ll\lc ):
18. Hanh vi vi ph~m phap lu~t(niu co): kh6ng co
19. QuySn lQ'imau thu~n vai lQ'iich c6ng ty: kh6ng co
T6i xin cam doan nhfrng lai khai tren la hoan toan dung S\f th~t, nSu sai
t6i xin chiu trach nhi~m truac phap lu~t.
BienHoa, ngay25 thang 05 nam 2020NgU'o; khai
(kf;, ghi ro h9 ten) ___
~/
Le thi H6ng Lilu
2
DANH sxcnNGUm coLIEN QUAN
Tai khoan giao Ngay cap Noidp M6ilien S6 c6Chirc VI} t~i S6CMNDI h~ vO'i phi~uStt Ten t6 chirc/ca nhan djch chrmg
cong ty (n~u co) DKKD CMNDI CMNDI Dja chithanh vien sO'hnu Ghi chu
khoan (n~u co) DKKD DKKDchu chat cu6iky
CA TP. H6 487/38A Le Quang1 teThi H6ng Cuc 025434564 08/04/2011
Chi Minh Dinh, P,I, Q.Go yAp, Em 0TP.HCM
C\lCCanh sat106 duong 12, P.5,2 Le Thi H6ng Anh 08317200018 27/02/2017 QLHCvS Em 0
TTXH Quan 8, TP. HCM
CA TP.H6 23111013Ton That3 r.eThi H6ng Nhung 024931174 05/06/2008
Chi Minh Thuyet, P.3, Q.4, Em 0TPHCM
CATP.H651E dirong so 6,
4 Le Trung Chanh 025147621 09/09/2009Chi Minh phirong 4,quan4, Em 0
TP.HCM
BienHoa, ngay25 thang 05 ndm 2020
NguOi khai
(Jry, ghi ro ho ten)
.>:isTht Hong Lieu
3
Mfiu ly lich Ol/2020-DHCD\.~,
CONG HoA xA HOI CHU NGHiA VIET NAM. . .Doc Hip - Ttl' do - Hanh phue
saYEU LV LIeD•(Dung cho cae thanh vien H(JiiJ6ngquan tri, Ban T6ng giam iJ6c,Ban Kiim soat)
1. H9 va ten:
2. Gi6i tinh:
CAO THI HoAI THU
Dnam Ii:] nft
3. S6 CMND: 186223801 ; Ngay cfrp:2/10/2010 ; Noi cfrp: CA NgheAn
4. Ngay thang nam sinh:11104/1975
5. Quoc tich: Vi~t Nam
6. Dan tQc: Kinh
7. Que quan: Hung Thai- Hung Nguyen- NgheAn
8. Dia chi thuong tni: 1455/4 Tinh LQ 10, Phuong Tan T~o A, Quan Binh Tan
9. S6 di~n thoai lien lac: 0901552708
10. Trinh dQvan hoa: 12/12
11. Trinh dQchuyen mon: Ke toan
12. Qua trinh cong tac (neu tom tdt noi cong tdc, chuc v~, nghJ nghiepcia qua):
Tir thang nam DO'n vi cong hie Clnrc Vl}.d~n thang nam
5/1999 ->5/2002 Cty TNHH San xuatva Thuong MaiMy A Ke toan tnrong
6/2002 ->5/2020 Cty TNHH San xuat va Thirong Mai Dai PMc Ke toan tnrong
13. Chirc V\1dang n~m gift tai Cong ty: Thanh Vien Ban Kiem Soat Cong Ty C6 Phfin
T~p Doan Thep Tien Len.
14. Clnrc V\1dang n~m gift tai t6 chuc khac: khong co
15. S6 c6 phfin dang n~m gift: 21.857 c6 phfin, chiem 0,022% tren s6 c6 phieu luu
hanh cua cong ty (Thai di€m 251512020)
16. Trong do:
+ Sa hiiu ca nhan: 21.857 c6 phfin, chiem 0,022% tren s6 c6 phieu luu hanh cua
cong ty (Thai di€m 251512020)
+ D~i di~n sa hiiu phfin ( t6 chuc ) : khong co
17. Nhiing nguai co lien quan (xem ph\1l\1c ):
1
18. Hanh vi vi pham phap lu~t(niu co): Kh6ng
19.Quyen Ioi mau thufin voi loi ich cong ty: Kh6ng
T6i xin cam doan nhirng Ioi khai tren la hoan toan dung sir that, neu sai t6i
xin chiu trach nhiem tnroc phap luat.
TP HeM, ngay 25 thong 05 ndm 2020
Ngrro'j kh i(kj, ghi ro h. fen)
I /t:l~.
~~II
2
~;'~~~"/. A . " '*<,// 'X''_' "<!iF
;'~J ~ .~, o ("')~, _ rA
DANH SACH NGU' CO LIEN QUAN ,!
M6i
Stt Ten taclurc/ca nhfin Tai khoan Chirc vI} tai S6 CMNDI Ngitydp Noi cap Dja chi lien h~S6 ca Ghi
giao djch cong ty (n~u DKKD CMNDI vOiphi~u chuCMNDI thanhchirng khoan co) DKKD DKKD vien
sO'hiru(n~u co)
chitcu6iky
ch6t
AThanh vienlIDQT/BKS
1 180022180 17/03/2009CA Ngh~ Kh6i 7, thi tr~n Hung Nguyen,
B6 0Cao Van Manh An Ngh~ An
2 180490743 21112/2000CA Ngh~ Kh6i 7, thi tr~n Hung Nguyen,
Mv 0H6 Thi Kien An Nghe An
3 310710506 23/03/2007CA Ti~n Tan Hoa, Go Cong Dong, Ti~n
Ch6ngVo Tuong Chinh Giang Giang 0
CA Ti~n145514tinh 1(>10, P.Tan T<;loA
4 312447899 2/6/2015Giang
Quan Binh Tan TP HCM Con 0Vo Tuong Duy Q.Binh Tan, TPHCM
5 182169344 13/0111996CA Ngh~ Kh6i 7, thj tr~n Hung Nguyen,
Em trai 0Cao T~t Binh An NgMAn
6 182208766 16/12/2000CA Nghe Kh6i 7, thi tr~n Hung Nguyen,
Em trai 0Cao Ti~n Dung An Ngh~ An
7Vo Ngoc Thuy ] 45514 tinh 1(>10, P.Tan T<;loA
Con 0Duong Quan Binh Tan TP HCM
TPHeM, ngay 2~n~ 05 ndm 2020
,.. .~ 3