0001104659-21-127782.txt : 20211019
0001104659-21-127782.hdr.sgml : 20211019
20211019215943
ACCESSION NUMBER: 0001104659-21-127782
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211015
FILED AS OF DATE: 20211019
DATE AS OF CHANGE: 20211019
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: LI CHUWAN HAU
CENTRAL INDEX KEY: 0001636635
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-54884
FILM NUMBER: 211332639
MAIL ADDRESS:
STREET 1: 7F, NO. 311 SECTION 3
STREET 2: NAN-KING EAST ROAD
CITY: TAIPEI CITY
STATE: F5
ZIP: 00000
FORMER NAME:
FORMER CONFORMED NAME: HAU LI CHUWAN
DATE OF NAME CHANGE: 20150316
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: China United Insurance Service, Inc.
CENTRAL INDEX KEY: 0001512927
STANDARD INDUSTRIAL CLASSIFICATION: INSURANCE AGENTS BROKERS & SERVICES [6411]
IRS NUMBER: 300826400
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 7F, NO. 311 SECTION 3,
STREET 2: NAN-KING EAST ROAD
CITY: TAIPEI CITY
STATE: F5
ZIP: 00000
BUSINESS PHONE: 415-955-8900
MAIL ADDRESS:
STREET 1: 7F, NO. 311 SECTION 3,
STREET 2: NAN-KING EAST ROAD
CITY: TAIPEI CITY
STATE: F5
ZIP: 00000
4
1
tm2130547d1_4.xml
OWNERSHIP DOCUMENT
X0306
4
2021-10-15
0
0001512927
China United Insurance Service, Inc.
CUII
0001636635
LI CHUWAN HAU
7F, NO. 311, SECTION 3
NAN-KING EAST ROAD
TAIPEI
F5
105-95
TAIWAN
1
0
0
0
Common Stock
2021-10-15
2021-10-15
4
J
0
864463
3.40
A
2216629
D
On August 13, 2021, China United Insurance Service, Inc. (the "Company") along with its wholly owned subsidiary Action Holdings Financial Limited entered into the Amendment 4 to the Acquisition Agreement (this "Amendment") with Mr. Chwan Hau Li, a member of the board of directors of the Company. Pursuant to the Amendment and as additional consideration for Mr. Li due to certain adjustments, the Company issued Mr. Li 864,463 shares of Company's common stock on October 15, 2021.
/s/ Chwan Hau Li
2021-10-19