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