Annex I

Model Letter of application for obtaining
a license1 or for notification2 or for authorisation3
to be sent to the Governor of the National Bank of Cambodia

 

Dear Sir, 

In my capacity as ………………………..⁴ 

I would like to apply to the National Bank of Cambodia for: 

• obtaining or renewing a license for (company name) in the context of chapter IV of the Law on Banking and Financial Institutions.

• notification of change in shareholding distribution in the context of Article 23 of the Law on Banking and Financial Institutions.

• authorization of change of shareholding distribution in the context of Article 24 of the Law on Banking and Financial Institutions.

To this end, please find herewith an application set out in accordance with the provisions of Prakas No. ……… 

Very truly yours,
Signature 

1. in the case of requests for a license or for renewal of such a license.

2. in the case of changes in the shareholding distribution referred to in Article 23 of the Law on Banking and Financial Institutions.

3. in the case of changes in the shareholding distribution referred to in Article 24 of the Law on Banking and Financial Institutions.

4. indicate the status of the signatory: chairman, manager, other corporate officer, expressly empowered agent (attach documentary proof of said capacity).
   

Annex II 

MODEL LETTER
TO BE SENT TO THE GOVERNOR OF THE NATIONAL BANK OF CAMBODIA 

Dear Sir, 

With a view to my appointment as a manager of (name of bank) where I will hold the position of ………………. please find herewith the information (including curriculum vitae and questionnaire provided for in Annex IV) requested under Article 6 of Prakas No. ………. 

I hereby certify that the information is complete and accurate and that to the best of my knowledge there are no other material facts of which the National Bank of Cambodia should be informed. In particular, I certify that I am not subject to the prohibitions listed in Article 18 of the Law on Banking and Financial Institutions. 

I undertake to inform the National Bank of Cambodia immediately of any change which would significantly alter the information provided. 

I further undertake to ensure that the institution of which I am a manager will provide the National Bank of Cambodia with all regulatory information concerning its administrative and accounting organization, its financial condition, particularly regarding the quality of its loan portfolio, and the financial condition of its shareholders. 

Very truly yours, 

Signature

Annex III 

MODEL LETTER
to be sent to the Governor of the National Bank of Cambodia
by capital contributors who directly or indirectly hold
20 percent or more of the capital or the voting rights of a bank 

Dear Sir, 

In my capacity as (indicate the status of the signatory), please find herewith the information requested by the National Bank of Cambodia (Prakas No ……) with regard to the equity holding that (contributor's name) has taken or intends to take in (name of bank). 

I hereby certify that this information is complete and accurate and that, to the best of my knowledge, there are no other material facts of which the National Bank of Cambodia should be informed. 

I undertake to inform the National Bank of Cambodia immediately of any change which could significantly alter the information provided. 

I have taken note of the provisions of Article 27 of the Law on Banking and Financial Institutions, pursuant to which the National Bank of Cambodia may, where the situation requires, enjoin the influential shareholders of a bank to provide such bank with the support it needs. 

Very truly yours, 

Signature

Annex IV

CURRICULUM VITAE
and
Questionnaire for individuals who are, or who propose to become
Directors, Shareholders or Managers of a Bank

 

1.      Family name: 

2.      Given name(s): 

3.      Other name(s) by which you are or have been known: 

4.1.    Please state in what capacity you are completing this form, i.e. as a current or prospective director, shareholder or manager or any combination thereof. 

4.2.    Please describe the particular duties and responsibilities attaching to the position(s). 

4.3.    In carrying out your duties, will you act in concert with or in accordance with the instructions of another individual or legal entity other than the applicant? In either event, give all relevant information. 

4.4.    Indicate if you are a capital contributor to the applicant and if you intend to carry out directly or through an intermediary, personal or professional transactions with the applicant. 

5.      Your private address: 

6.      Your previous private address (es) during the last 5 years: 

7.      Your date (day/month/year) and place of birth (including district, town or city). 

8.      Your nationality and how it was acquired (birth, naturalization, and marriage). 

9.      Name(s) and address(es) of your bankers within the last 5 years.

10.     Your academic degrees and/or professional qualifications and the place and year they were obtained. 

11.1.  Your current occupation and employment and over the past 10 years, including the name and address of the employer in each case, the nature of the business, the position held and relevant dates. 

11.2. Indicate whether you are or in the past ten years have been a significant shareholder (namely holding directly or indirectly at least 10 percent of the share capital or voting rights) in a company other than the applicant. If so, state the name and activities of such companies and the amount of your shareholding or interest in them. 

11.3. Indicate, to the best of your knowledge, which of the companies in which you have held or hold a position of responsibility, or in which you have been or are a significant shareholder, has or might soon have significant business relations with the applicant. 

12.     Have you or any entity with which you are associated as a director, shareholder, or manager ever held or applied for a license or to carry on any business activity in any country ? If so, if any such application was refused or withdrawn after it was made or if any authorization was revoked, give particulars. 

13.     Have you, or any entity with which you have been involved in the conduct of its affairs, been disciplined, warned as to future conduct, publicly criticized, or the subject of an investigation by any regulatory authority or any professional body ? If so, give particulars. 

14.     Have you, in any country, been dismissed from any office or employment by your employer or barred from entry to any professional or occupation ? If so give particulars. 

15.     Have you failed to satisfy any debt adjudged due and payable by you under an order of a court, or have you been declared bankrupt by a court in any country or has a bankruptcy petition ever been served on you ? If so, give particulars. 

16.     Have you, in connection with the management of any entity been adjudged by a court, in any country, to be legally liable for any fraud, or other misconduct by you toward such an entity or any of its members ? If so, give particulars. 

17.     Are you now, or do you other than in a professional capacity expect to be engaged in any litigation in any country ? If so, give particulars. 

18.    Please supply an audited statement of personal net worth providing a breakdown of your assets and liabilities. 

19.     Indicate the names, addresses, telephone numbers and positions of three individuals of good standing who would be able to provide a reference on your personal and professional integrity. The referees must not be related to you and should have known you for at least five years.