BANeKo SerrneL Ne PtutprNes

OFFICE OF THE DEPUTY GOVERNOR

SUPERVISION AND EXAMINATION SECTOR

MEMORANDUM NO. M.2OT7 - OM

To AttNON-BANK REMITTANCE AND TRANSFER COMPANIES and

MONEY CHANGERS/FOREIGN EXCHANGE DEALERS

Subject GUIDELINES ON THE ISSUANCE OF CERTIFICATE OF REGISTRATION

and OTHER APPTICATIONS REQUIRING PRIOR APPROVAL

Pursuant to Monetary Board Resolution No.38 dated 05 January 2Ot7, approving

the amendments in Section 4511N and Appendix N-8 of the Manual of Regulations for
Non-Bank Financial lnstitutions (MORNBFI) with the issuance of Circular No. 942 dated
20 January 20L7, the following guidelines shall govern the implementation of the pertinent
provisions of the MORNBFI on the issuance of Certificate of Registration as Remittance and
Transfer Company (RTC), Money Changer (MC)/Foreign Exchange Dealer (FXD) and other
applications requiring prior Bangko Sentral ng Pilipinas (BSP) approval.

l. GeneralGuidelines

A. Authorized Signatory

The application for BSP Certificate of Registration as RTC/MC/FXD, collectively

known as Money Service Business (MSB) operators, and other requests that require
prior BSP approval shall be filed with the Integrated Supervision Department | (lSD l),
BSP. The application form shall be signed by the proprietor/managing partner/
president or officer of equivalent rank and shall be accompanied by the necessary
documentary requirements. The applicant shall ensure its completeness, reliability
and conformity with the BSP-prescribed forms. No application shall be accepted
from a person or entity other than the proprietor/partner/president unless the
yl
person or entity applying in behalf of the proprietor/partnership/corporation
submits a duly executed and notarized special power of attorney authorizing the
person or entity. In the case of a corporate applicant, a certified true copy of the
board resolution authorizing the person or entity shall likewise be submitted.

B. BSP-prescribedForms

All applications shall be submitted using the following prescribed Data Entry
Template/Form, otherwise, it shall not be accepted.

Application Form Description

Form 1M Certificate of Resistration
Form 2M Change of Registered/Business Name
Form 3M Change of Ownership or Control

A. Mqbini St., Molote 1004 Monilo, Philippines . (6321 708-7701 . www.bsp.gov.ph . bspmoil@bsp.gov.pn
 C. Start of Processing of Application

Applications shall only be processed upon receipt of the following:

1. Proof of payment of non-refundable filing fee of P1,000 deductible from the

registration fee.

Payment of fees may be made through the following:

a. Cash Department located at Ground Floor Multi-Storey Building, BSP

Complex, A. Mabini Street, Malate, Manila upon generation of Order of
Payment at the ISD I Registration Counter or at any BSP Regional
Offices/Branches as the case maybe.

b. In the form of Manager's Check (MC) or Postal Money Order (PMO) payable
to the Bangko Sentral ng Pilipinas sent through registered mail or courier.

2. Complete documentary requirements which may be submitted either through:

a. Personal filing at ISD I Registration Counter, Ground Floor Multi-Storey

Building, BSP Complex, A. MabiniStreet, Malate, Manila; or

b. Postal/Courier services addressed to:

The Director
Integrated Supervision Department I

Bangko Sentral ng Pilipinas

14th Floor, Multi-Storey Building
BSP Complex, A. MabiniStreet
1004 Malate, Manila

ll. SpecificGuidelines

A. lssuance of Certificate of Registration

Registration constitutes a two-stage process. Stage 1 is a preliminary screening

process for BSP to determine if applicant is eligible for registration. In Stage 2, the
eligible applicant is required to submit supporting documents to complete the
registration process.

1. First stage

The applicant shall submit the following for evaluation together with proof of
payment of non-refundable filing fee of P1,000:

i. Application Letter

Page 2 of 7
 The applicant shall indicate the entity's contact number/s, e-mail address and
the classification of RTC/MC/FXD it is applying for signed by the authorized
signatory. For Type A, B, E and F applications, the average monthly network
volume of transactions based on the applicant's faithful disclosure should
likewise be indicated in the application letter.

For the purpose of this Memorandum, the volume of transactions shall refer
to the aggregate of the following: (a) FX bought; (b) FX sold; (c) domestic and
international pay-out (inward) transactions; and (d) domestic and
international send-out (outward) transactions as shown in the sample format
below.

TRANSACTION ESTIMATED AVERAGE MONTHTY

VOTUME {in Php)*
FX Bought / FX Purchase
FX Sold / FX Sale
Domestic and international pay-out
(inward) transactions
Domestic and international send-out
(outward) transactions
TOTAT
*For existing BSP-registered RTC/MC/FXD,
actual transaction volume shall be disclosed

ii. Business Plan including target markets

The Business Plan should contain the following information, at a minimum:

a. Purpose ofthe Business;

b. Form of Business organization and organizational structure;
c. Products and Services to be offered;
d. capital Requirements and details of source of Funding/Financing;
e. Target Market;
f. Target Network (including number of branches/offices to be accredited as
Remittance Sub-agents (RSAs), if any); and
g. Operational Workflow.

iii. Listof owners/controlling shareholders, directors, and principal officers with

the following information :

Name Citizenship Address Position TIN Amount of % of Ownership Contact Email

Contribution Number address

The entity's officers shall be invited for a presentation of its business model, if
warranted.

Page 3 of 7
2. Second stage

lfapplicant is deemed eligible in Stage 1, the applicant shall be required to

submit relevant supporting documents.

Submission guidelines:

1. The application shall be submitted using the prescribed Data Entry Template
(DEr).

In using the DET, the following shall be observed:

a. Download the prescribed DET and User's Guide or request directly from
BSP-ISD I thru email address ISD_I@bsp.gov.ph.

b. Accomplish the prescribed DET and save the file using the prescribed
format as follows:

<Application Form Number>DET - <Entity Name>

(example: lMDET -XYZ Money Changer and Remittance Business)

c. The duly accomplished DET shall be submitted through e-mail address

lSDlLicensing@bsp.gov.ph using the prescribed format for the subject as
follows:

<Application Form Number> - <Mode of Submission*>, <Province,

City/Municipality** of Head Office>, <Entity Name> as illustrated below:

lllustrotion
To: lSDLLicensine@ bsp.eov. ph
Subject: Form lM - Personal, Metro Manila, Manila, XYZ Money
Changer and Remittance Business

* Mode of submission of documents, if through Personal filing (Personal) or

Postal/Courier services (Mail)
** The city/municipality in the subject refers to the location of the head office.

The e-mail address to be used by the entity should belong to an

authorized responsible officer. lt shall be considered as the official e-mail
address registered with BSP which shall be used for official
communications.

d. Print the corresponding DET generated application Form 1M.

Said Form 1M duly notarized and signed by the authorized signatory shall
be submitted together with the documentary requirements listed in
Annex A. The applicant shall submit both the soft and hard/printed copy.

Page 4 of 7
 The applicant shall submit the documents/DET generated forms within
five (5) business days from the date of the e-mail. Otherwise, the
application may be considered as withdrawn.

2. The applicant shall be informed of the result of evaluation. An entity that

received a notice of approval shall pay the corresponding registration fee
(net of filing fee paid) for the issuance of the Certificate of Registration (COR).
The type/classification of RTC/MC/FXD is indicated in the said COR.

3. Registration Process for Existing BSP-Registered MSBs

All existing registered MSBs as of date of signing of this Memorandum shall

re-register with BSP within six (6) months from the date of effectivity of Circular
No. 942 or until L0 August 20L7.

The following guidelines shall govern:

L. The entity shall simultaneously submit the requirements for the first and
second stage as listed in item ll.A above.

2. The entity's application for head office and notification of its operating
officesl using the DET-prescribed form should likewise be simultaneously
submitted. The notification guideline is covered by a separate Memorandum.
Previously registered RTC/FXD/MC offices that are not included in the said
notification shall be DEIISTED from the BSP Registry of MSBs.

3. The applicant shall be informed of the result of evaluation. An entity that

received a notice of approval shall pay the corresponding registration fee
(net of filing fee paid) for the issuance of the COR. The new BSP registration
number and type/classification of RTC/MC/fXO are indicated ln the said COR.

4. Existing RTC/MC/FXD offices including pending applications with paid

processing fee of P1,000 shall be applied accordingly.

B. Other Applications Requiring Prior BSP Approval

t. Change of Registered/Business Name

A BSP-registered MSB wishing to change its registered/business name shall

submit an application using the BSP-prescribed Form 2M duly notarized and
signed by the authorized signatory and be accompanied by the following
documentary requirements at least ten (10) business days before effecting the
change:

a. Certificate of Registration from the Department of Trade and Industry (DTl),

Securities and Exchange Commission (SEC) or Cooperative Development

' Including pending application/s received by BSP prior to effectivity of Circular No. 942

Page 5 of 7
 Authority (CDA), as the case may be, indicating the new business/registered
name;

b. Original copy of Bangko Sentral COR issued under the old name;

c. Certified true copy (by the Head of Business Permit and Licensing Office or
equivalent position, with printed Name and Designation) of the
city/municipal license/business license/mayor's permit for the current
period; and

d. Payment/Proof of payment of applicable fees.

2. Change of Ownership or Control

a. A BSP-registered MSB wishing to change/transfer ownership or control shall

submit an application using the BSP-prescribed Form 3M duly notarized and
signed by the authorized signatory and be accompanied by the documents
listed in Annex B at least ten (10) business days before effecting the transfer.

b. lf such change of ownership or control shall result in change of classification

of BSP registration and/or change of registered/business name, the applicant
shall pay the corresponding fees to receive the new COR.

3. Reclassification of Registration Category

For MSB already registered as Small-Scale Operator requiring re-classification as

Large-Scale Operator and vice versa based on prescribed average monthly
network volume of transactions shall submit a new set of application in
accordance with the provisions in item ll.A as cited above together with the
original COR and proof of payment of P1,000 for COR replacement fee, subject to
evaluation of ISD l, BSP.

lll. Registration with the Anti-Money Launderini Council (AMLC).

MSBs are required to register with the AMLC within thirty (30) calendar days from the
actual date of commencement of money service business operations and shall submit
to ISD I proof of registration with AMLC within five (5) business days from registration
thereat. Failure to register shall result in the automatic cancellation of the Bangko
Sentral registration as MSB.

Page 6 of 7
lV. Business Hours

A. ISD I Registration Counter at Ground Floor Multi-storey Building, BSP Complex,

Manila

1. Acceptance of Applications/Notifications/payments
Monday to Friday, 9:00 a.m. - 2:00 p.m.

2. lnquiries/Clarifications
Monday to Friday, 9:00 a.m. - 4:30 p.m.

B. BSP RegionalOffices/Branches (Payments onlyf

Monday to Friday, 9:00 a.m. - 1:30 p.m.

For guidance and compliance.

t
p.['---L.JrL
ilESTOR A. ESPENITLA, JR.
Deputy Governor
T
3l March 2017

PageT of 7
 Form lM
(DET generated form)
Page 1 of 2

APPTICATION FOR REGISTMTION AS MONEY SERVICE BUSINESS OPERATOR

(Tobecompletely filled up. Indicate'NA' if an item is not applicable)

fhru: The Office ofthe Director Date:

Integrated Supervision Department I

Pursuant to Section 4511N of the Manual of Regulations for Non-Bank Financial Institutions - N (MORNBFI-N) Regulations, as amended by
lircular No. 942 dated 20 January 2017, I hereby apply for Registration as a Money Service Business Operator:
1. CTASSIFICATION OF MONEY SERVICE BUSINESS
A -Large-Scale Operator - Remittance Agent with or without money changin&/foreign exchange dealing operations with
average monthly network volume of transactions of at least P75.00 million.
B - Small-Scale Operator - Remittance Agent with or without money changing/foreign exchange dealing operations with
average monthly network volume of transactions of less than P75.00 million.
C - E-Money lssuer as authorized under Subsection X780.2 of MORB.
D - Remittance Platform Provider.
E - Large-Scale Operator - Money Changer/Foreign Exchange Dealer with average monthly network volume of transactions
of at least P50.00 million.
F - Small-Scale Operator - Money Changer/Foreign Exchange Dealer with average monthly network volume of transactions
of less than P50.00 million.
2. FUtt COMPANY NAME 3. TIN
(as appearing in the DTI/sEC Retistration)

4. COMPANY NAME ;. PS Reg. No.

6. REGISTERED BUSINESS/TRADE
NAME/S

7. DTr / SEC REGTSTRATTON NO. l. Date lssued 9. Valad Until

10. BUSINESS TOCATTON lf within a Bldg., specify stoll, room, floor
StreetNo.& Nome/Purok Bdrcngoy
number

City/Municiplity Province

Londline Mobile No. Emoil Address" Website

11. CONTACT INFO.

12. BUSINESS PERMIT/ NATURE or Eusiness Permit No. Dote lssued Volid Until Kind of Business

WPE OF BUS]NESS

13. FORM OF BUSINESS ORGANIZATION 14.rOTArEqUrry

AUTHORIZED CAPITAT STOCK
15. OWNERSHIP AND MANAGEMENT STRUCTURE
l9.t Llst ol Boord of Dhectors / Llst ol Pannerc / Owner
%of
Name Citizenship Address Position TIN Amount of Contribution Email address
Ownershio

15.2 Llst of Shoreholders

%ol
Name Citizenship Address TIN Amount of Contribution Email address

15.3 Llst ol Olflcers

Name Citizenshio Address Position TIN Email address

t/
Shall be considered the official e-mail address registered with BSP
 Form lM
(DET generated form)
Page2 of 2

ln support ol this application, l/we submit the documentory requirements listed in Annex A

REPUBLTC OF THE PHTLTPPTNES )

crTY )s.s.

|,,so|emnlyswearthatal|matterssetforthonthesestatementsaretrueand
correct to the best of my knowledge and belief.

Proprietor/Managing Partner/President/
Authorized Officer2/)

D"rig"rti""

SUBSCRIBED AND SWORN to before me this day of 20- in the City/

Municipality of . by:

Name Anv government issued lD Expirv Date

NOTARY PUBLIC

Doc. No.
Page No.
Book No.
Series of 20-

2/ Supported with notarized special power of attorney authorizin8 a person/entity to apply for an authority to operate a pawnshop business in behalf of the
proprietor/partnership/corporation. In the caie of a corporate applicant, a certified true copy of the board resolution authorizing the person or entity shall
likewise be submitted.
 Annex A
Page 1 of 2

Application for Certificate of Registration

Second Stage

Company Name: Date:

E-mailAddress: Contact Nos:

Documents to be submitted (fastened in a folder)

1. Printed copy of the e-mail advising the applicant to submit relevant supporting documents.
2. notarized Form 1M lData E
3. e-mail from
Incorporation papers duly authenticated by the Securities and Exchange Commission (SEC)
(for corporotion/partnershipl or proof of registration with the Cooperative Development
Authority (CDA) (/or cooperotivel indicating in its purpose/s the money service business/es
applied for; or copy of the Certificate of Registration duly authenticated by the Department of
Trade and I

5. Certified true copy (by the Head of Business Permit and Licensing Office or equivalent position,
with printed Name and Designation) of the business registration/permit from the city or
municipality having territorial jurisdiction over the place of establishment and operation of the
which should indicate the line of business of the
6. Notarized Deeds of Undertaking:
a. Annex A-1.1 (For the entity) signed by the proprietor/managing partner/president; and
b. Annex A-t.2 (For owners/officers) individually signed by the proprietor, partners, president
and directors, as the case mavbe.
7. -
Personal data sheet (using BSP-prescribed form for MSBs Annex A-2) with passport size
picture duly accomplished by the proprietor or partners or incorporators, directors and

8. Duly notarized authorization form (Annex A-3) for querying the BSP watchlist file from the
rtners/directors, president and principal officers.
9. Proof of attendance, or a sworn undertaking to attend, of the proprietor/partners/
directors/principal officers and other personnel directly involved in RTC/MC/FXD operations to
the required Anti-Money Laundering Act seminar conducted by the AMLC, Bangko Sentral, or
Bangko Sentral - accredited person, or for persons registered prior to the effectivity of Circular
No. 942, a certification of compliance executed by the President and Compliance Officer,
detailed as follows:

(continue in o separate sheet

10. Sworn certification (Annex A4), signed either by the proprietor, managing partner, or
president, that a Money Laundering and Terrorist Financing Prevention Program (MLPP) has
and disseminated to all
11. NBI Clearance, or its equivalent in foreign jurisdictions, for the proprietor/partners/directors/
principal officers.
With validity of at leost j months from the dote of appli
12. Dufy notarized certification (Annex A-5) from the proprietor/managing partner/president, as to
nce with the required minimum capital under Section 1 of Circular No. 942.
Additional documents for RTCs
List of remittance tie-up partners (Annex 4-6)
 Annex A
Page 2 of 2

Application for Certificate of Registration

Second Stage

Company Name: Date:

E-mailAddress: Contact Nos:

Documents to be submitted (fastened in a folder) Remarks

(Mgo dokumentong dapat ipaso no nokapaloob so folder)
14. Copy/ies of notarized tie-up agreement/s with RTC which shall be consularized if
orisinated/sisned abroad.
15. For any RTC or counterparty based abroad, proof that the RTC or counterparty is licensed by
the regulatory authority to engage in the remittance business and is subject to the anti-money
launderine laws of the countrv.
INCOMPTETE DOCUMENTS WILI NOT BE ACCEPTED
(HINDI TATANGGAPIN ANG MGA DOKUMENTONG KU,r'.NG)

NOTE(SI (to be filled-up by BSP personnel only):

1.

2.

3.

4.

5.

Submitted by: ! Received by: ! Returned by:

(Signature over printed name) (Signature over printed name)

Date : Date :
 Annex A-1.1
Page 1 of 3

Name of Applicant/Entity:

Address:

Tel. No.: Fax No.: TIN:

DEED OF UNDERTAKING

(name and designation), of legal age and under

oath, hereby abide to comply with the following requirements:

That I have been duly authorized by

(name of institution) and its Board of Directors/Partners/Owners to bind
(name of institution) to strictly comply with
all the requirements, rules and regulations of the Bangko Sentral ng
Pilipinas regarding the registration and operations of money service
business as well as the provisions of the Anti-Money Laundering Act of 2001
(R.A. No. 9160, as amended) and its revised implementing rules and
regulations as well as the implementing rules issued by the Bangko Sentral;

2. That I certify that (name of institution)

undertakes to strictly comply with all the requirements, rules and
regulations of the Bangko sentral regarding the registration and operations
of money service business as well as with all the provisions of the Anti-
Money Laundering Act of 2001 (R.A. No. 9160, as amended), which include,
among others, the exclusive use of bank account/s in the name of the
registered entity (rather than its proprietor/officer) in its official business
and proper recording and reporting of transactions (covered and suspicious
transactions) to the Anti-Money Laundering Council;

3. That I certify that (name of institution) undertakes to

provide the complete list of our counterparties, foreign or local, including
their contact details (i.e. business address, contact person and its numbers)
to consider full compliance with the Bangko sentral registration
requirements (this provision is opplicable to Remittance ond Tronsfer
Company only);
 Annex A-1.1
Page 2 of 3

4. That I certify that (name of institution)

undertakes that our counterparty(ies) is/are licensed/authorized by the
financial regulators in that territory to act as remittance agent;

5. That I certify that (name of institution)

undertakes to assume full responsibility of the Remittance Sub-agent's
compliance with all the requirements, rules and regulations of the Bangko
Sentral regarding the registration and notification requirements of RSAs as
well as with all the provisions of the Anti-Money Laundering Act of 2001
(R.A. No. 9160, as amended) and its revised implementing rules and
regulations, as well as the implementing rules issued by the Bangko Sentral
(this provision is applicable to Remittonce and Transfer Compony onlyl;

6. l/We shall maintain exclusive bank account/s in the name of the registered
entity (rather than its proprietor/officer) in its official business and that
bank account/s shall be subject to Bangko Sentral inspection/ examination
for Anti-Money Laundering purposes;

7. l/We shall notify the appropriate department of SES the following events:
(a) commencement of operations; (b) newly-accredited Remittance
Sub-agents; (c) change of tie-up partner/s; (d) transfer of location;
(e) closure of office; and (f) closure of business;

8. l/We shall obtain prior approval from the appropriate department of SES for
any change in ownership and control as may be prescribed by pertinent
Bangko Sentral regulations;

9. That I certify that (name of institution) commits

to strictly comply with requirements to maintain records and submit the
required reports as prescribed by the Bangko Sentral;

10. l/we shall maintain an internal control system commensurate to the nature,
size and complexity of the business and shall adhere to the guidelines
prescribed by the Bangko Sentral;

11. That l/we shall adopt the minimum standards of consumer protection in the
areas of disclosure and transparency, protection of client information, fair
treatment, effective recourse and financial education pursuant to part Ten
of the Manual of Regulations for Non-Bank Financial Institutions - e
Regulations, as may be applicable;
 Annex A-1.1
Page 3 of 3

12. That l/we shall comply with the applicable provisions of Section 4196N or
the Information Technology Risk Management of the Manual of Regulations
for Non-Bank Financial Institutions - N Regulations;

13. That I certify that (name of institution)

undertakes to pay Bangko Sentral the following fees: (a) registration fee;
(b) annual service fee; and (c) processing fee for the replacement of Bangko
Sentral Certificate of Registration, as prescribed by the Bangko Sentral;

14. That I certify that (name ofinstitution)

undertakes to strictly comply with the transactional requirements for
remittance and transfer companies/money changersforeign exchange
dealers on the regulation on large value pay-outs, and the sale of foreign
currencies and shall request prior exemption from the Bangko Sentral
before transacting higher limits as prescribed by the Bangko Sentral; and

15. That I certify that (name of institution) commits

to strictly comply with possible sanctions/penalties as prescribed or
imposed by the Bangko Sentral.

(Signature over Printed Name of

Proprietor/Managi ng Partner/President)

{Designation)

Subscribed and sworn to before me this day of 20

affiant exhibiting to me his/her issued at on

NOTARY PUBLIC
 Annex A-L.z
Page 1 of 1

Name of Owner/Partner/Director:

Address:

Tel. No.: Fax No.: TIN:

DEED OF UNDERTAKING

(name), (designation and name of

institution), of legal age and under oath, hereby abide to comply with the following
requirements:

1. That I certify that I shall be responsible for any violation of any of the
provisions of the Anti-Money Laundering Act of 2001 [Republic Act (R.A.)
No. 9160, as amendedl and its revised implementing rules and regulations
as well as the implementing rules issued by the Bangko Sentral and shall
be subject to the administrative sanction prescribed under Section 36 of
R.A. No. 7653, otherwise known as the "New Central Bank Act" and other
applicable laws, rules and regulations; and

2. the required seminar on Anti-Money Laundering Law before

I shall attend
commencement of actual operations.

(Signature over Printed Name)

(Designation)

Subscribed and sworn to before me this day of 20-,

affiant exhibiting to me his/her issued at

NOTARY PUBLIC
 Annex A-2
Page 1 of 7

COMPANY NAME

lD picture taken within

ADDRESS the last 6 months
3.5 cm. x 4.5 cm.
PERSONAT DATA SHEET (passport size)

Computer generated
or photocopy of
NAME picture is not
acceptable

POStTl0N

I hereby certify that the information contained in this document and its supporting schedule
of my own knowledge is true and correct.

Signature over Printed Name

Designation

REPUBLTC OF THE PHtltPPINES )

crTY )s.s.

SUBSCRIBED AND SWORN to before me this _ day of 20_ , in the

City/Municipality of by:

Name Anv government issued lD Expirv Date

Notary Public

Doc. No.
Page No.
Book No.
Series of 20
 Annex A-2
Page 2 of 7

BIOGRAPHICAT DATA

NAME

ADDRESS

PERSONAT INFORMATION:

SUFFIX (e.
1. NAME:

2. TIN : 3. UPDATED AS OF :

4. OTHER NAMES USED, IF ANY :

5. MANAGEMENT LEVEL :
! Director ! Officer

6. DATE ELECTED / RE-ELECTED / APPOINTED / POSITION CHANGED :

7. RESIDENCE ADDRESS :

8. TELEPHONE NO. : 9. E-MAILADD :

10. BUSINESS ADDRESS

11. TELEPHONE NO. : 12. E-MAILADD :

13. CIVIL STATUS :

I Single ! Married ! Divorced/Separated flWidow
14. SEX :
! lvtale ! Female 15. CITIZENSHIP :

16. DATE OF BIRTH : 17. PLACE OF BIRTH :

(Pleose indicate "N/A" for fields thot ore not applicoble)

 Annex A-2
Page 3 of 7

UPDATED AS OF

EDUCATION AND TMINING:

18. Educational Attainment

YEARS
SCHOOL LAST ATTENDED GRADUATED/ATTENDED
COLLEGE :

POST-GRADUATE :

OTHERS :

19. Seminars/Training on Money Service Business, AML and other related Fields

NATURE/TITLE CONDUCTED BY YEAR TAKEN

(continue in seporote sheet if necessory)

WORK EXPERIENCE:

20. Present Position - This lnstitution

NAME OF OFFICE POStTtON DATE ASSUMED

(continue in separate sheet if necessory)

(Please indicate "N/A" lor fields that ore not applicable)

 Annex A-2
Page 4 of 7

NAME UPDATED AS OF

WORK EXPERIENCE:

21. Present Position - Other Private Institution (lncluding Corporate Directorships)

INDICATE IF OWNER/
NAME OF OFFICE POSTTTON DATE ASSUMED PARTNER/ STOCKHOLDER

(continue in separate sheet if necessary)

22. Present Position - Government (lncluding Directorships in Government Corporate Institutions)

INDICATE IF ELECTIVE OR
APPOINTIVE AND
NAME OF OFFICE POSTTTON DATE ASSUMED PART/FULL-T|ME

(continue in separote sheet if necessary)

23. Past Positions-This Institution

DURATTON (YEAR)
NAME OF OFFICE POSTTTON FROM TO

(continue in separate sheet if necessory)

24. Past Positions - Other Private Institutions (lncluding Corporate Directorships)

DURATTON (YEAR)
NAME OF OFFICE POSTTTON FROM TO

(continue in seporote sheet if necessary)

(Please indicate 'N/A" for lields that dre not appticobte)

 Annex A-2
Page 5 of 7

NAME UPDATED AS OF

WORK EXPERIENCE:

25. Past Positions - Government (lncluding Directorships to Government Financial Institution)

DURATTON (YEAR)
NAME OF OFFICE POStTtON FROM TO

(continue in separate sheet if necessary)

FAMIIY RELATIONS (Legitimate or Common-Law]:

SURNAME MIDDLE SUFFIX (e.9. Jr., lll)

26. NAME OF SPOUSE

27. TIN

28. Present Employment

DURATTON (YEAR)
NAME OF OFFICE POSITION FROM TO

SURNAME GIVEN MIDDLE SUFFIX (e.9. Jr., lll)

29. NAME OF COMMON-
LAW SPOUSE
30. TIN

31. Present Employment

DURATTON (YEAR)
NAME OF OFFICE POStTtON FROM TO

(Please indicote "N/A" for fields that are not opplicable)

 Annex A-2
Page 6 of 7

NAME UPDATED AS OF

FAMItY REIATIONS (legitimate or Common-law]:

32. First Degree Relatives by Consanguinity: Parents and Children of legal age:
Legitimate or illegitimate

NAME (Surname Given, Middle RELATIONSHIP

(continue in separote sheet if necessary)

33. First Degree Relatives by Affinity: Parents-in-Law and Children-in-Law of legal age:
Legitimate or illegitimate

NAME (Surname, Given, Middle RELATIONSHIP

(continue in seporote sheet if necessory)

34. Second Degree Relatives (of legal age) by Consanguinity: Grandparents, Grandchildren, Brothers and
Sisters

NAME (Surname, Given, Middle) RELATIONSHIP

(continue in seporote sheet if necessory)

35. Second Degree Relatives (of legal age) by Affinity: Grandparents-in-law, Grandchildren-in-law, Brothers-in-
law and Sisters-in-law

NAME (Surname, Given, Middle RELATIONSHIP

(continue in separate sheet if necessory)

(Please indicate "N/A" for fields that are not opplicoble)

 Annex A-2
PageT of7

NAME UPDATED AS OF

OTHERS:

36. Business establishments where the directors/officers and their spouses and within the second
degree relatives have equity interests (As of ).
PERCENT OF
STocKHoLDTNGS/
NAME OF CORPORATION/ NAME OF PERTINENT STOCKHOLDERS, DATE OF INFORMATION
ASSOCIAT MEMBER CENTRAL P OTHERS FILED

(continue in seporate sheet if necessory)

37. Have you ever been convicted, judicially or administratively of an offence or judicially declared insolvent,
spendthrift, or incapacitated to contract?

! Yes nruo
lf yes, please state:

PARTICULARS
NATURE OF OFFENSE COURT OF JURISDICTION DATE INFORMATION FILED

(continue in seporote sheet if necessory)

(Please indicate'N/A" lor lields that are not applicobte)

 Annex A-3
Page 1. of 2

AUTHORIZATION

t, , after being sworn in

accordance with law, do hereby authorize the following, pursuant to the provisions of
Section 1 of BSP Circular No. 942 dated 20 January 2017, Amendments to the Manual of
Regulations for Non-Bank Financial Institutions (MORNBFI):

a. (compony name)
to conduct a background investigation on myself as
(position) in (compony nome)
which include, among others, inquiring from the Watchlist Files of the Bangko
Sentral ng Pilipinas; and

b. The Bangko Sentral to disclose its findings pertinent to the

ng Pilipinas
aforementioned inquiry on the said Watchlist Files to
(compony nome).

With the above authorization, I hereby waive my right to the confidentiality of the
information that will be obtained as a result of the said inquiry, provided that disclosure of
said information will be limited for the purpose of ascertaining my qualification or non-
qualification for the said position.

lN WITNESS WHEREOF, I have hereunto set my hand this

(Signature over Printed Name)

SlGNED IN THE PRESENCE OF:

(Witness) (Witness)
 Annex A-3
Page 2 of 2

ACKNOWTEDGEMENT

REPUBLTC OF THE PHTLTPPTNES )

crrY )s.s.

BEFORE ME, this _day of _ 20_ in

personally appeared the following person:

Name Anv government issued lD Expiry Date

known to me and to me known to be the same person who executed the foregoing
instrument which (he/she) acknowledged to me as (his/her) free and voluntary act and
deed, consisting of only pagef s, including this page in which this Acknowledgement
is written, duly signed by (him/her) and (his/her) instrumental witnesses on each and
every page hereof.

WITNESS MY HAND AND SEALthis Philippines.

Notary Public

Doc. No.
Page No.
Book No.
Series of 20
 Annex A-4
Page 1. of 1

REPUBLTC OF THE PHtLTPPTNES )

crTY )s.s.

SWORN CERTIFICATION

This is to
certify that that a Money Laundering and Terrorist Financing
Prevention Program (MLPP) has been developed, adopted and disseminated to all
employees of
(compony name) with principal address at

contact details

(Signature over Printed Name of

Proprietor/Managing Partner/President)

(Designation)

SUBSCRIBED AND SWORN to before me this _ day of 20- ,in

the City/Mu nicipality of by:

Name Any government issued lD Expiry Date

Notary Public

Doc. No.
Page No.
Book No.
Series of 20
 Annex A-5
Page 1 of 1

REPUBLIC OF THE PHILIPPINES )

CITY )s.s.

SWORN CERTIFICATION

This is to certify that

(compony nome) with principal address

and contact details has the financial capacity to

a money service business and is compliant with the
organize and operate
minimum capital under Section 1 of Circular No. 942. As of
(dote of opplicotion), the company's paid-in capital is
(omount) evidenced by
(otto ch ed su p po rti n g docu me nts).

(Signature over Printed Name of

Proprietor/M an agi n g Partn er/President)

Designation

SUBSCRIBED AND SWORN to before me this _ day of 20_ ,in

the City/Mu nicipality of by:

Name Any government issued lD Expiry Date

Notary Public

Doc. No.
Page No.
Book No.
Series of 20
 Annex A-6
(DET generated form)
Page 1 of 1

(FUtt COMPANY NAME)

IIST OF REMITTANCE TIE.UP PARTNERS
(To be completelyfilled up. Indicate "NA" if an item is not applicable)

Date:

BSP Registration Number

No. FullCompany Name Complete Business Address
(if applicable) Domicile Contact Person Designation Email Addiess

(Signature over Printed Name of

Proprietor/Managing Partner/President/
Authorized Officerl/l

0.slgn.llon

peMn or entity sh.ll lilef,i* be $bnitt€d,

Submission Deadline: Form 2M
At least 10 business days before (DET generated form)
effecting name change page 1 of 1

APPUCATTON FOR CHANGE OF REGTSTERED/EUS|NESS NAME

(To be completely filled up. Indicate "NA" if an item is not applicable)

Ihru: The Office of the Director Date:

Integrated Supervision Department I

Pursuant to Section 4511N of the Manual of Regulations for Non-Bank Financial Institutions - N (MORNBFI-N) Regulations, as amended,
hereby apply for Change of Registered/Business Name;
1. FULr COMPANY NAME (OLD) 2. COR NO.
3. FULI COMPANY NAME (NEW)
4. COMPANY NAME (NEW
5. REGISTERED BUSINESS/TRADE
NAME/S (NEw)
5. BUSTNESS LOCATTON lf within o Bldg., specit'y stoll, room, floor
number
No. & Nome I Eorongoy
'trcet

City/MunicipoliW Province

7. BUSINESS PERMIT/ NATURE or Business Petmit No. I Dote lssued Volid Until Kind of Business
TYDF rlF RIIqINF<(

In support of this application, l/we submit the following documentary requirements:

a. Certificate of Registration from the Department of Trade and Industry (DTl), Securities and Exchange Commission (SEC) or
Cooperative Development Authority (CDA), as the case may be, indicating the new business/registered name
b. Original copy of Bangko Sentral COR issued under the old name
c. Certified true copy (by the Head of Business Permit and Licensing Office or equivalent position, with printed Name and
Designation) of the city/municipal license/business license/mayo/s permit for the current period
d. Payment/Proof of payment of applicable fees

REPUBLTC OF THE PHtLtPPtNES )

crTY )s.s.

solemnly swear that all matters set forth on these statements are true and correct to the
best of my knowledge and belief.

Very truly yours,

President/Authorized Off icerl/)

Designation

SUBSCRIBED AND SWORN to before me this _ day of 20- in the CiV

Municipality of _ by:

Name Any government issued lD Expirv Date

NOTARY PUBLIC

Doc. No.
Page No.
Book No.
Series of 20-

1/ Supported with notarized special power of attorney authorizing a person/entity to act in behalf of the proprietor/partnership/corporation. In the case of a corporate
applicant, a certified true copy of the board resolution authorizing the person or entity shall likewise be submitted.
Submission Deadline: Form 3M
At least 10 business days before (DET generated form)
effecting change of ownership Page L of 2

APPTICATION FOR CHANGE OF OWNERSHIP OR CONTROT

(To be completely filled up. Indicate "NA" if an item is not applicable)

Thru: The Office of the Director Date:

Integrated Supervision Department I

Pursuant to Section 4511N of the Manual of Regulations for Non-Bank Financial Institutions - N (MORNBFI-N) Regulations, as
amended, I hereby apply for Change of Ownership or Control:
1. CHANGE OF OWNERSHIP 2. COR. NO.

3. FUtt COMPANY NAME (as appearing 4. TIN

in the DTI/SEC Registration)

5. COMPANY NAME
6. REGISTERED BUSINESS/TRADE
NAME/S
7, DTt/ SEC REGTSTRATTON NO. 8. Date lssued 9. Valid Until
10. BUstNEss rocATtoN lf within d Bldg., specify stoll, room, floor
number
Street No. & Nome / Purok Borongay

CMMunicipolity Province

Londline Mobile No. Email Addressu Website

11. CONTACT INFO.

12. BUSINESS PERMIT/ NATURE or Business Permit No. Dote lssued Valid Until Kind of Business
WPE OF BUSINESS
13. FORM OF BUSINESS ORGANIZATION 14. TOTAL EQUrry
AUTHORIZED CAPITAT STOCK
15. OWNERSHIP AND MANAGEMENT STRUCTURE

Ls.L List of Boord of Diredon / List ol Portnen / Owner

Name Citizenship Address
lo ol
Position TIN Amount of Contribution Email address
Ownershio

tS,2 List of Shoreholderc

Name Citizenship Address
%ot
TIN Amount of Contribution Email address
OwnershiD

Ls.3 List of qficea

Name Citizenship Address Position TIN Email address

t/
Shall be considered the official e-mail address registered with BSp
Submission Deadline: Form 3M
At least X0 business days before (DET generated form)
effecting change of ownership Page 2 of 2

suppon of this opplication, l/we submit the documentary requirements listed in Annex
ln support A B

REPUBLIC OF THE PHILIPPINES )

crrY ) s.s.

|,,so|emn|yswearthata||matterssetforthontheses.
|,,so|emn|yswearthata||matterssetforthonthesestatementsaretrueand
thJU.it of
correct to thJUeit ry lno*t"Oe" and
lno*f"Oe" a"d beliet.

(Sig*tr," Pri"t"d N* rf
N.r"
Proprietor/Managing
Prop
"*t
rietor/Ma nagi ng Pa rtne
rtner/P1
r/P reside nt/
Authorized Officer2/)

D"tig*ti".
D"tig*tio.

SUBSCRIBED AND SWORN to before me this _ day of _ 20

2 , in the City/
Municipality of UV,

Name Any government issued lD Exoirv Date

NOTARY PUBLIC

Doc. No.
Page No.
Book No.
Series of 20-

2/ Supported with notarized special power of attorney authorizing a person/entity to act in behalf of the proprietor/partnership/corporation. ln the case of a
corporate applicant, a certified true copy of the board resolution authorizing the person or entity shall likewise be submitted.
 ANNEX B
Full Transfer of Ownership
Page 1 of 1

Application for Change/Transfer of Ownership

Company Name: Date:

E-mailAddress: Contact Nos:

Documents to be submitted (fastened in a folder) Remarks

.. (Mga dokumentong dapat ipasa na nakopotoob so
fotder)
ruil ! ranster ot Ownershap
For the Vendor/Transferor:
1. Letter informing BSp of the transfer/change of ownership signed by the
proprietor/managing partner/president.
Notarizedstatementbyproprietor/managingpartner7pre@
a. The entity's books of accounts, records and documents shall be preserved
for five (5) years from date of last entries before the transfer of ownership;
b. All unused accountable forms have been properly disposed of to prevent
their unauthorized use; and
c. The transferor money service business (MSB) operator shall be liable for all
claims arising from transactions of the entity prior to the effective date of
transfer, unless the transferee MsB operator assumes such liability, in which
case, such transferee MSB operator shall submit a notarized statement to
that effect.
5' urlglnal 65P Lertlllcate ot Registration issued to the transferor MSB operator (in
case of change in company Name qnd/or Address) or an affidavit in case of loss.
FOr tne vendee/Transferee
*. "uty ,ruro,rr.a ,ofm 5M luata Entry remplate (DET) generated forml,
l. 9o.mply with the requirements of rssuance or certiricatJor negistratiof
6. Submit a coffit effpctino the francfor nr n.^,
7. Payment/Proof of payment of applicable fees.

rr"r Lrrdnge/lransrer or 5nares (Partnershaps and Corporations only), the documentary

requirements are listed in Annex 8.1
n'r Lnange/lransrer or gwnershap trom a Deceased Person to Heir/s, the documentary
requirements are listed in Annex 8.2
INCOMPTETE DOCUMENTS WItt NOT BE ACCEPTED
(HINDI TATANGGAPIN AN6 MGA DOKUMENTONG KULANG)
NOTEISI (to be fiiled-up by BSp personne! only):

I Received by: ! Returned by:

(Signature over printed name) (Signature over printed name)

Date : Date :

I
Section ll.A of this Memorandum (Guidelines on the lssuance of Certificate
of Registration)
 ANNEX B.1
Changefi ransfer of Shares
(Partnerships and Corporations only)
Page 1 of 1

Application for Change/Transfer of Shares

Company Name: Date:

E-mailAddress: Contact Nos:

Documents to be submitted (fastened in a folder) Remarks

(Mgo dokumentong dapat iposa no nakapaloob sa
fotder)
cnange/Transfer of Shares (partnerships and Corporations only)
r-. uuly noranzed Form 3M lDota Entry Templote (DET) senerated forml.
2. Copy of the contract/agreement/arrangements shall be suUmitttO if suctr transactioffi
itself or in relation with other/previous transactions, will:
a. Result in change in ownership or control in a MSB organized as a partnership or at
least twenty percent (zo%) of the voting shares of stock of MSBs organized as a
corporation by any person, whether natural or juridical, or which will enable such
person to elect, or be elected as, a director of such MSB; or
b. Effect a change in the majority ownership or control of tne uoting shares of stock of
the MSB organized as a corporation from one (1) group of persons to another srouo.
3. New partners and newly elected/appointed directors/officers shall submit:
a. Dufy notarized Personal data sheet (using BSP-prescribed form for MSBs
- Annex A-2)
with passport size picture;
b. NBI Clearance;
With volidity of at leost 3 months from the dote of opplicotion
c. Dufy notarized authorization forr! (Annex A-3) for querying ttr" esp *at.hlist filc
d. Proof of
attendance, or a sworn undertaking to attend, of ttre partnery
directors/principal officers and other personnel directly involved in RTC/MC/FXD
operations to the required Anti-Money Laundering Act seminar conducted by the
AMLC, Bangko sentral, or Bangko sentral - accredited person, or for persons
registered prior to the effectivity of circular No. 942, a certification of compliance
executed by the President and compliance officer, detailed as follows:
Name Position Date(s) Attended

(continue in o seporote sheef if nercssarvl

4. Payment/Proof of payment of applicable fees.

INCOMPTETE DOCUMENTS WItt NOT BE ACCEPTED

(HINDI TATANGGAPIN ANG MGA DOKUMENTONG KUUNG)

NOTE(S) (to be filled-up by BSp personnel only):

1..

2.

3.

4.

5.

Submitted by: by: !

! Received Returned by:

(Signature over printed name) (Signature over printed name)

Date : Date :
 ANNEX 8.2
From a Deceased Person to Heir/s
Page 1 of 1

Application for Change/Transfer of Ownership

Company Name: Date:

E-mailAddress: Contact Nos:

Documents to be submitted (fastened in a folder) Remarks

(Mgo dokumentong dopat iposo no nokapoloob so folder)
Change/Transfer of Ownership (From a Deceased Person to Heir/s)
1. Death Certificate.
2. Extrajudicial Settlement of Estate/Affidavit of Self-Adjudication.
3. Affidavit of Waiver and Release from Liabilitv
4. Original Certificate of Registration (COR) issued by BSP (in case of change in Company
Name and/or Address) or an affidavit in case of loss.
5.
Duly notarized Form 3M [Dota Entry Template (DET) generoted form].
6. Comply with the requirements of lssuance of Certificate of Resistration'.

INCOMPTETE DOCUMENTS WItt NOT BE ACCEPTED

(HtNDt TATANGGAqTN ANG MGA DOKT//MENTONG KULANG)

NOTE(S) (to be filled-up by BSP personnel onty):

1.

2.

3.

4.

5.

Submitted by: I Received by: ! Returned by:

(Signature over printed name) (Signature over printed name)

Date : Date :

'Affidavit of waiver and release of BSP and its officers/employees from any court action/liability or claims of whatever nature of a third person that may arise
from the application of transfer of ownership
-
' Section ll.A of this Memorandum (Guidelines on the lssuance of Certificate of Registration)