APPLICATION FOR LICENCE FORM

1. MANDATORY REQUIREMENTS FOR AN APPLICANT

• A:This application must be completed in English.
• B:The application must be addressed to the Governor of the Reserve Bank of Fiji (see address below) with a covering letter summarising the profile of the applicant and the licence applied for.
• C:The application and supporting documents required under Annex 1 must be true and correct.

2. LICENCE APPLIED FOR

3. NAME OF APPLICANT

(In capital letters in the order the names appear on the Registration Certificate, etc)

Name of Applicant: ________________

Application for (specify category of applicant) ________________

4. APPLICANT’S CONTACTS

4.1 Physical Address ________________

Town/City____________ Street/Road ________________

Name of Building ________________

4.2 Mailing Address: ________________

________________

4.3 Phone Contact:

Tel. No. ____________

Mobile No.____________Other Tel. Nos.________________

E-mail Address:________________

4.4 Authorised Contact

Provide the following details of the person who will be liaising with the Reserve Bank of Fiji on this application. This person should be familiar with the application and able to address queries from the Reserve Bank of Fiji on the application. The applicant accepts responsibility for all submissions and representations which will be made by this authorised personnel/contact person.

5. OTHER INFORMATION ABOUT THE APPLICANT

• 5.1State whether any of the partners/ directors/ shareholders is an undischarged bankrupt.

  (If so, provide details) ________________

  ________________

• 5.2State whether any of the partners/ directors/ shareholders have a beneficial interest in any other business licensed to provide payment services. ________________

  ________________

• 5.3Has any previous application by you been rejected or cancelled under the National Payment System Act 2021? (If so, provide details) ________________

  ________________

6. REFEREES

The following details should be completed by two different referees who have known the entity/person in a professional capacity.

1st Referee________________

I certify that the information given in this form is true and correct to the best of my knowledge.

Full Name: ________________

(Block letters as the names appear on the person’s birth certificate)

Postal Address:

P.O. Box: ____________ Postal Code: ________________

Post Office Town/City: ________________

Phone and Fax Contact:

Tel. No. ____________ Fax No. ________________

Mobile No. ____________ Alternative Tel. No. ________________

E-mail Address: ________________

Occupation: ____________ Signature:________________

2nd Referee ________________

I certify that the information given in this form is true and correct to the best of my knowledge.

Full Name: ________________

(Block letters as the names appear on the person’s birth certificate)

Postal Address:

P.O. Box: ____________ Postal Code: ________________

Post Office Town/City: ________________

Phone and Fax Contact:

Tel. No. ____________ Fax No. ________________

Mobile No. ____________ Alternative Tel.No. ________________

E-mail Address: ________________

Occupation: ____________ Signature: ________________

7. DECLARATION

I/We hereby declare the information we have provided in this application is true and correct to the best of my/our knowledge. I/We also understand that it is an offence to give false information in support of any application.

Name......................................................................................................................................................................................................................................................................................................................................................................................................................................................

Designation......................................................................................................................................................................................................................................................................................................................................................................................................................................................

Signature......................................................................................................................................................................................................................................................................................................................................................................................................................................................

Date......................................................................................................................................................................................................................................................................................................................................................................................................................................................

8. COMPLETED APPLICATION FORMS SHOULD BE RETURNED TO:

Reserve Bank Bldg, Pratt Street

Private Mail Bag

Suva, Fiji

Tel: (679) 331 3611

Fax: (679) 330 2094

E-mail Address: info@rbf.gov.fj

ANNEX 1: SUPPORTING DOCUMENTS TO BE SUBMITTED

At a minimum, every new application must be accompanied by:

• 1.Documents of registration, including the certificate of incorporation and the memorandum and articles of association.
• 2.For a payment service provider:
  • (a)a certified copy of a current licence from the relevant authority in Fiji or elsewhere; and
  • (b)in the case of an e-money issuer, a certified copy of the management agreement where a custodial trust relationship exists with the payment service provider.
• 3.Evidence that the payment system operator and payment service provider hold the initial capital set out in Schedule 2. For applicants seeking to conduct more than one regulated payment service, the Reserve Bank of Fiji will make a determination of the relevant capital requirements to be met based on the applicant’s systemic importance and risk profile.
• 4.A business plan, at a minimum, which includes the following:
  • (a)a description of your organisation and the business concept;
  • (b)details of the proposed system configuration with block diagrams, proposed technology interface with other licensees, network and terminal equipment and/or customer premise equipment (CPE) and the standards they conform to, etc;
  • (c)for payment service providers that are conducting e-money account issuance services, outline details for e-money account issuance services that the applicant intends to provide and if the applicant intends to provide more than one type of account, indicate the details such as load limit, redemption limit, channels of loading, channels for redemption and spending and indicate if it is incidental to any services;
  • (d)an indicative budget for the first 3 financial years that demonstrates that the applicant is able to operate efficiently and safely in Fiji;
  • (e)a list of the type of services to be offered and the programme of operations to offer these services (including the terms and conditions that will apply to customers, agents and cash merchants);
  • (f)details on the mechanisms that have been put in place to protect users’ funds in the eventuality of system failure, revocation/suspension of licence and/or insolvency; and
  • (g)information on the public interest that will be served by the provision of the payment service or payment system.
• 5.A valid tax compliance certificate from the relevant tax authority in Fiji or elsewhere.
• 6.A current credit rating report from a credit reference bureau (if applicable).
• 7.A letter of no objection from the home regulatory authority where the applicant is a subsidiary of a foreign company, recommending the applicant to operate a payment system or payment service in Fiji.
• 8.Details of:
  • (a)the applicant’s governance arrangements and internal control mechanisms, including administrative, risk management and accounting procedures, which demonstrate that these governance arrangements, control mechanisms and procedures are proportionate, appropriate, sound and adequate;
  • (b)the internal control mechanisms which the applicant has established to comply with the Financial Transactions Reporting Act 2004, its regulations and guidelines;
  • (c)the applicant’s structural organisation including, where applicable, its intended use of agents, cash merchants, branches and outsourcing arrangements, and its participation in a national and/or international payment system.
• 9.Details of the identity of:
  • (a)responsible persons for the management of the payment service provider and operator;
  • (b)the custodial trustees holding the cash which is represented in the payment service of the applicant; and
  • (c)persons who, if the activities for which the licence is being sought are to be conducted in a separate division, are responsible for the management of that division.
• 10.If applicable, a detailed list of the volumes and value of transactions for the last 12 months.

Pursuant to regulation 3(3) of the National Payment System Regulations 2022, the Reserve Bank of Fiji may require further information to be accompanied with a new licence application for a payment system operator or payment service provider.