Form No. 7 attached to Decree 52/2024/NĐ-CP: Application for the issuance of a license for providing payment intermediary services.
Form No. 07
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ORGANIZATION NAME
APPLICATION FOR LICENSE
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SOCIALIST REPUBLIC OF VIETNAM
Independence - Freedom - Happiness
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……., [day]... [month].... [year].....
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APPLICATION FOR INTERMEDIARY PAYMENT SERVICE OPERATION LICENSE
To: The Governor of the State Bank of Vietnam.
Based on Decree No. .../.../NĐ-CP dated ... month ... year ... of the Government regulating cashless payments and the amendments and supplements (if any);
Based on Circular No. .../.../TT-NHNN dated ... month ... year ... of the State Bank of Vietnam regulating the provision of intermediary payment services and the amendments and supplements (if any);
Based on the Resolution of the meeting of the Members' Council/General Meeting of Shareholders/Board of Directors/Document from the authorized representative of the owner of ……(1)……, No. ..... dated ... month ... year ..., agreeing to apply for an intermediary payment service operation license;
……(1)…… requests the State Bank of Vietnam to consider granting an intermediary payment service operation license with the following details:
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Name of the organization requesting the intermediary payment service operation license:
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Full name in Vietnamese:
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Abbreviated name in Vietnamese (if any):
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Full name in English (if any):
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Abbreviated name in English (if any):
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Name used for transactions (if any):
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Business establishment license/Business registration certificate/Business registration number …….. issued by .............. dated ... month ... year ...
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Business registration code/Tax code: ........................................
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Address of the main office, phone number, fax number, email.
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Name(s) of the intermediary payment services requesting the license:
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We commit to fully comply with the legal regulations and those of the State Bank of Vietnam; we take full responsibility for the accuracy and truthfulness of the contents in the Application for the License; and we will not copy or falsify any documents proving eligibility for the intermediary payment service operation license in this application. In case of violation, we take full responsibility before the law.
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Attached Documents:
1.
2.
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LEGAL REPRESENTATIVE
(Sign, full name, seal)
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Note: ...(1)... Name of the organization requesting the intermediary payment service operation license.
Download detailed file here.