application for licensing, please provide any other information which may assist the Central Bank in reaching a decision on the application. In any other case, please provide any other information, which may assist the Central Bank in deciding whether the director, shareholder, controller or manager fulfils the criteria in the Third Schedule of the Act.
I certify that I have read sections
10(8)
and
126(1)(b)
and (c) of the Act. I am aware that it is an offence under the terms of sections
10(8)
and
126(1)(b)
and (c) of the Act knowingly or recklessly to provide to the Central Bank or any other person any information which is false or misleading in a material particular in connection with the application for a licence under this Act or otherwise.
I certify that all the information contained in and accompanying this form is complete and accurate to the best of my knowledge, information and belief and that there are no other facts relevant to this application of which the Central Bank should be aware.
I undertake to inform the Central Bank of any material changes to the application which arise while the Central Bank is considering the application.
I recognize the institution's obligation under sections
10(8)
and
126(1)(b)
and (c) of the Act, to provide the Central Bank with any information in its possession relevant to the exercise by the Central Bank of its functions under the Act in relation to the institution. Consistent with this obligation, I undertake in accordance with regulations 16 and 20 of these Regulations that, in the event that the institution is granted a licence under the Act, I will notify the Central Bank of any material changes to, or affecting the completeness or accuracy of, the answers to the questions above as soon as possible, but in any event no later than twenty one days from the day that the changes come to our attention.
Sworn at Kampala this …………………………day of ………………
…………………………… ………………………… … Name Position held
…………………………… ………………………… … Signed Date
I know and understand the contents of this declaration and that I am making it under oath. Sworn at Kampala, Uganda this ……………day of …………………
………………………………… ………………………… … Signature of deponent (Position)
The Deponent understands the contents of this affidavit.
Before me, …………………………………… COMMISSIONER FOR OATHS