OUTSOURCING APPLICATION

FOR CAPITAL MARKET INTERMEDIARIES

Market Intermediary: …………………………………………

Date of Submission : …………………………………………

DECLARATION

We hereby confirm that the arrangement between (Name of the capital market intermediary) and (Name of the service provider) is in compliance with securities laws, regulations and all relevant guidelines;and that measures are in place to ensure compliance on a continuous basis.

We have conducted a review of the operations of (Name of the service provider) and are satisfied that (Name of the service provider) has the capability and capacity to efficientlyfulfil its duties and responsibilities in respect of the outsourced function(s).

We declare that, to the best of our knowledge and belief, all information given in this applicationform is true and accurate.

………………………………………………… ………………………………………………….

Name: ……………………………………… Name: ……………………………………….

(Chief Executive Officer/ Executive Director) (Person responsible for submission)

Date: Date:

Part I: Details of Service Provider orSub-Contractor

(to fill up separately for sub-contractor and multiple service providers)

1. / Name
2. / Date of incorporation
3. / Directors
(Please indicate executive status, if any, and Chairman of the Board) / Name & Designation
1.
2.
3.
4. / Shareholders as at (dd/mm/yyyy) / Name / %
1.
2.
3.
5. / No. of personnel dedicated to perform outsourced functions
6. / Key financialfigures for the last threeyears / RM mil / [Date] / [Date] / [Date]
Issued capital
Shareholders’ funds
Turnover
Pre-tax profit
7. / Brief information on outsourcing arrangement, which includesfunctions outsourced and mechanism in monitoring the outsourcing arrangement
8. / Service provider’sexperience and expertise in providing the outsourced functions
9. / Details of all present and potential litigation proceedings, in which the service provider may become engaged in, which mayhave potential impact in itsengagement as a service provider or a sub-contractor

PART II : Irrevocable Undertaking and Declaration by Director or Authorised Person (or Chief Executive Officer/ Executive Director)On Compliance with Guidelines on Outsourcing for Capital Market Intermediaries

(To be adopted under the letterhead of the capital market intermediary)

Date:

Managing Director

Market Supervision Division

Securities Commission Malaysia

No.3, Persiaran Bukit Kiara

Bukit Kiara

50490 Kuala Lumpur

Dear Sir,

LETTER OF IRREVOCABLE UNDERTAKING AND DECLARATION
TO CARRY OUT OUTSOURCED FUNCTION

We hereby irrevocably agree to undertake and declare that we, in all material respects based on our good faith, shall exercise ongoing due diligence and make reasonable enquiries to ensure that (Name of the Capital Market Intermediary) fully complieswith the requirements of the Securities Commission Malaysia (SC) Guidelines On Outsourcing for Capital Market Intermediaries (“Guidelines”) in discharging its obligations under the Guidelines, in consideration of the SC to grant the approval to carry out the outsourcing function. We undertake that the responsibilities for effective due diligence and oversight of outsourcing and accountability for all outsourcing decisions shall continue to rest with the board of directors and management of (Name of the Capital Market Intermediary).

We unconditionally undertake and declare to

(i)ensure continuous compliance with the stated requirements and any other conditions imposed by the SC under the Guidelines as well as any other requirements as may be specified by the SC from time to time in due care; and

(ii) ensure that all information, reports and statements provided to the SC at all times is neither false nor misleading.

The above Irrevocable Undertaking and Declaration has been signed by me as (**Director or authorised person or Chief Executive Officer/ Executive Director) of (Name of the Capital Market Intermediary) pursuant to authority granted to me by a resolution of the board of directors on (insert date of resolution).

Yours faithfully,

…………………..………..

Name of signatory

Designation

Date

PART III: SUBMISSION CHECKLIST

Requirements /

Compliance Check

/ SC’s remarks
Check / Remarks
1. / Application form (SC/MI-OUTSOURCING)
2. / Letter of Irrevocable Undertaking and Declaration by the Capital Market Intermediary
(only one letter of irrevocable undertaking is required for multiple applications)
3. / Service Level Agreement (SLA)
  • A copy of executed SLA between the market intermediary and the service provider
  • A copy of executed sub-contracting agreement (if applicable)

4. /

Letter of undertaking from a service provider or sub-contractor to allow access to and make copies of information, records and documents

5. /

Extract of Board Resolution approving the outsourcing/sub-contracting arrangement

6. /

Rationale to outsource to service provider or sub-contractor outside Malaysia and explanation on why the particular function could not be undertaken domestically (if outsourced to service provider or sub-contractor outside Malaysia)

7. /

Rationale for sub-contracting(if applicable)

8. /

Rationale in seeking exemption

(applicable to application for exemptions or variations from compliance with any requirement of the outsourcing guidelines)

9. / Other attachments (if any):
(i) ……………………………..
(ii) ……………………………..
(Please specify)

For SC’s Internal Use Only

Submission of Documents

Please tick the relevant box:

Complete

Incomplete

If incomplete, please state the missing documents:

……………………………………………………………..……………………………………………………………….

………………………………………………………………………………………………………………………………

(Date of complete submission received: ………………………….)

Officer
………………......
Name:
Date: / Manager/ Reviewer
…………………………………
Name:
Date:

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