Schedules To The Kepss Rules And Regulations

Schedule A KEPSS PARTICIPATION APPLICATION FORM (Name and address of the applicant) …………………… …………………….………… Date …… The Director, Banking Services and National Payment System Department, Central Bank of Kenya P.O. Box 60000, NAIROBI Dear Sir, RE: Application for Participation in the Kenya Electronic Payment and Settlement System (KEPSS) We ………………………………………………bank Ltd., do hereby apply to become a participant in KEPSS and furnish the following particulars of the bank;

No.	Particulars	Comment
1.	Physical Address of Head Office: L.R. No.
2.	Settlement account at the Bank
3.	Commitment to exchange SWIFT authentication keys with all participants
4.	Technical capacity: (a) Webstation capable of effectively communicating with KEPSS (tested and ascertained by the Bank) (b) Have in place contingency arrangements to enable business continuity
5.	Execute and agree to be bound by the terms and conditions of the Agreement for Participating in KEPSS

We hereby certify that the information given in this Application is complete and accurate to the best of our knowledge, and that we have not omitted any material facts. If any information or facts contained in this Application is found to be misleading, the Bank shall nullify the application (if granted). We shall abide by terms and conditions of the Rules and Regulations of KEPSS. Yours Faithfully, For and on behalf of the bank

Name …………………………….	Name …………………………….
Designation	Designation
Authorised Signatory …………………	Authorised Signatory ……………..

Company Seal