CONG HOA xA HOI CHU NGHIA VIET NAM. . .NGRN HANG Quae DRN

s6: 196120191TB-NHQD

DQcl~p - T\f do - H~nh phuc

Ha N(Ji, ngay p6 thang 12 nam 2019

THONG BAoVlv: (fng cu, dd n/' de duoc bitu boosung Thanh vien H(Jidong quem tri V(I

Thanh vien Ban Kidm soat nhiem k)! 2015 - 2020

Kinh gtl'i: Quy c6 dong - Ngan hang TMCP Qu6c Dan.

Can cir Ludt cdc T6 chicc lin dung nam 20 I 0 va cdc van ban sua dc3i, b6 sung:Can cit' Didu I¢ Ngdn hang TMCP Quoc Dan;Can CIf Nghi quyet cua HDQT s6 55120191NQ-HDQT ngay 11/1112019 vd viec 16 chucD(.Jihoi dong c6 dong b6t thuong;

Nham hoan thien CO' du cua HQi dong quan tr] (HDQT) va Ban Ki€m scat (BKS) dam bao tuanthu cac quy dinh cua phap luat va tang cuong nang lire quan tri ngan hang trong tho'i gian toi,Ngan hang TMCP Quoc Dan (NCB) se tien hanh b§u b6 sung Thanh vien HDQT va Thanh vienBKS nhiern ky 2015 - 2020 tai cuoc hop Dai hoi d6ng c6 dong b~t thucrng, C6 dong/nhom c6dong co quy€n lrng cu' lam lrng vien ho?c d€ cU'lrng vien vao danh sach lrng vien b§u b6 sungCh(fCdanh Thanh vien HDQT va Thanh vien BKS nhi~m ky 2015 - 2020 n~u xet th§y Lrngviendam bao cac tieu chuAn va di€u kien thea quy dinh clla phap 11I?tva Di€u I~ NCB,HDQT NCB tran tning thong bao t6i cac c6 dong v€ vi~c lrng CLf/d€Clf b6 sung vao ChCfCdanhThanh vien HDQT va Thanh vien BKS NCB nhi~m ky 2015 - 2020, ql th€ nhu sau:I. s6 LUQNG BAu BO SUNG:

1. s6 1U'Q'ngthanh vien HDQT bAu b6 sung: 01 thanh vien2. s6 Im_rngthanh vien BKS bAu b6 sung: 01 thanh vien

II. TIEU CHUAN, DIEU KI~N Val U'NG VIEN DUQC DE CU, UNG CU:1. Quy~n tfng Clf, d~ cU'Thanh vien HDQT va Thanh vien BKS nhi~m ky 2015 - 2020:

C6 dong va nhom c6 dong s6 hu'u c6 ph§n clla Ngan hang TMCP QU6cDan thea danh sachch6tt~i ngay 02/12/2019 dUQ'cquy~n LrngClf, d~ Clf thea quy dinh cua Lu?t cac T6 ch(rc Tin d~lngnam 20 I0 va cac van ban Sl'rad6i, b6 sung va Di€u I~NCB, th~rchi~n nhlr sau:c6 dong ho?c nhom c6 dong sO-hilll tren 10% (n1ll'oi phftn tram) t6ng s6 c6 ph§n ph6 thong trongth6i gian lien t~ICit nh~t 06 (sau) thang co quy€n d€ Clf nglfc:rivao HDQT va BKS. S6 IU'Q'ngLrngcLrvien co th~ d~ Clf du'Q'cth~rchi~n nhu' sau:

a) C6 dong ho?c nhom c6 dong n~m giu' tlf 10% (Imrcri ph§n tram) d~n dll'6i 20% (hai mLroiph§n tram) t6ng s6 c6 ph§n co quy~n bi€u quy~t trong 06 (sau) thang lien t~ICdll'Q'cd~ Clf01 (mQt) lrng cU'vien;

b) C6 dong ho?c nhom c6 dong n~m giu' tlf 20% (hai mll'O'i ph§n tram) d~n dLr6i 30% (ban1ll'oi ph§n tram) t6ng s6 c6 ph§n co quy€n bi€u quy~t trong 06 (sau) thang lien t~ICduQ'cd€ CLl'02 (hai) LrngcU'vien;

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c) c6 dong hoac nhorn c6 dong n{1I11giG' tu 30% (ba muoi ph~n tram) d~n duoi 40% (b6nmuoi phan tram) tong s6 c6 phan CO'quyen bi~u quyet trong 06 (sau) thang lien t~ICdLfQ'Cd€ cu 03 (ba) ung cu vien;

d) c6 dong hoac nhorn e6 dong nam giG' nr 40% (bon muoi ph§.n tram) d~n duoi 50% (namrnuoi ph~n tram) tong s6 c6 phan CO'quyen bi~u quyet trong 06 (sau) thang lien t\1Cduocd€ cu' 04 (bon) Cl'I1gcu vien;

e) ce dong hoac nhorn c6 dong nam gifr tll' 50% (narn muoi phan tram) d~n duoi 60% (saumuoi ph§.n tram) tong s6 c6 phan CO'quyen bieu quyet trong 06 (sau) thang lien t\1Cduocd€ elf 05 (nam) Cl'I1gcu vien;

f) ce dong hoac nhorn c6 dong nam giu nr 60% (sau muoi ph~n tram) d~n duoi 70% (baymuoi ph~n tram) t6ng s6 c6 ph~n CO'quy€n bi~u quy~t trong 06 (sau) thang lien t\1Cdu'9'cd€ Clf 06 (sau) CrngCll'vien;

g) c6 dong ho~c nh6m c6 dong n~m giG' tLr70% (bay muoi ph~n tram) t6ng s6 c6 ph~n CO'quy€n bi~u quy~t tr6 len trong 06 (sau) thang lien t~ICdUQ'c d€ Clr dLI s6 CrngCll' vien d\1'ki~n b§.u,

Cac c6 dong ph6 thong tll nguy~n t~p hQ'p th~lI1hnh6m th6a man cac di€u ki~n quy dinh d~ d€ clrngu6'i van HDQT va BKS phai thong bao v€ vi~c de clr ho~c t~1'CrngClf (n~u cO') ch~m nhat ngay20/12/2019,2. Di~u ki~n va tieu chuAn d6i v6'iThanh vien HDQT va Thanh vien BKS:

a) Khong thuQc d6i tUQ'ng quy dinh t~i Khoan 1 Di€u 33 cua Lu~t cac T6 Ch(fCtin d\1ng nam2010 va Khoan 6 Di€u I Lu~t s6 17/2017 IQH 14 sua d6i, b6 sung mQt s6 dieu cua Lu~tcac T6 chCrc tin d\1ng nam 20 I0, bao g6m:Ngu6'i chua thanh nien, ngu6'i bi h~n ch~ ho~c bi mat nang 1\1'chanh vi dan Sll.Ngu'o'i dang bi truy cCru trach nhi~m hlnh S~I,dang chap hanh ban an, quy~t dinh v€ hlnhS~IClla Toa an.Ngu6'i da bi k~t an v€ tQi xam ph~m sO'hG'u ma chLl'aduvc x6a an tich.Ngu6'i aa bi k~t an v€ tQi tLrtQi ph~m nghiem trQng tr6 len.Can bQ, cong chCl'c, nguo'i quan Iy tLrcap phong tr6 len trong cac doanh nghi~p ma Nhamr6c n~m tLr 50% v6n di€u I~ tr6 len, tl"LIngLlo'i duQ'c ell' lam d~i di~n quan Iy ph~n v6ng6p clla Nha mr6c t~i t6 chCrc tin d~lI1g.Sy quan, h~ sy quan, quan nhan chuyen nghi~p, cong nhan qu6c phong trong cac CO' quan,don vi thu9C Quan dQi nhan dan Vi~t Nam; Sy quan, Iw sy quan chuyen nghi~p trong cacco' quan, don vi thuQc Cong an nhan dan Vi~t Nam, trLI'nguo'i dUQ'c cU' lam d~i di~n quanly ph~n v6n g6p cua Nha nu6c t~i t6 ch(l'c tin d\1ng.Ngu6'i thuQc d6i tUQ'ng kMng duQ'c tham gia quan ly, di€u hanh thea quy dinh Clla phaplu~t v€ can b9, cong chCt'cva phap lu~t v~ phong, ch6ng tham nhung.Nguo-i dii tLrng 1ftchu doanh nghi~p tu nhan, thill1h vien hQ'p danh Clla cong ty hQ'p danh,Giam d6c (T6ng giam d6c), Chu tich va cac thanh vien HQi d6ng quan tri, HQi d6ngthanh vien, Ban Ki~m soar cua doanh nghi~p, Chu nhi~m va cac thanh vien Ban qWln trihQ'P tac xii t~i thO'i di~m doanh nghi~p, hQ'p tac xii bi tuyen b6 pha san, trLI'truong hQ'pdoanh nghi~p, hQ'Ptac xii bi tuyen b6 pha san VI ly do b~t kha khang.Ngu'o'i d~i di~n thea phap lu~t cua doanh nghi~p t~i tho'i di~m doanh nghi~p bi dlnh chiho~t d9ng, bi bU9C giai th~ do vi ph~m phap lu~t nghiem trQng, trLt'truo-ng hQ'p la d~i di~n

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thea d~ nghi ella co quan nha nuoc co thAm quyen nham chan chinh, cung e6 doanh

nghiep do.Nguo! dil tung bj dinh chi chuc danh Chu rich HQi dong quan tri, thanh vien HQi dong

quan trj, Chu tich HQi d6ng thanh vien, thanh vien HQi dong thanh vien, Truong BanKiern soat, thanh vien Ban Kiern scat, T6ng giam d6e (Giam d6e) ella t6 chirc tin dungtheo quy dinh tai Di~u 37 ella Luat cac T6 chuc tin dung narn 2010 hoac b] co quan cothftm quyen xac dinh nguoi do co sai pham dAnd~n viec t6 chirc tin dung b] thu h6i Gi~yphep,Nguoi phai chiu trach nhiern thea k~t luan thanh tra dAnd~n viec Ngan hang b] XLI' phat vipharn hanh chinh trong linh vue ti~n t~ va ngan hang o' khung ph~t ti~n cao nh~t d6i v6ihanh vi vi ph~m quy dinh v~ gi~y phep, quan tri, di~u hanh, e6 ph§n, c6 phi~u, gop v6n,Illua c6 ph§n, dp tin d\lIlg, Illua trai phi~u doanh nghi~p, ty I~ bao dam an toan theo quydinh ella phap lu?t v~ XLI' Iy vi ph~m hanh ehinh trong ITnhv~reti~n t~ va ngan hang.

b) Tuan thll Di~u 34 ella Lu?t cae T6 eh(re tin d~lI1gn3m 20 I 0 v~ nh[i'ng tnro-ng hQ'Pkhongeung dam nhi~m eh(reV~I:Thanh vien HQi d6ng quan tri ella t6 ehLretin dVng khong dU'Q'ed6ng tho-i la ngu'oi quanIy ella t6 eh(re tin d\lIlg khae, trCrtnro'llg hQ'Pt6 eh(re nay la eong ty con ella t6 eh(fe tind\lIlg do. Thanh vien HQi d6ng quan tri ella t6 eh(re tin dvng khong dUQ'ed6ng tho'i lathanh vien Ban ki~m soM ella t6 eh(l'etin dVng do.

c) Co d~o d(fe ngh~ nghi~p;d) Co b5ng d~i hQetr6 len (Khoim 10 Didu I Lu(it s6 1712017IQH14 st'ra tl6i, b6 sung mpt

s6 tlidu cua Lu(it cac T6 cht{·c tin d1;lngnam 20 I0 (St'ra tl6i, b6 sung tlidm c khoan IDidu50 Lu(it cac TCTD 2010);

e) Co it nh~t 03 n3m la ngu'o'iquan Iy, nguo'i di~u hanh ella t6 eh(re tin d\lIlg ho~e co it nh~t05 n3m la nguo-i quan Iy, ngll'o-i di~u hanh ella doanh nghi~p ho~t dQng trong nganh taiehinh. ngan hang. k~ toanoki~m toan ho~e ella doanh nghi~p khae co v6n ehLISO' hu'u t6ithi~u b5ng m(fe v6n phap dinh d6i v6'i 10~lihinh t6 eh(re tin d~lIlg tuong (rng ho~e co itnh~t 05 n3m lam vi~e tr~re ti~p t?i bQ ph?n nghi~p V~Iv~ tai ehinh, ngan hang, k~ toan,ki~m toan (Khoan 10 Ditu I Lu(il s6 1712017IQH14 Stt'Gtl6i, b6 sung mpl .\'6 tlitu cuaLu(il cac 16 Chl,f'Ctin d(mg nam 2010 (86 sung tlidm d VaG khoan I Ditu 50 Lu(it cacTCTD 2010)

3. D6i vO'i thanh vien d(lc I~p clh H(li d6ng qUlin trj, ngoai cac tieu chld~n, (1i~u ki~n quydjnh tl;li di~m 2 Ml}c III nen tren, con co cac tieu chuftn, di~u ki~n sau day:

a) Khong phai la nguo'i dang lam vi~e eho ehinh t6 eh(re tin dVng ho~e eong ty con ella t6eh(re tin d\lIlg do ho?e dil lam vi~e eho ehfnh t6 eh(fe tin dVng ho?e eong ty con ella t6ehLretin d~lIlg do trong 03 n3m li~n k~ tru6'e do;

b) Khong phai la nguo'i hU'6ng luong, thu lao thLro'llg xuyen ella t6 eh(re tin d\lI1g ngoainhu'ng khoan plW dp eLlathanh vien HQi d6ng quan tri dLrQ'ehU'6ngtheo quy dinh;

c) Khong phili la nguo-i co VQ',eh6ng, eha, Illy, con, anh, chi, em va VQ',ch6ng ella nhu'ngngu'o-inay la e6 dong 16nella t6 eh(re tin d\111g, ngu'o-iquan Iy ho?c thanh vien Ban ki~111soat eLlat6 eh(rc tin d\lI1gho?e eong ty con clla t6 ch(rc tin d~lI1g;

d) Khong tr\re ti~p, gian ti~p sO'hUll ho?e d?i di~n SO' hCl'utCI'1% v6n di~LI I~ ho?e v6n e6ph§n co qLly~n bi~LIquy~t treYlen cLlat6 eh(rc tin d\lIlg; khong CLlI1gnguo-i co lien quan SO'

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hiiu ttl' 5% v6n ai@u I~ hoac v6n c6 phan c6 quyen bi~u quyet trc len cua t6 ChLI'Ctindung;

e) Khong phai la nguoi quan ly, thanh vien Ban kiern scat cua t6 ChLI'Ctin dung tai b~t kythoi ai~111nao trong 05 narn Ii@nk@truce 06.

III. HO sa uNG CU, DE CtY VA cAc THU Tl)C LIEN QUAN:1. Danh rnuc h6 SO',g6m co:

a) DO'n ung cu/c1@CLI'tharn gia HDQT, BKS (ap dung cho tnrong hop tu ung Cll'!c1@ctr, Mill01): 03 ban goc;

b) Thong bao a@cu ung cu vien tham gia HDQT, BKS (ap dung cho truong hQ'P nh6m c6dong d@cu, Mill 02): 03 ban goc;

c) Truong hQ'P do Phap nhan d€ cu ung cu vien d€ nghi gui: Nghi quyet HDQT va Congvan cua Phap nhan d€ CLI'nguoi tham gia vao HDQT, BKS NCB: M6i loai 03 ban g6c;

d) Ban ke khai Iy lich do ung cir vien W khai (Mill 03): 03 ban goc;e) Phi~u Iy lich tu phap (LLTP) cua Lrng vien do So' Tu' phap cfrp: 03 ban g6c. Trucmg hQ'p

Lrng vien khong c6 qu6c tich Vi~t Nam, Phi~u LLTP phai au'Q'c co quan c6 th~m quy@ncua nu'O'c ma nguo-i nuO'c ngoai cu tru truO'c khi a~n Vi~t Nam cfrp. Trucmg hQp nguo-inu'O'c ngoai hi~n da CU' trLI t~i Vi~t Nam ttl' au 6 thang tr6 len thl Phi~u LLTP do co quanquan Iy co so' du' li~u Iy lich tu' phap t~i Vi~t Nam nO'i ngU'()'jnuO'c ngoai aang CU' trLIcfrp).Phi~u LLTP phai c6 d~y dll thong v€ an tich (bao g6m an tich da all'O'c x6a va an tfchclma du'O'cx6a) va thong tin v€ cftm aam nhiem ChLI'Cvu, thanh lap, quan Iy doanh nghiep(m§u 02 thea quy dinh cua SO'Tu phap);

f) Bao cao cong khai IQ'ifch lien quan cua Lrng vien (Mill 04): 03 ban g6c;g) Ban khai ngLH)ic6 lien quan Clla Lrngvien (Mill 05): 03 ban g6c;h) CMND/HQ chi~u va cac van b~ng, chLrng chi chu'ng nh~n trinh dQ van h6a, trlnh dQ

chuyen mon. Cac van ban khac chu'ng minh ung cu' vien all tieu chu~n va ai€u ki~n theaquy dinh t~i Lu~t cac T6 chu'c tin dl,lng nam 20 I0 (n~u c6): 03 ban sao c6 chu'ng th~l'c,

LU'u V:Phi~u ly lich tll' phap (ho?c van ban c6 gia tri tuO'ng auO'ng) va cac van ban chung thl,l'ckhac phai aUQ'c cfrp trong tho-i h~n 06 (sau) thang tinh a~n tho'i ai~m n9P h6 sO' a€ nghich~p thu~n danh sach dl,l'ki~n nhan S~.

Van ban trong h6 sO' phai au'Q'c l~p b~ng ti~ng Vi~t Nam. Van ban I~p 6' ml'6c ngoai phaidUQ'c hQ'p phap h6a lanh Sll va dich sang ti~ng Vi~t. Cac ban sao ti~ng Vi~t va cac bandich ttl' ti~ng ml'6c ngoai sang ti~ng Vi~t phAi dUQ'c co quan c6 thttm quy€n chu'ng thl,l'cthea quy ainh cua phap lu~t.

2. NO'i nh~ll h6 SO'll'l1g CU', a~ CLr d~ bAll b6 sling th~lllh vien HDQT va BKS nhi~m ky 2015-2020:H6 sO' u'ng CLI',a@cCI'thea quy ainh aU'Q'cgCl'itr~l'c ti~p ho?c gu'i qua Buu ai~n du6i hlnh thu'c baoaam a~n:

Van phong NCBSB 28C - 28D, phB Ba Tri~ll, phU'(Yng Hang Bai, QlI~1l Hoan Ki~m, TP. Hit NQi.Di~n tho~i: (024) 6269 3355 (May Ie: 1887) Fax: (024) 62693535Email: vphdgt2@ncb-bank.vn Website: www.ncb-bank.vn

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3. Thoi gian nh~n hA so': d€n h€t 17 gio 00 ngay 20 thang 12 narn 2019. Cac h6 so gir! d€nNCB sau thoi gian tren se khong c6 gia trio4. Theo quy djnh ciia Phap lu~t, danh sach cac ung vien dU'Q'cd~ CIT, ung CIT phai dU'Q'cNgan hang nha nmrc Vi~t Nam chAp thuan trutrc khi D~i hQi dAng c6 dong thuc hi~n bAub6 sung lam Thanh vien HDQT va Thanh vien BKS NCB.Ngoai cac nQi dung da thong bao neu tren, cac nQi dung khac (neu c6) se duoc thirc hien theaquy dinh hien hanh cua phap luat lien quan va Di~u I~NCB.

Trfin trong thOng bao!

No'; nhiin:- Nhu K/g;- Luu: Vanphong NCB; BP Van thu.

TM. HOI D<?NG QUAN TRI~'.I,···CHU TTCH.... "(:1

CHU T!CH HDQT

NGUYEN TIEN DUNG

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MAuOl

CONG HOA xA HOI CHU NGHiA VIET NAM. . .DQc L~p - Tl! do - Hanh phuc

HQi Dang Quan Tr] Ngan hang TMCP Qu6c Dan.

Hom nay, ngay tai .

Toi la c6 dong ca nhan/nguoi dai dien cua c6 dong t6 chirc cua Ngan hang

TMCP Quoc Dan (NCB), co ten sau day, sa hC'rutren phan tram ( %) t6ng s6

c6 phan pho thong cua NCB trong thai han lien tuc it nh~t sau (06) thang truce ngayhom nay, cu the:

HQ va ten: Quoc tich: .

s6 CMNDIHQ chieu: dp ngay tai .

Dia chi: ..

Dai dien c6 dong cua t6 chirc (neu fa dai dien cua c6 dong t6 chuc):

Ten to chirc: .

DKKD: cap ngay tai .

Dia chi tru so cua to clurc: .

s~ ;: I ~ NVB . ~. 'I - ~ h;_o co p 'ian ma toi sa 1UU: co pan.

Bang van ban nay, Toi xin duoc thong bao va cam k~t voi HQid6ng Quan tri NCB nhir sau:

1. Toi tv nguyen tv irng clrld~ cu nguoi (nhung nguai) co ten duai day ra D~i hQi

d6ng c6 dong b~t thuang clla NCB d~ duQ'c b~u lam Thanh vien HQi d6ng Qufll1tri/Thanh vien Ban Ki~m soar cho nhi~m ky 2015-2020 clla NCB nhu sau:

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MAuOl

STT HQ va Ngay Quae saCMND Dja chi sa c6 ph~nTen frng thang tjch SO' hfru taivien narn sinh NCB

2. Toi cam k~t dam baa duy tri ti l~ sa htru tren muoi phan tram (10%) t6ng s6 c6phan ph6 thong cua NCB trong thai han lien tuc it nhat sau (06) thang tnroc ngayhQP Dai hoi dong c6 dong b~t thuong cua NCB d~ dam baa hieu I\Ic phap ly cuaviec irng clr/d~ cir cac ung vien tren vao HQiDong Quan TrV Ban Ki~m soat cua NCBtai ngay hQPDai hoi d6ng c6 dong b~t thuong.

3. Toi cam doan va chiu trach nhiem truce NCB, tnroc phap luat v~ cac noi dung cuavan ban tv irng clr/d~ cir nay.

4. Toi xin gtri kern thea thong baa nay h6 sa cua cac ung vien i?p thea dung qui dinhcua phap luat va thea yeu cc1ucua NCB.

CO DONG(Ky, ghi r8 h9 ten)

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MAu02

CONG HOA xA HOI CHU NGHiA VI~T NAM

Kinh gll'i: HQi dAng Quan tr] NCB.

Hom nay, ngay thang nam 2019, can cir thong bao s6 /2019/NCB-HDQTngay 112/2019 cua Hoi d6ng Quan tri Ngan hang TMCP Quoc Dan (NCB),toi/chung toi la c6 dong/nhom c6 dong sa htru/nr nguyen t~p hQP thanh nh6m c6 dongso htru tren tong s6 c6 phan ph6 thong cua NCB trong thai han lien tuc itnhat sau (06) thang truce ngay hom nay.

Toil chung toi xin thong bao va cam k~t voi Hoi dong quan tri/Ban Ki~m soar NCBnhu sau:

1. Th6ng nh§.t d~ CLI" nguoi co ten duoi day duoc b~u b6 sung VaGHDQTfBKS nhiemky 2015-2020 nhu sau:

STT HQ ten frng cir vien sACMND, NO'i dp, Ngay dp

I

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...

2. Toil Chung toi cam ket irng vien dam bao cac tieu chuan, di~u kien thea quy dinhphap luat, Di~u I~ NCB; dong thoi cam ket dam bao duy tri ty I~ so hiru s6 c6 ph~nNCB trong th6'i gian lien n,lc it nh§.t sau (06) thang (tll' d~n................. )1 va vi~c t~p hQP thanh nh6m c6 dong thea danh sach du6i day d~n ngayhQP D<;lih<)id6ng c6 dong b.1t thucmg, nh~m dam bao hi~u Ivc phap Iy clla vi~c d~ clicac u'ng vien tren, d~ D<;lih<)id6ng c6 dong b~u b6 sung VaGHDQT/BKS NCB nhi~mky 2015-2020,

3. Toil Chung toi xin gll'i kern thea thong bao nay h6 sa c6 lien quan clla u'ng cli vienI~p thea dung quy dinh CLIa phap lu~t.

Thong tin CEldonglDanh sa.ch cac c6 dong t~p hQ'pthanh nh6m:

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MAU02

CHO' KYSO CP so HO'U TY (VA DONG DAu

HQTEN co SO LIEN TI)C L~/TONG TRONG TRUONGSTT DC)NG CMND/DKKD TRONG VONG 6 SOCO HQP CO DC)NG LA

THANG TRUOC PHAN CllA D~I DI~N PHANNGAY HOM NAY NCB VON GOPCLJA

DOANH NGHI~P)

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3 ...

TONG CONG

Dong thai chung toi thong nhat CLI" Ong/Ba lam dai dien Nh6m d~

thuc hien cac thu tuc d~ CLf thea dung quy dinh v~ viec tham gia d~ ctr vao HUQTIBKS cua NCB nhiem ky 2015 - 2020:

Ong (Ba): .

CMNDIH(J chieu s6: Ngay cdp: NO"icdp: .

Dia chi thuong tru: .

Trinh d(Jh9C vdn: Chuyen nganh: .

Hien dang sa hiiu: c6 phdn (Bang chic: .)

'T'. ' ,.;: ~ h ., I' (;I ~ ,)1 U071gung vat tong men gia a taong): .

... ngay thang ndm 2019

£)~I DI~N NHOM'

(Kf; WI ghi ro ho ten)

'U6i voi c6 dong phap nhan:- Nguoi dai dien thea Phap luat ky ten va dong dau, hoac:- Twang hop phap nhan cir dai dien g6p von (dai dien thea uy quyen) thi nguoi dai dienky ten va dinh kern cac van ban cir nguoi dai dien thea quy dinh.

2/2

MAu03

sa YEU LV LICH(l)

1. v~ban than .... Anh he>chieu(4x6cm)

- HQva ten khai sinh.

- HQva ten thuorig goi.

- B1 danh.

- Ngay, thang, nam sinh.

- Nai sinh.

- Quoc tich/cac quoc tich (neu co).

- Dia chi thuong tru thea he>khau, dia chi thea chirng minh nhan dan/can cuoc cong dan va diachi cir tru hien nay.

- S6 chirng minh nhan dan/can circe cong dan (hoac he>chieu/giay to clurng thirc ca nhan hQ'Pphap tuong duorig khac); Ngay, thang, nam va nai cap chirng minh nhan dan/can circe cong dan(hoac he>chieu/giay to chtrng thuc ca nhan hop phap tuong dirong khac),

- Ten, dia chi cua phap nhan rna minh dai dien, ty I~ von gop diroc dai dien (tnrong hop la ngiroidai dien ph~n von gop cua c6 dong hoac thanh vien gop von la phap nhan hoac la nguoi duoc cirlam dai dien phan v6n gop cua Nhc1nuO'c t~i t6 chu·c tin dvng).

2. Trinh dQ hQc v5n

- Giao dvc ph6 thong.

- HQc ham, hQc vi (neu r6 ten, dia chi truang; chuyen nganh l19c; thai gian l19c; b~ng dp (Ii~t ked~y du cac b~ng dp).

3. Qua trinh cong tac:

- Nghe nghiep, dan vi, chirc vu cong tac nr nam 18 tu6i d~n nai2).

Thai gian (nr Dan vi cong Linh V1lCheat dong cuaSTT hang/nam d~n Chirc V\l(4) doanh nghiep va nhiem Ohi ChU(5)

hang/ni'un)(3) tacvu diroc giao

- Khen thuong, ky luat, trach nhiern thea k~t Iuan thanh tra dan d~n viec t6 chirc tin dung, chinhanh ngan hang mroc ngoai bi xu phat vi pham hanh chinh(6).

4. Nang It.t'c hanh vi dan S,!(7)

5. Cam k~t trurrc phap lu~t

Toi cam k~t:

- Dap irng tieu chuan, dieu kien d~ gifr chirc danh ... tai t6 chirc tin dung, chi nhanh ngan hangmroc ngoai.

- Khong vi pharn cac quy dinh cua phap luat trong linh VIJCtien t~ va ngan hang.

- Thong bao cho t6 chirc tin dung, chi nhanh ngan hang nuoc ngoai ve b~t ky thay d6i nao lienquan d~n n9i dung bim khai nay phat sinh trong thai gian Ngan himg Nha nuac dang xem xet denghi cLla... (ten t6 chuc tin d\lng, chi nhanh ngan hang nuac ngoai).

- Cac thong tin ca nhan Toi cung dp cho t6 chuc tin d\lng, chi nhanh ngan hang nuac ngoai d€trinh Ngan himg Nha mrac xem xet, ch~p thu?n dV ki~n nhan sv la dung S\l' th?t. Toi xin chiutrach nhi~m tnrac phap Iu?t ve tinh d~y du, trung th~rc, chinh xac Clla cac thong tin ke khai neutren.

...., ngay ... thang ... nam ......Chii' ky va hQ ten d~y do coa ngU'O'i khai

(Chung th~rcchi1:kY nguc}i khai)

Ghi chu:1. Nguai khai phai ke khai ddy du thong tin thea yeu cdu va chiu trach nhi?m tru6'c phap lw;it vat6 chirc tin d1:mg,chi nhanh ngan hang nu6'c ngoai v~ tinh ddy du, chfnh xac, trung th1:rccua h6sa, truong h(Jp khong phat sinh thi ghi ro khong co.2. Nguai khai phai ke khai ddy du cong vi?c, don vi cong tac, cac chirc V1:{ da veldang ndm girl'3. Phai dam bao tfnh lien t1:ICv~ m(lt thai gian.4. Neu ro niu nhdn S1:f lel nguai quan ly, nguai di~u hanh theo quy djnh cua philp lu4t vel f)i~u I?ctta t6 chit'c tin dZ:Jng,daanh nghi?p.

2

5. Ghi chu neu don vi cong tac thuoc cac truong h9'P sau:a) Cong ty can cua t6 chuc tin dung;b) Doanh nghiep rna Nha nutrc So' hiiu tic 50% v6n di~u If tro len:c) Dan vi thea quy dinh tai diem e khoan 2 [)i~u 33 Ludt Cdc t6 chuc tin dung;d) Dan vi thea quy dinh 19i diem c, d khoan 1 Di~u 33 Ludt Cac t6 chuc tin dung;6. Ghi cu thi neu nhdn SI! thuoc truong h9'Pneu tai diem d, h khoan 1 ou« 33 Ludt Cac t6 chuctin dung7. Ghi cu thi- ddy du/han chi/mat nang lice hanh. vi dan su.(Ngoai nhiing n{ji dung co' ban tren, ngU'iJ'ikhai co thi b6 sung cae n{ji dung khdc niu thaycan thiit)

3

, < '~' 't,'"~<':1/ NOAN HANG .... \ MAu 04flit 0 A, , A

;\!\rHlldN~~~IG6~PHAN;1 CONG KHAI LQI ICH CO LIEN QUAN'" 0!(''a9POC.DAN' ,>-'rj, T~ hi' in d ~ ')010 '" , khai , I i Ich 'I" h'\ ',:>fi~u tJleu'39t ""cac 0 C U'Ctin ung nam _ , tOI xin cong at cac Q"I IC co len quan n usau:\1) ,~~ , ' , "' "~ ,.~~,~~_!J' ~lgOoanh nghi~p rna toi va ngu'o'i co lien quan dang la thanh vien H(ii dong quan tr], thanh vien H(ii dong thanh vien, Thanh vien Ban kiem soat, Tonggiarri" ot' am doc:

STT Ten Ooanh nghi~p Nganh, ngh~ kinhdoanh

S6, ngay dp, nrridp gi~y chuug

nh~n f)KKD/Gi~pphep thanh I~p

S6 c6ph~n/v6n gop

Ty I~Nf)LNgu'o'i colien quan Chirc vu Ghi chuOoanh

nghi~p

2

45

3

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- --I--~~~-I--"--~--'--- --- ----~~__l----

'-f------

-t-- -~~_l--

2. Oanh sach nhii'ng Ooanh nghi~p/TCKT rna toi va nglro'i co lien quan dU'ng ten so' hfru ph~n v6n gop, c6 phan hoac uy quyen/uy thac cho ca nhan/t6 clurc khac dU'ngten til' 5'1.. v6n di~u I~ tro' len:

STT Ten Ooanh nghi~p Trl.! so' chinh Nganh, ngh~ kinhdoanh

S6, ngay dp, no'idp gi~y chu'ng

nh~n f)KKD/Gi~pphep thanh I~p

S6 c6ph~n/v6n gop

Ty I~Nf)L

Uyquy~n/iiy

Ngu'i'ri co thac cholien quan c:I nhan/tA

chu'c khac(n~u co)

Ghi chuOoanhnghi~p

I2345-

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- .. --'-_l-~~~--I---~- ..

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Toi xin cam doan nhung thong tin neu tren la hoan toan d~y du, chinh xac va trung th\lc. NSu sai toi xin chiu mQi trach nhi~1ll tru6"c D(_lih9i d6ng c6 dong va tru6"c phap lu~t.

----- -- - --~~__t_ ..---

............... , Ngay thang nam .NGU'cn KE KHAI(Ky, ghi ro ho ten)

MAU05

(Ban hanh kern Thong tu s6 22/20 18/TT-NHNN ngay 05 {hang 9 nam 2018 cua Th6ng a6c Ngdnhang Nha nuac huang ddn thu tuc, h6 S(J chap thudn danh sach du kdn nhdn su cua ngdn hang

thu . ,,: hue tin dung phi ngdn hang va chi nhanh ngdn hang nuac ngoai)

!<?f NGAM,i~rlG~O HOA XA H(H CUlT NGHiA VI~T NAMt;(THUdMG,,~A1CO~PH~'KI:J DQc l~p - Tl}' do - H~nh phuc\~~\. (lI1Oe DAN)~1 ---------------~,~~

Ban ke khai nguoi co lien quan

NgU'o; khai S6/ngay Chirc vu Chirc vt,l tai Ty I~sO' hiru cA

va "ngU'('ri co M6i quan chung minh tai to Cong ty con phAn ho~c ty I~

STT lien quan" h~ v6i nhan dan chirc tin cua tA chtrc v6n gop dai dienho~c can currc tai tA chirc tin ...

ella nguo'i nguiri khaicong dan/HQ dungd~ tin dungd~ dungd~ngh]khai

ehi~u ngh] nghi(%1

(1) (2) (3) (4) (5) (6) (7) ...

1 Nguyen Van INguoi khaiA

2 Nguyen Thj B IVg...

Toi cam k~t cac thong tin cung dp tren day la dung SI,!' th~t. Toi xin chiu trach nhi~m tnr6c phaplu~t v~ tlnh d~y au, trung thl,l'C,chinh xac cua cac thong tin ke khai neu tren .

..... , ngay ... thang ... narnNgU'<ri khai

(Ky, ghi ro ho ten)

(Chung tl1\,l'cchfr ky nguai khai)

Ghi ehu:

- D6i vai phdn ke khai ngU'Crico lien quan t(li c(Jt (3): Can cu' rn6i quan h~ thlj'c ti cua ngU'Cricolien quan t(li c(Jt (2) Ihu(Jc trU'Crnghop Cljthd thea quy ajnh '(Ii khaan 28 Di§u 4, khaan 2 Didu 62Ludt Cac t6 chu'c tin dung va quy ajnh co lien quan ad ai§n vaa c(Jtnay

(Ngolti nhtl'1lg n{Jidung tiJi thidu neu tren, ngu,(J'ikIwi co tId bJ sung cae n{Jidung kJuic niuthity can tlliit)