MALTA FINANCIAL SERVICES AUTHORITY
Authorisation Forms

Form AA117: Notification Form for the opening of a new Branch locally or in a third country
High Level Guidelines
General This form, Form AA117: Notification Form for the opening of a new Branch locally or in a third country (‘Notification’), shall be duly filled in by Maltese Financial Institutions wishing to open a new branch locally or in a third country as per Article 8 of the Financial Institutions Act (Chapter 376 of the Laws of Malta). In this respect, the Maltese Financial Institution (hereinafter ‘the Applicant’) shall to the best of its knowledge, provide information, which is truthful, accurate and complete. The Applicant shall notify the MFSA immediately if the information provided changes in any respect either prior to or subsequent to authorisation. The Applicant shall note that it is a criminal offence, under Article 22(1)(c) & (d) of the Act, to furnish information or to make a statement which one knows to be inaccurate, false or misleading in any material respect, or to recklessly furnish information or to make a statement which is inaccurate, false or misleading in any material respect, pursuant to any of the provisions of this Act or of any Regulations made or of any Rules issued thereunder, or any condition, obligation, requirement, directive or order made or given as aforesaid. The Applicant is required to make reference, and where applicable comply with, the Act, the Regulations made, or Rules issued thereunder during the completion of the Application. The Applicant shall also refer to the respective National and/or European Regulatory Frameworks or other binding regulation as may be applicable. The Applicant shall not tamper with, or modify in any manner, this Application or its respective Annexes. Should it transpire that the documents were tampered with, or modified in any manner, the Authority shall consider the Application to be invalid. Any potential improvements should be communicated to the MFSA for consideration. The Authority may at its sole discretion request from the Applicant further information/documentation. Definitions For the purposes of this Notification, the definitions identified below should be read in conjunction with the provisions of the Act. In the event that any of the definitions contained hereunder conflict with a definition under the Act, the definitions set out in the Act or in any other such law shall prevail, unless otherwise specified herein. ‘Act’ means the Financial Institutions Act (Chapter 376 of the Laws of Malta) ‘Authority’ means the Malta Financial Services Authority established by the Malta Financial Services Authority Act (Chapter 330 of the Laws of Malta) Instructions The Applicant is required to complete all the respective sections of the Application, as follows: Section 1 – Applicant Details Section 2 – Details of Branch Section 3 – Activities of Branch Section 4 – Governance & Internal Controls Declaration Form Applicants are to note that further instructions in relation to the Notification may be found on the Guidelines to the Authorisation Forms (link). It is noted that the Application should reflect the Applicant’s structure and method of operations at time of notification. Following submission of the Application via the LH Portal, the Declaration Form should be printed and sent, originally signed, to the Authority. In the printed Declaration Form, the Applicant is reminded to enter the Application ID, which is provided automatically through the LH Portal upon on-line submission of the Notification. It is to be noted that only this Declaration Form should be sent physically to the Authority, unless it is signed using a valid qualified signature in accordance with the circular issued by the MFSA on the use of electronic signatures dated 15 November 2022. Further instructions can be found in the Declaration Form itself. In order for the Notification to be considered complete, the Applicant is required to have submitted, along with a duly filled Application, all the required documentation as identified within this Notification. Privacy Notice The MFSA ensures that any processing of personal data is conducted in accordance with Regulation (EU) 2016/679 (General Data Protection Regulation), the Data Protection Act (Chapter 586 of the Laws of Malta) and any other relevant European Union and national law. For further details, you may refer to the MFSA Privacy Notice available on the MFSA webpage https://www.mfsa.mt/privacy-notice/. Disclaimer It is noted that the submission of this Notification and/or its determination of ‘completeness’ shall not be construed as a granting of authorisation by the MFSA.

Applicant Details
Identification Details
Authorisation ID	Enter text
LEI Code (if available)	Enter text
Registered Name	Enter text
Registered Number	Enter text
Contact Person (Note: This refers to a contact point of the Applicant)
Title	Select item
Name	Enter text	Surname	Enter text
Business Email Address	Enter text	Business Direct Number	Enter text

Details of Branch
Branch Details
General Details
Name of Branch	Enter text
Company Registration Number or equivalent	Enter text
Branch Address
Number/Name	Enter text	Street/Road	Enter text
City/Town/Village	Enter text	Region/State	Enter text
Post Code	Enter text	Country	Enter text

Activities of Branch
Proposed Activity
Proposed date of commencement of activities/services	Enter date
Country in which the Applicant intends to operate	Enter text
Proposed Financial Service Activity to be undertaken by the Branch Indicate the proposed activities of Financial Institutions, as set out in the First, Second and Third Schedule of the Act, which the Applicant intends to undertake through the Branch.
Lending (including personal credits, mortgage credits, factoring with or without recourse, financing of commercial transactions including forfaiting, Equity Release)	Select item
Financial leasing	Select item	Venture or risk capital	Select item
Payment Services set out in the Second Schedule of the Financial Institutions Act	Services enabling cash to be placed on a payment account as well as all the operations required for operating a payment account	Select item
Services enabling cash withdrawals from a payment account as well as all the operations required for operating a payment account	Select item
Execution of payment transactions, including transfers of funds on a payment account with the user’s payment service provider or with another payment service provider:	execution of direct debits, including one-off direct debits	Select item
execution of payment transactions through a payment card or a similar device	Select item
execution of credit transfers, including standing orders	Select item
Execution of payment transactions where the funds are covered by a credit line for a payment service user:	execution of direct debits, including one-off direct debits	Select item

Activities of Agent

execution of payment transactions through a payment card or a similar device	Select item
execution of credit transfers, including standing orders	Select item
Issuing of payment instruments	Select item
Acquiring of payment transactions	Select item
Money remittance	Select item
Payment initiation services	Select item
Account information services	Select item
Issuing and administering other means of payment (travellers cheques and bankers’ drafts and similar instruments) insofar as this activity is not covered by point 4 above	Select item
Guarantees and commitments	Select item
Trading for own account or for account of customers in:	money market instruments (cheques, bills, Certificates of deposit and similar instruments)	Select item
foreign exchange	Select item
financial futures and options	Select item
exchange and interest rate instruments	Select item
transferable securities	Select item
Underwriting share issues and participation in such issues	Select item	Money broking	Select item
Issuing of Electronic Money as set out in the Third Schedule of the Act	Select item
Shall the branch also distribute and, or redeem electronic money?	Select item
Section 4 – Governance & Internal Controls
Identification & Contact Details of Director/s and, or Person/s Responsible for the Management of the Branch
Directors & Persons Identification Details (Note: This sub-section may be repeated as necessary)
Title	Select item
Position	Enter text
Name	Enter text	Surname	Enter text
Business Email Address	Enter text	Business Direct Number	Enter text
Director/s responsible for the management of the branch must be fit and proper persons
Attachment | Personal Questionnaire of the Directors and Persons Responsible for the Management of the Branch
Attachment | MFSA Application AX02 - Involvement Suitability Assessment This Application shall be prepared by the Applicant for each individual submitting a Personal Questionnaire.
Detail of the Money Laundering Reporting Officer (“MLRO”)
Title	Select item	MFSA PQ Code	Enter text
Position	Enter text
Name	Enter text	Surname	Enter text
Business Email Address	Enter text	Business Direct Number	Enter text
Attachment | MFSA Application AX02 - Involvement Suitability Assessment
Attachment | Personal Questionnaire in relation to the appointment of the MLRO

Governance & Internal Controls

Business Plan
Provide a business plan, which demonstrates that the branch is able to employ the appropriate and proportionate systems, resources and procedures to operate soundly, comprising: main objectives and business strategy of the branch and an explanation of how the branch will contribute to the strategy of the applicant and, where applicable, of its group; a forecast budget calculation for the first three complete financial years.
Enter text
Attachment | Business Plan including Financial Forecast (Note: The Financial Forecast should include the budget calculation for the first three complete financial years)
Systems and Controls
Governance arrangements and internal control mechanisms, comprising the following items: description of the governance structure of the branch, including functional and legal reporting lines and the position and role of the branch within the corporate structure of the applicant and, where applicable, of its group; description of internal control mechanisms of the branch, including the following items: internal risk control procedures of the branch, the link with the internal risk control procedure of the applicant, and where applicable, of its group; details of the internal audit arrangements of the branch; details of the anti-money laundering procedures to be adopted by the branch in the country.
Enter text
Attachment | Policies and Procedures
Outsourcing of Operational Functions (if applicable)
Name of Outsourcing Service Provider	Enter text
Address of Outsourcing Service Provider
Number/Name	Enter text	Street/Road	Enter text
City/Town/Village	Enter text	Region/ State	Enter text
Post Code	Enter text	Country	Enter text

Governance & Internal Controls

Contact Details of a person within the Outsourcing Service Provider
Title	Select item
Name	Enter text	Surname	Enter text
Business Email Address	Enter text	Business Direct Number	Enter text
Attachment | Outsourcing Contractual Agreements

Declaration Form
Following submission of the Application, this Declaration Form should be printed and sent, originally signed, to the attention of Authorisations, Fintech Supervision Function, MFSA. It is to be noted that only this form should be sent physically to the Authority and that should the Applicant submit the entire Application, only the version submitted via the LH Portal shall be maintained and used for the purposes of the MFSA’s authorisation processes. Where the Applicant is a natural person, this Declaration Form is to be signed by the individual. On the other hand, where the Applicant is a not a natural person, this Declaration Form should be signed by the two signatories vested with legal representation of the Applicant.
The undersigned, on behalf of Applicant, declare that: Notification Submission and Authorisation Requirements the Applicant has resolved to submit this notification with the MFSA for the activities provided for within this Application; the Applicant has duly authorised the undersigned to complete and submit this Notification to the MFSA; the Applicant is aware of the requirements under the provisions of the Act; and the Applicant shall at time of authorisation, should this be granted, be in adherence with the obligations stipulated under point 1 (c) above. Information Provided to Authority the information given in answer to the questions within the Notification is complete and accurate to the best of our knowledge, information and belief and that there are no other facts relevant to this Notification of which the Authority should be aware; the Applicant has not tampered with, or modified in any manner, this Notification or its respective Annexes, and understands that such tampering with, or modification in any manner of these documents will result in a refusal of this Notification; there are no inconsistencies between the provisions of the Constitutional Documents, the documents submitted with this Notification (where applicable) and the information given in answer to the questions within the Notification; the MFSA will be notified immediately if the information given in answer to the questions within the Notification changes and/or affects the completeness or accuracy the Notification either prior to or subsequent to authorisation should this be granted; and this Declaration Form corresponds to the Notification submitted to the Authority via the LH Portal bearing the following ID: Application ID This ID is provided automatically by the MFSA through the LH Portal and is not required for the on-line submission of the Application. In this respect, following submission of this Application via the LH Portal the Application ID will be available on the submission page and also within the acknowledgement email. Enter text
the following documentation as indicated in the below have been submitted together with this Application: Checklist of Documentation to be Submitted with the Application Personal Questionnaire/s Enter number of submissions MFSA Application AX02 - Involvement Suitability Assessment Enter the number of submissions Organisational Chart Select Item Business Plan inc. Financial Forecast Select Item Policies and Procedures Select Item Outsourcing Contractual Agreements (if applicable) Select Item Any other document/s (if applicable) Select Item
Representatives and Disclosure the MFSA is hereby being authorised to make such enquiries as it may consider necessary in connection with this Notification; and the MFSA is hereby being authorised to contact any or all of the above-named or any other person considered by the Authority to be relevant, both at the date of notification and at any time in the future unless and until I/we rescind this authority in writing. Privacy Notice I/we have read and understood the MFSA Privacy Notice and the terms and conditions included therein.
Signature 1
Name	Enter text	Surname	Enter text
Position	Enter text	Date	Enter date
Signature 2
Name	Enter text	Surname	Enter text
Position	Enter text	Date	Enter date

For further information visit: https://www.mfsa.mt/privacy-notice/