ECMA FORM A2.1

APPLICATION FOR A SERVICES LICENSE (SAF, CISO, SC, IB, SPM, SB, SD OR SBD)

Instructions:

i. Applicants are required to complete relevant sections of the application form and submit same together with the applicable checklist of supporting documents written in English or Amharic, to the Authority.

ii. Where the supporting documents to be filed with the application are presented in any language other than the aforementioned, certified translated versions of such documents in English or Amharic, shall accompany the application.

iii. All sections of the application form that are relevant to the specific license(s) being sought must be completed. Where the response to a section is “Not Applicable”, it should be stated as such, with cogent reasons why the information is deemed not applicable. An application for a Services License will only be considered as having been filed when all complete documentation(s)/information have been submitted.

APPLICANT

SECTION 1: TYPE OF APPLICATION (Tick as applicable)

Securities Appraisal FirmCollective Investment Scheme (CIS) OperatorSecurities CustodianInvestment BankSecurities Portfolio Manager (Excluding Automated Investment Advisory Services)Securities Portfolio Manager (Including Automated Investment Advisory Services)Securities BrokerSecurities Dealer

SECTION 2: GENERAL INFORMATION

SECTION 2.1: Self-Evaluation Form