AI'PENDIX ATO SURPAR'I' I Oil ['AIT'[' I03 - D Ii N'I' AC C O U Til'S C li,ll'l' I FI C ATI ON RIT GARDI I{ G C O I{R.I' SI' ON FOlt FOITIIIGN tlAIt'lKS IOMB Control Number 1505-01841 to sectiotts 5318(il und Tlre informution containecl in this certificcttion is soughl pursuunt und 319(b) o-f the LISA 53lS(k) of Title 3l of the United Stcttes Code, as ocldecl b1'seclions 313 PATRIOT ACT oJ'2001 (I'ublic Law 107-56)' that nTairrtains a ctirresp.ndent This certification shoLrld be cornpleted by any {breign bankl. (a coverecl {inancial inslitution account rvith any L-J.S. banl< or I.J.S. broker-dealer in securitics bank is tloi rcqriiretl ttr as definecl in 31 C.F.lt. 103.175(0). An entity that is not a lilrcign cornplete thi s Certi f-lcation. oi'thc urri'L.--cl Stiitcs A lbreig, bank is a bank organized under lbreigrr larv and located or-rtside branciics. ancl age,cics ol' (see <letirrition at 31 C.F.R. 103.11(o)) A bank incluc.lcs ol'flccs. banl<s' thriii institutiorls' creriit commercial banks or trust ccltrtpatrics, private ballks, national pnder Iau's and sttpcrvised br parll<irlg r-r;tions, and other organizations ohartererj bankilg supervisors of any state (see definition at 3l C'F'R' t03'11(c))'1 cleposits 1i"ott't' tllai'c A correspondent Account fbr a foreign banl< is any acc()unt to rcccivc othcr linancial transactititts paytnents or cjisbursements orr behalf of a foreign banl<. or haudle related to the lbreign banl<. branch or oi'llce ola lJ's' banli outsicic Special instruction for loreign branches ol tJ.S. banlts: A is not rcquircci to complctc this trre ljnitccl States is a loreign bank. Such a branch or o1't'rcc branchcs aud olliccs of thc sat-ne certifrcation rvitl-r respect to cclrrespondent Ai:co.rnts rvith IJ.S. Ll.S. banl<. branches on a single ccrtiflcation: A tbrcig',tr balrl< ina,v Special instruction lbr covering multiple 'i'hc tl-re Unitcd statcs' co*plcte one certiiication for its branches and ol'llces oLttsicic arc covereci iincr rrust incluclc tlre certifrcatiorl mLlst tist ail ol. the bra,crres ancl 0frccs tl-rat part or'fice that mai.tains a corrcspo,clc.l Accourrt irrlbr,ration reqr_rirecr in c 1or each branch or shcets as necessary' with a covered Financial lnstiturtion. Use attachment .fhe ASIA llank i,imitccl ("l''tlrcign llanli") hcrcby' A. unclersignecl f rrrancial institution, NIC ccrtifics as lbllows: i as a or monctat')'t.n authoritv that lLtlctions 'A ,,loreign bank,, docs r-rot inclucie any foreigneipn ccrltralccntral banli central banli, banli ecl by trcatY or internaliotlal or any inlernational frnancial institution or regional agreement. Page 1 of 13 #S(r&\ - ${te A5!A BANK I-TD. RGGI51Gft€D OFFIC€ KAT:{MANN IJ. Correspontlent Accounts CoYerccl b1' this Certil'icatitln: Ttris Certification applies to all accourrts establishec1 1br l''orcigrr Ilar-rk by'Covcred I:inancial Institutions. C. l'}hysical Presence/ Itegulated Alliliate Status: NIC ASIA Bank Lirnited maintains a physical prescnce in't'rade forver Nepal''fhapathali- ll, I(athmandu, where it ernploys onc or rrore individLrals on a lirll-tirlc basis anci t'nairltains operati.g records related to its banking activitics.'l'he abovc addrcss is in Ncpal r'r'ircrr: Nl(l ASIA Bapk Lirnited is authorizecl to concluct barrking activitics. NIC ASln []anli [.imitcd is banking autlioritv sr-rb-iect to inspection by Nepal Rastra llank (Central Banl< ol'Nepal)' thc that licensed the NIC ASIA Bank I-irnited to conduct banking activities" .l-he prcscrrce NIC ASIA IJank Lirrited Branches, listed in tlte Anncxurc, rnaintaitr a plil'sical that means each NIC ASIA Bank l-imited l]rarrch: ()ne ,/ Ilas a place ol'business at tl-re acJclress listec'i in Atr.rrcxurc. u'hcrc it erlplors or more ernployees on a full time basis ancl maintains operatilrg rccorcls rclateti io its banking activities: bLrsiuess is ,/ Is ar-rthorizecl to conduct banking activities at placc rvherc its place of' looated; ,/ Is subject to inspcction by Nepal Rastra llank (Central llanl< of Ncpal) D. Indirect Use of Correspondcnt Accounls: bc itsecl '."t-r No Corresponclent Account maintainecl by a CoVerecl Financial lnstitLrtion trav l.rcrebl' inclirectty provide banking services to certain fbreigr"r barrl<s. NIC ASIA Ilanlt [-imitccl (lovcrccl certifies that it and its branches do not USe any Corrcsponclent Acctlrtnt u'ith a that docs not Firrancial Institutiol to indirectly provicle banl<ing services 1o an5' lbreign banl< maintain a physical presence in any coLrntry and lhat is a not a rcurtlatccl afliliate' E. Orvnership Information: NIC ASIA Bank Limired's shares are pLrblicly tradcci. I'}ubliclv traclcd lllcans that the sirares is rcgr-rlatccl b1' a are tradcd on an exchange or an organizecl over-lhc-countcr marl<ct that Act of' fbreign securities authority as definecl in scction 3(aX50) ol'rhc Scculilies lrxcharrg.c 1934 (l s l.J.S.C. 78o(a)(s0)). F. I'rocess Agent: resident of l'lre lollowing inclividual or cntity: Globol I'uyment Advit Group (GPAG) is a the United States at the following"street address: 4" #& r**c,As!A Page 2 of 13 H A, H !( t-T D. frec,steP€DNoFFtc€ 90\zillagc Grcen, Bardonia, Nerv York, 10954 [JSA, and is :tLrthorizcd to accept scrvice oi- legal process on behalf oINIC ASIA Bank I-irritcd lronr the Secretarl'ol-the 'l'reasurr,- orthc Attonrey General ol-the [Jnited States pursuant 1o Section 53 I 8(k) ol- title 3 I , tJnitcd Statcs Code. G. General NIC ASIA Bank Limitecl hereby agrees to notifll, in writing each (loverccl l]inancial Institution at r.vhich maintains any Correspottdent Account of atry chang,e irl lhcts or circumstances reported in this Certification. Nolillcation sirall be givclt rvithirt 30 calenclar days of such change. NIC ASIA Bank t,irnited undcrstancls that cach Coverecl Financial Institution at lvhich it n-raintains a correspondent Accounl rnay providc a copy ol-this Certif.rcation to the Secretary o1'the'freasury and thc Attorncy Gerreral of thc [,]nitcd Slatcs. NIC ASIA IJank Limited further uncicrstarrds that the statcrtrr--nts cotrtained in this Certiljcation may be transmitted to one or more departments or agencics ol-the L.Jrtited Statcs of America 1or the pLlrpose o1' fLrlfilling such departu-tcrt1s' ancl agcrtcics' govcrrlmclltal functions. I, Roshan Kumar Neupane, certify that I have read and undcrstand this Ccrtifrcation. thal thc statements rnade in this Certif-ication are complete and corrcct. and that I ani authofizccl to execute this certif-rcation on BehallolNIC ASIA Ilank l-inritecl' )f .4h w.a-qr,q. - t, Roshan l(umar-Neupane F\IEC ASXA '/V Acting Chief Executive Officer BANK LTtr. NIC ASIA Bank Limited, R€GISI€RED OFFIC€ I(ATHMANOU Executed on this 21't day of June,2018. Received and Reviewed By: Name: Title: For: (Name of Covered FinanciaI Institutiorr) Date: Page 3 of 13 Annexure: List oI NIC ASIA I]SIrILI,imited llranclteq Phone Numbers Regu I ator S, No Entity Branches Address NIC ASIA Nopal llastra uank Rcg ist ere d 'l.hapalhali t9/ I 1 511-11"'11/51L11/9 Ila nk 7 Limited Office I rade Tower, l.hapathali, l(athmandu NIC ASIA Ncpal I(!stra Bank 'I - 11 | 9/1 1 4263212.142.63)18 tlank 2 Limited Tripureswor riDUreswore, Kathmandu Metropolltan City NIC ASIA Ncpal Ilastra Bank - Ne!al, t97 I 2\ 52.1921. llank 3 Limited Iliratnagar Opposite D.S.P Office, Uiratnagar 3 NIC ASIA Nilpal Ilajrra tlank | 9 l't 1 55!55481 \555042/1,555064 llank 4 Limited Jawa lakhel lawalakhel, LalitPur NIC ASIA Nepai llastra tlank 1 977 2s 5u6980/5u6981/5869112 llank 5 Limited Itahari Itahari 1, Sunsari NIC ASIA t97 5)1 102, !9 l'l ? I 521145, Ncpdl Iiastra Ilank I 2l gAo,tgl,:'/OO tlnnk 6 Li m ited lla m llam 1, llam NIC ASIA Ncpa ltastra Bank 977 .1-4D32.6s1 4) 231691 42.)) 411 / 4? 31]43, []af l( 7 Limited New tload Meera llome, KhichaPokhari NIC ASIA NcpaL tlastra uank o1 1 -660801/ 660802/660U03 IJank 8 Limite d llanepa tlancpa 10, Kavre NIC A5IA Nepal I{as1ra Ilank )S/1 16()191821 ij619183/ 6619184 tlank 9 Limited Bhaktapur survabinavak Chowk, BhaktaPur NIC ASIA Ncpal ,lastr a Bank 9t /,2.3 540917 541415 . []anl( 10 t.imited llirtamod tlhadrJpur lload, llrrtamod / ASIA N1C Ncpal llastra uank Bank tg I /, 3 4561 I 5? 352,67 / 5234664 11 iimited Ka lan ki Kalanki, l(athmandu NIC ASIA Ncpai itasira Ilank t9 l'1 42.68876,425 /441 tlank 1,2 Limited Chhetrapati Chhetrapati, Kathmandu NIC ASIA Ncpa l{astra B.P. l(oirala lnstitute of llealth Sclcnces, (ihopa Bank Ilank 9 /7 - 02 s-533333/985203 1?"2-5 13 Lim rted Dharan Camp, i)hardn NIC ASIA Ncpal llastra Llank -43 /939 t 43 /939a llank Maharaj8unj r 91 t'1 /9396 1 43 I 1,4 Limited ara tpt Naravangopal Chowk, NlC ASIA N0prl llaitra tlank .tg| 7 -056 -57 OO34 1056-570035 tldfk 15 Limited Narayangarh ilharatpur Na. I)a.4, Lions Chowk NIC AS]A Ncpal Itasrra llank l)rfk I.]utwal, Ilupendehi +97 /-0.1),"543238 r6 l.i m itcd B utwa I Sharawan I)ath, NIC ASlA Ncpal liastra 1 97 / 061-s39645/0 6 t 5249 41"/ A61 Ilank 52 4).2A/98:,601317 6 tlank 1,7 Limited Pokhara Mahendra Pool, Pokhara +977-01.- NIC ASIA 43B7O5sl 438705619A:tr1) o t)a I t 9 / t'a1 Nopal tlastra Bank Ilank - 29 43IJ7061/01 4 r8o07n 18 Limited Samakhushi Samakhushi MetroPolitan Ntc ASlA Ncpal uastra Bank lla n l( l.loudha ) I I / O1 tt49969) I 4491 192/44931 93 19 Li m itcd uoudha Kathmandu 6, l.usal Chowk, NIC ASIA Nepal itattrn Bank Ilark t 9 /1 A1.'4)'t2.54'3 / 42 12 1 2 A )0 timitcd LlagbJlar Ilagbazar 31, {lagbazar NIC ASIA r9 / I -A8I' Ncpal ltasira Bank uank e n t 1, I sz /8J ) I s) / B t3 /9858A2.2618 21 Limitcd Nepalgunj Surkhet lioad, NePalgunj NIC ASIA Ncpal llastra Ilank +97 l-0L 66347 /3 tlank 22 Lim ited Kausaltar l(ausaltar, BhaktaPUr NIC ASIA Nopal Ilastra llank tlatrk I];r gun.-11.