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Appendix

No. : Encl. :

To

Bank Indonesia

Jl. M.H. Thamrin No. 2 JAKARTA 10350

Attn. Directorate of Sharia Banking

Subject : Application for Approval of Issuance of PUAS Instrument

Assalamu’alaikum Wr. Wb.

We hereby would like to apply for approval of issuance of a PUAS Instrument under the name of : ……….………

As supplement to this application, please find herewith we enclose :

a. copy of National Sharia Council fatwa concerning the PUAS Instrument to be issued;

b. sharia opinion of Sharia Supervisory Board of Sharia Bank or UUS on the PUAS Instrument to be issued;

c. explanations on the PUAS Instrument to be issued including characteristics, transaction scheme, accounting process, authorized parties, infrastructure, and risk analysis on the PUAS Instrument;

d. draft or major stipulations in financial agreement or contract; and

e. information and/or other documents considered relevant and useful to evaluate benefit and risk of the PUAS Instrument.

Looking forward to hearing from you soon.

Wassalamu’alaikum Wr.Wb.

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