Instruction

Please complete all sections of the form. Do not exceed more than 150 words for each field. Where the space allocated is insufficient, you may provide further information via additional exhibits and documents (e.g., white paper). For any additional attachments, please make clear reference to which section and question they are relevant to and upload them via the "File Upload" section at the end of this application.

In addition, the following documents are to be attached in conjunction with this form (if applicable):

• A copy of the applicant's Memorandum and Articles of Association, or equivalent incorporation documents (Part 1)
• Evidence of the applicant’s registration with any other regulatory authority (Part 1)
• A copy of the relevant pages of the relevant person's identification document (to include name, date of birth, nationality, signature, expiration date, and photograph) (Part 2)
• Copy of any relevant degrees, educational certificates, and professional qualifications (Part 2)
• Copy of statement of financial position (and/or financial statements) (Part 3)
  Internal controls and risk management policies and procedures, including digital token management, cybersecurity operations, operational controls, regulatory compliance, reporting policies, code of conduct, etc. (Part 3)
  The completeness and clarity of the information provided in this form will determine the time taken for QFC to review the application.

For any clarification, email: digitalassets@qfc.qa.

Note: Participants are required to obtain the necessary licenses and/or authorisations before commercialising their products or services. Participation in the DA lab does not guarantee the issuance of a license or authorisation.

1.f Contact Person Details

I, hereby affirm that to the best of our information, knowledge, and belief that the contents of Part 1 of Self-Evaluation form and any attachments provided with this form are true, correct and not misleading.

7.a Present Employer

7.b Previous Employer (last five years) – Please provide below detail for each employer

7.c List of Full Legal Names of Companies of which the relevant person (if any):

I, the undersigned, hereby declare that to the best of my knowledge, information, and belief, the contents of this form and any attachments provided with it are true, accurate, and not misleading.

I also authorize the QFC to conduct inquiries and obtain further information as it deems necessary to verify the information provided in Part 2 of the Self-Evaluation Form for the purpose of conducting due diligence and background checks. I understand that the findings of these checks may be disclosed to the person who submitted this application.

16.a
I, hereby affirm that to the best of our information, knowledge, and belief that the contents of Part 3 of Self-Evaluation form and any attachments provided with this form are true, correct and not misleading.

17.a
An acknowledgement that the following laws, regulations and rules will apply to you in relation to your activities in the QFC if recognition is granted, and an unconditional undertaking to comply with those laws, regulations, and rules:

• The QFC Law and Regulations made under it (and in particular FSR, article 82).
• The AML/CFT Law and any regulations made under it; (Note- The AML/CFT Law of the State of Qatar (and any regulations made under it) applies to a recognised exchange as it does to any other entity that operates within the State.)
• Other Laws and Regulations of the State of Qatar that are applicable in the QFC.
• Market abuse and Fees of these rules.

17.b
Unconditional undertakings: 

• To submit to the Authority’s exercise of its functions in relation to supervision and investigations (under FSR, Part 8) and disciplinary and enforcement proceedings (under FSR, Part 9), in relation to the applicant’s operations in the QFC;  
• To comply with any directions given by the Authority in relation to those operations; and  
• To submit to the jurisdiction of the Regulatory Tribunal and the Civil and Commercial Court in relation to the applicant’s operations in the QFC;

17.c
If the law or practice in the applicant’s home jurisdiction requires the applicant to have, in that jurisdiction, 1 or more individuals approved by an overseas regulator to perform a function that is the equivalent of a controlled function: 

• A list of those functions and the names of the individuals; and  
• Details of the approval of each individual. 

18.a
If you intend to conduct your business in accordance with Shari’a, your application must include: 

• A statement to that effect; and 
• A statement of the names of the proposed members of the applicant’s Shari’a supervisory board.

19.a
I, hereby affirm that I acknowledge the Laws, Rules and Regulations in Part 4 and QFC have the right to audit and reserve the right to amend any applicable rules.