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Form 2 Regulation 7(3) THE REPUBLIC OF UGANDA THE ELECTRONIC SIGNATURES REGULATIONS, 2012 LICENCE TO PROVIDE CERTIFICATION SERVICE No. ________________ ……………………………………………………(name) of ………………………..(address) is licenced to provide certification services in accordance with the Electronic Signatures Act, 2011. This licence is subject to the following conditions……………………………………. …………………………………………………………………………………………….. This licence is valid for twenty four months from date of issue. Dated this ______ day of _______________, 20 ____ __________________________________ Controller

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