Client Due Diligence Questionnaire

Corporate Client

Section 1: Company Information

Legal Name of Company:
Trading Name(s):
Registered Address:
Principal Place of Business (if different):
Country of Incorporation:
Registration Number/Company Number:
Date of Incorporation:
Nature of Business Activities:
Website URL:
Telephone Number:
Email Address:

Section 2: Ownership and Control Structure

List of Shareholders (Individuals and Entities):

Name:
Nationality/Place of Incorporation:
Percentage Ownership:
Beneficial Owner Status (Yes/No):
Name:
Nationality/Place of Incorporation:
Percentage Ownership:
Beneficial Owner Status (Yes/No):
Please include structure chart

List of Directors and Senior Management:

Name:
Position/Title:
Nationality:
Date of Birth:
Name:
Position/Title:
Nationality:
Date of Birth:

Details of Ultimate Beneficial Owners (UBOs):

Name:
Date of Birth:
Nationality:
Residential Address:
Percentage of Ownership/Control:

Section 3: Business Activities and Operations

Geographic Markets Operated In:
Major Clients, Suppliers, and Business Partners:
Annual Turnover:

Section 4: Politically Exposed Persons (PEPs)

Are any directors, UBOs, or senior officers considered Politically Exposed Persons?
(Yes/No, if yes, provide details)

Are there any close associates or family members of PEPs involved in the company?
(Yes/No, if yes, specify)

Section 5: Tax Identification Number

Country of Tax residency Tax Identification Number (TIN)
  
  
  
If unable to provide TIN, please specify the reason why:

Section 5: Documentation requirements

Please provide copies of the following documents

Section 6: Certification

I certify that I am authorized to make this declaration on behalf of the above named corporation and that the information contained herein is true and correct.

Name:
Position:
Signature:
Date: