Client KYC Form

CLIENT KYC FORM

This Client KYC Form is entered into by and between Client Name: and Company Name: on Effective Date: .

Recitals

WHEREAS, the Company requires identification, verification and related information from the Client for the purposes of complying with applicable anti-money laundering, counter-terrorist financing, sanctions and other financial compliance obligations; and

WHEREAS, the Client is willing to provide the information and certifications set forth in this Form and to consent to screening, verification and ongoing monitoring by the Company and its authorized agents; and

WHEREAS, the parties intend that the information supplied herein will be relied upon by the Company to establish the Client relationship and to satisfy regulatory due diligence requirements.

NOW THEREFORE, in consideration of the Company accepting the Client relationship and the mutual covenants contained herein, the parties agree as follows.

1. Definitions

For purposes of this Form: "Client" means the person or entity identified above; "Company" means the party receiving this Form and conducting identity verification; "Beneficial Owner" means any natural person who ultimately owns or controls the client or on whose behalf a transaction is being conducted. Words defined elsewhere in this Form have the meanings ascribed to them therein.

2. Client Identification

3. Entity Information (if applicable)

Entity Type: Individual Corporation Partnership Trust Other

4. Beneficial Ownership

Provide beneficial owner information for each natural person owning or controlling 25% or more (or as required by law). Attach additional pages if necessary.

5. Source of Funds and Wealth

6. PEP, Sanctions and Adverse Information

Is the Client or any beneficial owner a Politically Exposed Person (PEP), sanctioned individual/entity, or subject to adverse regulatory or criminal action?

Yes No

7. Certifications and Declarations

The Client hereby certifies, represents and warrants that all information provided in this Form and in any supporting documentary evidence is true, complete and correct to the best of the Client's knowledge, and that the Client will promptly notify the Company of any material change.

The Client expressly authorizes the Company and its agents to perform identity verification, sanctions and adverse media screening, credit and fraud checks, and to disclose relevant information to regulators or law enforcement where required by law.

I certify that the information provided is accurate and complete. I consent to identity verification and screening described above. I confirm that true copies of the identification documents have been provided to the Company.

8. Data Processing and Privacy

The Client acknowledges that personal data supplied will be processed by the Company for the purposes of client onboarding, account administration and compliance with legal obligations. The Client agrees that such processing is lawful for compliance and legitimate interests, and where required consents to such processing and to cross-border transfers to jurisdictions where the Company or its service providers operate.

I consent to the processing and transfer of my personal data as described above.

9. Ongoing Monitoring

The Client acknowledges that the Company may carry out ongoing monitoring of the relationship, including periodic requests for updated information, transaction monitoring, and additional due diligence where necessary. Failure to provide requested information may result in account restrictions or termination.

10. Confidentiality

The Company will treat information provided as confidential but may disclose such information when required by law, regulation, legal process, or in the exercise of its compliance obligations, including disclosures to competent authorities and service providers for compliance purposes.

11. Representations; Warranties; Indemnity

The Client represents and warrants that it is not subject to any legal restriction that would prevent it from providing this Form, and agrees to indemnify and hold harmless the Company from any loss or liability arising from false or misleading information supplied by the Client.

12. Notices

13. Governing Law; Entire Agreement; Severability; Amendments; Waiver; Counterparts

Governing Law: This Form shall be governed by and construed in accordance with the laws chosen by the Company in its onboarding policy, without regard to conflicts of law principles. Entire Agreement: This Form constitutes the entire agreement between the parties with respect to client identification and due diligence and supersedes prior understandings. Severability: If any provision is held invalid or unenforceable, the remaining provisions will remain in full force. Amendments and Waiver: No amendment or waiver shall be effective unless in writing and signed by both parties. Counterparts: This Form may be executed in counterparts, each of which is an original and together constitute one instrument.

14. Additional Declarations

Acknowledgement

By signing below, the Client and the Company acknowledge receipt of the information set forth in this Form, confirm the accuracy of the information to the best of their knowledge, and agree to the terms and consents set forth in this Form.

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