Client Verification Questionnaire

Client Verification Questionnaire

This Client Verification Questionnaire (the Agreement) is entered into between: Service Provider Name: and Client Name: .

WHEREAS

WHEREAS, Service Provider has been engaged to perform compliance, onboarding, and related services for Client, and requires accurate identity, ownership and business information to satisfy internal and regulatory verification requirements;

WHEREAS, Client agrees to provide complete, correct and verifiable documentation and information and to certify the accuracy of such information for the purposes of risk assessment, anti‑money laundering checks, and ongoing monitoring; and

WHEREAS, the parties intend that the information and representations made by Client in this Questionnaire be relied upon by Service Provider in performing its obligations and delivering the Scope of Work set forth herein.

Client Identification

Individual    Corporation    LLC    Partnership    Trust    Other:

Verification Documents Provided

Government-issued photo ID    Certificate of Formation / Articles    Operating Agreement / Bylaws    Proof of Address    Bank Reference    Financial Statements    Other:

Compliance & Risk Assessment

Is the Client subject to economic or trade sanctions imposed by any jurisdiction?   Yes   No

Is any beneficial owner or principal officer a Politically Exposed Person (PEP)?   Yes   No

Has the Client or any principal officer been convicted of a financial crime or facing pending criminal proceedings?   Yes   No

Scope of Work

Service Provider shall perform onboarding verification, risk assessment, and ongoing monitoring as described below. Client must provide the information and documentation requested in a timely manner to permit Service Provider to perform the Scope of Work.

Payment Terms

Client shall pay Service Provider fees as follows: Amount: $ . Payment schedule: .

Late payments shall incur a late fee of per month on overdue balances, calculated monthly, plus recovery costs and interest to the extent permitted by law.

Term and Termination

This Agreement commences on Start Date: and continues until End Date: unless earlier terminated in accordance with this section.

Either party may terminate this Agreement without cause upon days' prior written notice. Termination for material breach may be immediate upon written notice if the breaching party fails to cure within a commercially reasonable time.

Confidentiality

Each party acknowledges that it may obtain Confidential Information of the other. "Confidential Information" means non‑public business, financial, technical and operational information disclosed in connection with this Agreement. The receiving party shall maintain confidentiality, use such information solely to perform its obligations, and not disclose it except to employees, advisors or contractors who have a need to know and are bound by confidentiality obligations at least as protective as those set forth herein. Confidentiality obligations shall survive termination for a period of three (3) years, except for trade secrets which shall remain protected for as long as permitted by applicable law.

Governing Law

This Agreement shall be governed by and construed in accordance with the laws of without regard to its conflict of law principles. Venue for any dispute shall be in the courts of the chosen jurisdiction unless the parties agree otherwise in writing.

Entire Agreement

This Questionnaire, together with any attachments and written agreements expressly incorporated herein, constitutes the entire agreement between the parties with respect to the subject matter and supersedes all prior and contemporaneous understandings, agreements, representations and warranties, both written and oral.

Certification

By signing below, Client certifies, under penalty of perjury and to the best of Client's knowledge and belief, that the information provided in this Questionnaire is true, complete and accurate. Client agrees to promptly notify Service Provider of any material changes to the information supplied. Client authorizes Service Provider to verify any information provided and to obtain additional documentation as reasonably required to satisfy regulatory obligations.

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