Finance Know Your Client Form

FINANCE KNOW YOUR CLIENT FORM

Client Reference / Account Number:

SECTION A — CLIENT IDENTIFICATION

Individual    Corporation    Partnership    Trust    Other:

Date of Birth / Incorporation:    Place of Birth / Jurisdiction:

SECTION B — BUSINESS / OCCUPATION / ACTIVITY

SECTION C — FINANCIAL PROFILE & TRANSACTIONAL EXPECTATIONS

Expected Account Currency:    Expected Monthly Deposits:

Expected Average Balance:    Expected Number of Transactions / Month:

Salary / Wages    Business Income    Investments / Dividends    Inheritance    Other:

SECTION D — BENEFICIAL OWNERS & CONTROLLING PERSONS (FOR ENTITIES)

Does the entity have any individual beneficial owners holding 25% or more ownership?   Yes    No

SECTION E — SANCTIONS, PEP & AML DECLARATIONS

Are you or any beneficial owner a Politically Exposed Person (PEP) or immediate family member of a PEP?   Yes    No

To the best of my knowledge, I certify that neither I nor any associated beneficial owner is subject to international sanctions, nor is any portion of the funds derived from illegal activity, money laundering, or terrorist financing. I acknowledge that the financial institution may conduct identity verification, sanctions screening, and ongoing monitoring and may request additional documentation.

SECTION F — TAX RESIDENCY & REPORTING

Country(ies) of Tax Residence:

I understand that the information provided may be used for tax reporting and compliance with applicable law and that failure to provide accurate tax residency information may require withholding or account restrictions.

SECTION G — DOCUMENT CHECKLIST (TO BE PROVIDED WITH THIS FORM)

Please indicate documents attached:

Government-issued photo ID (passport, national ID)    Driver's license

Proof of address (utility bill, bank statement)    Corporate documents (articles, certificate of incorporation)

Board resolution or power of attorney for authorized signatories    Other:

SECTION H — CONSENT, CERTIFICATION AND AUTHORIZATION

By signing below, I certify under penalty of law that the information supplied in this Finance Know Your Client Form is true, complete and accurate. I authorize the financial institution to verify any information provided, to obtain additional identification or documentation, and to conduct screening against sanctions lists, law enforcement, and other relevant databases. I further authorize disclosure of account and identifying information to regulatory, tax, or law enforcement authorities where required by applicable law.

I acknowledge that the institution may retain copies of identification documents and may record information necessary to satisfy anti-money laundering, counter-terrorist financing, and tax compliance obligations. I agree to notify the institution promptly of any material changes to the information provided in this form.

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