Legal CDD Form

LEGAL CDD FORM

This Legal Customer Due Diligence Form is entered into by and between Provider Name: and Customer Name: effective as of .

RECITALS

WHEREAS, Provider is engaged in services requiring compliance with anti-money laundering, counter-terrorist financing, or other compliance obligations and must collect Customer due diligence and identification information; and

WHEREAS, Customer seeks to establish a business or transactional relationship with Provider and agrees to provide truthful information and supporting documentation necessary for Provider to perform customer due diligence; and

WHEREAS, the parties intend to record the Customer's identification, beneficial ownership, source of funds, and related attestations in accordance with Provider's compliance policies and applicable law;

NOW, THEREFORE, in consideration of the mutual covenants contained herein, the parties agree as follows:

1. DEFINITIONS

For purposes of this Form, "Customer" means the individual or entity identified herein. "Beneficial Owner" means any natural person(s) who ultimately own(s) or control(s) the Customer, including persons with significant responsibility to control, manage or direct the Customer. Terms not otherwise defined herein shall have their ordinary commercial meaning.

2. CUSTOMER IDENTIFICATION

3. ENTITY TYPE AND BENEFICIAL OWNERSHIP

Entity Type: Individual Corporation Trust Partnership Other

Provide the full legal name, date of birth, nationality, address, and percentage ownership for each Beneficial Owner with 25% or greater ownership or control. Attach additional pages if necessary.

4. POLITICALLY EXPOSED PERSONS (PEP)

Is the Customer or any Beneficial Owner a Politically Exposed Person (PEP)? Yes No

5. SOURCE OF FUNDS AND WEALTH

Provide a description of the origin of the funds expected to be used in the relationship, the regular source(s) of wealth, and the expected transaction patterns or volumes.

6. RISK ASSESSMENT, MONITORING AND RECORDKEEPING

Provider will assess the Customer's risk level based on the information provided, perform screening against relevant lists, and retain records in accordance with applicable recordkeeping obligations. Customer acknowledges and agrees that Provider may request additional information or documentation at any time and may suspend or terminate the relationship if satisfactory information is not provided.

7. DOCUMENTS PROVIDED

The Customer has provided and will provide to Provider legible, true, and current copies of identification and verification documents sufficient to satisfy Provider's due diligence obligations. Typical documents include certified government-issued photo identification, corporate formation documents, ownership registers, and proof of address.

8. CONFIDENTIALITY AND USE OF INFORMATION

Provider will treat Customer information as confidential except as required by law, regulation, or legal process. Customer expressly consents to Provider's use and disclosure of Customer information to third-party service providers and to governmental or regulatory authorities where permitted or required by applicable law.

9. REPRESENTATIONS, WARRANTIES AND CERTIFICATIONS

Customer represents and warrants that (a) all information and documentation provided by Customer to Provider is true, complete and not misleading; (b) Customer will promptly notify Provider of any changes to the information provided; and (c) Customer is not subject to any sanctions or lawful restrictions that would prohibit the proposed relationship. Customer certifies under penalty of law that the information provided is accurate to the best of Customer's knowledge.

10. INDEMNIFICATION

Customer agrees to indemnify and hold harmless Provider, its affiliates and their respective officers, directors and employees from and against any and all losses, claims, damages, liabilities, fines or expenses arising from Customer's breach of this Form or from any false or misleading information supplied by Customer.

11. NOTICES

Notices shall be in writing and delivered to the addresses provided above and shall be effective upon receipt.

12. GOVERNING LAW; ENTIRE AGREEMENT; SEVERABILITY

Governing Law: This Form shall be governed by and construed in accordance with the laws of the jurisdiction specified below without regard to conflict of laws principles.

Entire Agreement: This Form constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements and understandings, whether written or oral.

Severability: If any provision of this Form is determined to be invalid or unenforceable, such invalidity or unenforceability shall not affect the remaining provisions, which shall remain in full force and effect.

13. AMENDMENTS; WAIVER; COUNTERPARTS

Amendments to this Form must be made in writing and signed by both parties. No failure or delay by either party in exercising any right hereunder shall operate as a waiver of such right. This Form may be executed in counterparts, each of which will be deemed an original.

14. ACKNOWLEDGEMENTS

By signing below, Customer certifies that the information provided is true, complete and accurate, and authorizes Provider to verify information, obtain additional documentation, and disclose information where required by law.

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