KNOW YOUR CUSTOMER (KYC)

AND DUE DILIGENCE QUESTIONNAIRE

Questionnaire Reference: _____________________________________________
Date Issued: _____________________________________________
Counterparty Name: _____________________________________________
Completed By: _____________________________________________

Date Completed: _____________________________________________

This questionnaire is to be completed by the counterparty named above and returned to the issuing party together with the supporting documents listed in each section. All information provided will be treated as strictly confidential and used solely for the purposes of compliance, due diligence, and risk assessment. Providing false or misleading information may result in termination of the commercial relationship and may constitute a criminal offence.

SECTION 1 — ENTITY IDENTIFICATION

Supporting Documents Required:

Certificate of incorporation or equivalent registration document (certified copy)

Current memorandum and articles of association or equivalent constitutional documents

Proof of registered office address (utility bill or bank statement, not more than 3 months old)

VAT / GST registration certificate (if applicable)

SECTION 2 — DIRECTORS AND OFFICERS

List all current directors, officers, managing partners, or persons with equivalent authority:
Supporting Documents Required:
Certified copy of passport or national identity document for each director / officer listed
Proof of residential address (utility bill or bank statement, not more than 3 months old) for each director / officer

SECTION 3 — ULTIMATE BENEFICIAL OWNERSHIP (UBO)

List all persons who directly or indirectly own or control 10% or more of the shares or voting rights, or who otherwise exercise ultimate control over the entity:
Supporting Documents Required:
Current shareholder register or equivalent document confirming ownership structure
Certified copy of passport or national identity document for each UBO listed
Proof of residential address for each UBO (not more than 3 months old)
If UBO is a corporate entity: repeat entity identification documents for that entity
SECTION 4 — BUSINESS ACTIVITIES
Supporting Documents Required:

Most recent audited financial statements (or management accounts if unaudited)

Copies of relevant licences, regulatory certificates, or approvals (e.g. IEC, RCMC, APEDA, export/import licences)
SECTION 5 — BANKING INFORMATION
Supporting Documents Required:
Bank confirmation letter or voided cheque on bank letterhead confirming account details
Most recent bank statement (not more than 3 months old, for AML verification purposes)
SECTION 6 — SANCTIONS AND PEP DECLARATIONS
SECTION 7 — COMMERCIAL PURPOSE OF RELATIONSHIP

SECTION 8 — DECLARATION AND SIGNATURE

I / We, the undersigned, being duly authorised to complete this questionnaire on behalf of the entity named herein, hereby confirm that:
All information provided in this questionnaire is true, accurate, and complete to the best of our knowledge and belief;
We will promptly notify the requesting party of any material change to the information provided;
We consent to the requesting party conducting such further due diligence checks as it considers necessary;
We understand that providing false or misleading information may result in termination of the commercial relationship and may constitute a criminal offence;
We agree to provide any additional information or documentation reasonably requested by the requesting party in connection with its compliance obligations.
Authorised Signatory: _____________________________________________
Full Name: _____________________________________________
Title: _____________________________________________
Entity Name: _____________________________________________
Date: _____________________________________________
Entity Seal (if applicable): _____________________________________________
Doc 22 — KYC and Due Diligence Questionnaire — Neutral Template

Full Legal Name:

Registered Trading Name(s) / DBA:

Legal Form:

(e.g. private limited company / partnership / sole trader / other)

Country of Incorporation / Registration:

Company / Registration Number:

Date of Incorporation:

Registered Office Address:

Principal Place of Business (if different):

VAT / GST Registration Number (if applicable):

Import / Export Code (IEC) (if applicable — India):

EORI Number (if applicable — EU):

Website:

Full Name

Nationality

Role / Title

Date of Birth

Full Name

Nationality

% Ownership

Nature of Control

Is the entity listed on a public stock exchange?

Yes / No If yes, name of exchange: _____________________________________________

Primary Business Activity:

Industry Sector(s):

Principal Products / Services:

Countries of Operation:

Annual Revenue (approximate, most recent year):

Number of Employees:

Does the entity hold any required licences or regulatory approvals?

Yes / No If yes, list: _____________________________________________

Is the entity subject to any regulatory investigation, court order, or legal proceeding?

Yes / No If yes, provide details: _____________________________________________

Bank Name:

Bank Country:

Account Name:

Account Number / IBAN:

SWIFT / BIC Code:

Sort Code / Routing Number (if applicable):

Is the entity, or any director, officer, or UBO, currently listed on any sanctions list?

Yes / No

Is any director, officer, or UBO a Politically Exposed Person (PEP) or a close associate of a PEP?

Yes / No If yes, provide details: _____________________________________________

Has the entity, or any representative, been convicted of any financial crime, money laundering, bribery, or corruption offence?

Yes / No If yes, provide details: _____________________________________________

Is the entity registered or operating in any jurisdiction subject to comprehensive trade sanctions?

Yes / No If yes, provide details: _____________________________________________

Describe the proposed commercial relationship or transaction:

Goods or services involved (include HS codes if known):

Country of origin of goods (if applicable):

Country of destination (if applicable):

Intended end-use of goods or services:

Estimated annual transaction value:

Source of funds / payment method:

KNOW YOUR CUSTOMER (KYC)

AND DUE DILIGENCE QUESTIONNAIRE

Date Completed: _____________________________________________

SECTION 2 — DIRECTORS AND OFFICERS

SECTION 3 — ULTIMATE BENEFICIAL OWNERSHIP (UBO)

Most recent audited financial statements (or management accounts if unaudited)

SECTION 8 — DECLARATION AND SIGNATURE

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