To Be Filled By Relationship Check Team

Engagement Leader / Director

Engagement Director / Manager
Legal entity name of client
Location of client (Territory where client is based)
Ultimate Parent Company (GUP)

Location of GUP
Product Code
Detailed description of engagement
In which country/territory will the assignment be executed?
Is the engagement a referral to or from a member firm? (Yes/No)
Is an AFS required and what is the status?

Legal entity name of third parties

Unique Project name (If applicable)
GUP of third parties
Location of GUP of third parties / Counterparty / Counterparties
Shareholders with control of significant influence (for forensic disputes or hostile
transactions)
For BRS engagements (See product codes), indicate the Corporate structure and
directors / directorships
Additional information on corporate structure and directors / directorships
Location / PwC firm relevant to client and engagement where request is to be sent