+370 5214 1818

info@satchel.eu

Ultimate Beneficial Owner Confirmation Form

Account Information Entity name

Registration number Jurisdiction of registration

Ultimate Beneficial Owner First name Last name

Information*

Date of birth/Personal code Citizenship

TIN (Tax identification number) NIC / Passport number

Tax residence country Ownership % in share capital

Is this person a PEP (Politically Exposed Person*), family member of PEP or close associate of PEP?

Ultimate Beneficial Owner Address line 1

Contacts

Address line 2

Authorized signatory confirmation I , the undersigned, acting on behalf of the Company, hereby certify, to my
✔ best knowledge, that the information provided in this document is
complete and correct.
Name

Title

Signature

Date

* — Refer to Glossary at the end of the document.

1
 +370 5214 1818
info@satchel.eu

Glossary

UBO Ultimate beneficial owner (UBO)  - natural person who owns or controls the Customer (if
the Customer is a legal entity or a foreign company) and/or a natural person on whose
behalf a transaction or activity is carried out.
The Beneficial Owner shall mean:
(A) for a legal entity:
a) a natural person who owns or controls, directly or indirectly, a legal entity
through a sufficient share of that legal entity’s stock or voting rights, including
bearer shares, other than public limited companies listed on regulated markets
that are subject to requirements for disclosure of information about own
business on a par with the European Union legislation or equivalent
international standards, or who otherwise controls it. A natural person who
holds 25 per cent and one share or a stake of more than 25 per cent in the
Customer’s equity shall be considered the direct beneficial owner. A natural
person or persons who controls or control a company or a group of companies
holding 25 per cent and one share or a stake of more than 25 per cent in the
Customer’s equity shall be considered an indirect beneficial owner(s);
b) a natural person in an executive position if no person specified in Clause (a)
above has been identified or if there is any doubt that the person who has been
identified is the beneficial owner;
(B) for a trust structure:
a) the settlor;
b) the trustee;
c) the protector, if any;
d) the natural person benefiting from the legal person or entity not having legal
personality, or where such a person has yet to be determined, the group of
persons in whose main interest that legal person or entity not having legal
personality are set up or operate;
e) any other natural person who in fact controls the trust structure, available direct
or indirect property, or other means;
(C) for a trust-like legal entity that administrates and allocates funds, a natural
person who holds a position on a par with the position specified in Clause (B)
above.

PEP Politically exposed natural person (PEP) - a natural person who is or has been entrusted with prominent
public functions and immediate family members or persons known to be close associates of such person.
“Close associate” means a natural person who:
(1) participates in the same legal entity or maintains other business relationships with a person who
performs or previously performed the prominent public functions;
(2) is the sole owner of the legal entity set up or operating de facto with the aim of acquiring property
or another personal benefit for a person who performs or previously performed the prominent public
functions.
“Close family member” means spouse, person in registered partnership (cohabitant), parent, brother, sister,
child and child’s spouse or child’s cohabitant.
“Prominent public functions” means functions within the Lithuanian, European Union, international or
foreign public authorities:
(1) the head of the State, the head of the government, a minister, a vice-minister or a deputy minister, a
secretary of the State, a chancellor of the parliament, government or a ministry;
(2) a member of the parliament;
(3) a member of the Supreme Court, the Constitutional Court or any other supreme judicial authorities
whose decisions are not subject to appeal;
(4) a mayor of the municipality, a head of the municipal administration;
(5) a member of the management body of the supreme institution of state audit or control, or a chair,
deputy chair or a member of the board of the central bank;
(6) an ambassador, a chargé d’affaires ad interim, a special envoy and a minister plenipotentiary or a
high-ranking military officer;
(7) a member of the management or supervisory body of a public undertaking, a public limited
company or a private limited company, whose shares or part of shares, carrying more than 1/2 of the total
votes at the general meeting of shareholders of such companies, are owned by the State;
(8) a member of the management or supervisory body of a municipal undertaking, a public limited
company or a private limited company whose shares or part of shares, carrying more than 1/2 of the total
votes at the general meeting of shareholders of such companies, are owned by the State, and which are
considered as large enterprises in terms of the Law of the Republic of Lithuania on Financial Statements of
Entities;
(9) a director, a deputy director or a member of the management or supervisory body of an
international intergovernmental organisation;
(10) a leader, a deputy leader or a member of the management body of a political party.