KNOW YOUR CUSTOMER (KYC)
COMPANY
Company Name :………………………………………………………………………………………………………..
Registered Address :………………………………………………………………………………………………………..
Correspondence Address :………………………………………………………………………………………………………..
Email address :………………………………………………………………………………………………………..
Website :………………………………………………………………………………………………………..
Short Business Description :………………………………………………………………………………………………………..
CONTACT PERSON
Full name :………………………………………………………………………………………………………..
Telephone :………………………………………………………………………………………………………..
Email address :………………………………………………………………………………………………………..
Home Address :………………………………………………………………………………………………………..
BANKING DETAILS
Bank name :……………………………………………. Branch :…………………………….
Branch Code :……………………………………………. Account No. :…………………………….
DECLARATION OF BENEFICIAL OWNERSHIP
The Company hereby confirms and certifies that as of this date, the following individuals are or are
the principal owners of the Company through ownership in intermediate or ultimate holding
companies:
Full Name Home Address Citizenship Ownership
Presentation (%)