Trust Client Client Due Diligence. ABN AMRO Bank N.V., Jersey Branch

Transcription

1 Trust Client Client Due Diligence ABN AMRO Bank N.V., Jersey Branch

2 1/15 Section 1 Trust Information Client Name Name of Trust 1 Account Name 2 Trust Jurisdiction Date Trust established D D M M Y Y Y Y Accounting Year End Date D D M M Y Y Y Y Country of Tax Residence Tax Identification Number Country of Tax Residence Tax Identification Number Country of Tax Residence Tax Identification Number Trustee(s) 3 Date of Birth Settlor(s) 3 /Protector(s) 3 /Beneficiary(ies) 3/4 Capacity 5 PEP 6 Date of Birth Please list the names and additional information requested in respect of all Settlor(s) and/or Protector(s) and/or Beneficiary(ies) (who has/have previously received a distribution or benefit from the Trust and/or hold a Politically Exposed Person (PEP) status as defined from time to time). 1. As recorded on the original Trust Instrument or subsequent documents. 2. Please record the Account Name to be established with the Bank. 3. Please enter the full names. 4. Any beneficiaries who have previously received a distribution or benefit. 5. Please enter Settlor/Protector and/or Beneficiary as appropriate. 6. Please enter PEP as appropriate. A PEP is an individual who is (or has been) entrusted with prominent public functions, their immediate family and close associates.

3 2 / 15 Section 2 Anti-Money Laundering Requirements We are required by current legislation and guidance recognised by the Jersey Financial Services Commission ( JFSC ) 7 to obtain evidence of (1) the identity(ies) and (2) residence(s) at the address(es) given in this application. Please tick the boxes next to the documents being provided. Please contact us if the provision of this information presents you with any difficulty. Please Note: It is extremely important that the photograph on all photocopies is a clear and recognisable likeness of the individual and is certified by a suitable certifier as outlined below. * CERTIFIED means: Documents provided have been notarised or certified by a suitable certifier being an Officer of an Embassy, Consulate or High Commission of the country of issue or an independent reputable lawyer, notary public, actuary, accountant or an equivalent reputable person who is a member of a recognised professional body that sets and enforces ethical standards and rules of conduct. Please note that a suitable certifier must certify all documents by adding CERTIFIED AS A TRUE AND ACCURATE COPY OF THE ORIGINAL SEEN BY ME and add to the copy(ies) in capital letters or by means of a stamp, their name, address, profession and contact telephone number and date upon which they have certified the documents. ALL documents containing a photograph (e.g. ), please note that a suitable certifier must certify all documents by adding CERTIFIED AS A TRUE AND ACCURATE COPY OF THE ORIGINAL SEEN BY ME AND THE PHOTOGRAPH BEARS A TRUE LIKENESS OF [enter name of person requesting certification] and add to the copy(ies) in capital letters or by means of a stamp, their name, address, profession, contact telephone number and date upon which the documents were certified. In respect of the statutory documents of any Corporate Trustee/Corporate Settlor/Corporate Protector and/or Corporate Beneficiary, these must be certified by a suitable certifier (as defined above) which is independent from the Corporate Trustee/Corporate Settlor/Corporate Protector and/or Corporate Beneficiary itself (ie not a officer of the Corporate Trustee/Corporate Settlor/Corporate Protector and/or Corporate Beneficiary). An exception to this may be made where the Trustees and administrative services provider of the Corporate Trustee/Corporate Settlor/Corporate Protector and/or Corporate Beneficiary are part of a licensed and regulated financial services business in either Jersey, Guernsey or the Isle of Man, where an officer of the Corporate Trustee/Corporate Settlor/ Corporate Protector and/or Corporate Beneficiary may provide the certification. 7. ABN AMRO Bank N.V, Jersey Branch is regulated by the Jersey Financial Services Commission ( JFSC ), who are responsible for the regulation of the financial services industry in the Island of Jersey.

4 3 / 15 Section 3 Personal Information relating to any Individual Trustees, Individual Settlors, Individual Protectors and Individual Beneficiaries For each Individual Trustee, Individual Settlor, Individual Protector and Individual Beneficiary (who has previously received a distribution or benefit from the Trust), please provide the information and a CERTIFIED copy of the relevant documents referred to below, and tick the box accordingly. (N.B. For each Corporate Trustee, Corporate Settlor, Corporate Protector and Corporate Beneficiary please see pages below.) 1st Individual Trustee, Individual Settlor, Individual Protector or Individual Beneficiary 2nd Individual Trustee, Individual Settlor, Individual Protector or Individual Beneficiary

5 4 / 15 3rd Individual Trustee, Individual Settlor, Individual Protector or Individual Beneficiary 4th Individual Trustee, Individual Settlor, Individual Protector or Individual Beneficiary

6 5 / 15 5th Individual Trustee, Individual Settlor, Individual Protector or Individual Beneficiary 6th Individual Trustee, Individual Settlor, Individual Protector or Individual Beneficiary N.B If there are more than 6 Individual Trustees, Individual Settlors, Individual Protectors or Individual Beneficiaries, please copy this page, complete accordingly and attach to the back of this form.

7 6 / 15 Section 4 Information relating to any Corporate Trustees, Corporate Settlors, Corporate Protectors or Corporate Beneficiaries For each Corporate Trustee, Corporate Settlor, Corporate Protector and Corporate Beneficiary (who has previously received a distribution or benefit from the Trust), please provide the information and a CERTIFIED copy of the relevant documents referred to below, and tick the box accordingly. (N.B. For each Individual Trustee, Individual Settlor, Individual Protector and Individual Beneficiary please see pages above.) 1st Corporate Trustee, Corporate Settlor, Corporate Protector or Corporate Beneficiary Company s Legal Name 8 Other Trading Name(s) Country of Registration/Incorporation Date of Registration/Incorporation Company Registration Number Accounting Year End Date D D M M Y Y Y Y Director(s) 9 Date of Birth Controller(s) 10 /Shareholder(s) and/or Beneficial Owner(s) 10 Capacity 11 % Shareholding and/or PEP 12 Date of Birth Please provide a CERTIFIED copy of EACH of the following and tick the box accordingly: Certificate of Incorporation Current Register of Directors Authorised Signatory List Certificate of Good Standing 13 Memorandum and Articles of Association Current Register of Shareholders Change of Name Certificate (if applicable) 8. As recorded on the Certificate of Incorporation or subsequent and latest Change of Name Certificate. 9. As recorded on the Directors Register. 10. Any person, other than a Director, who directly or indirectly exercises or can exercise control over the Company. 11. Please enter Controller/Shareholder and/or Beneficial Owner as appropriate. 12. Please enter % Shareholding and/or PEP as appropriate. A PEP is an individual who is (or has been) entrusted with prominent public functions, their immediate family and close associates. 13. A good standing certificate states that a company has been in continuous, unbroken existence since its incorporation and that no action is currently being taken to strike the company off the register and is therefore in good standing.

8 7/ 15 2nd Corporate Trustee, Corporate Settlor, Corporate Protector or Corporate Beneficiary Company s Legal Name 14 Other Trading Name(s) Country of Registration/Incorporation Date of Registration/Incorporation Company Registration Number Accounting Year End Date D D M M Y Y Y Y Director(s) 15 Date of Birth Controller(s) 16 /Shareholder(s) and/or Beneficial Owner(s) 16 Capacity 17 % Shareholding and/or PEP 18 Date of Birth Please provide a CERTIFIED copy of EACH of the following and tick the box accordingly: Certificate of Incorporation Current Register of Directors Authorised Signatory List Certificate of Good Standing 19 Memorandum and Articles of Association Current Register of Shareholders Change of Name Certificate (if applicable) If there are more than 2 Corporate Trustees, Corporate Settlors, Corporate Protectors or Corporate Beneficiaries, please copy this page and attach to the back of this form and complete accordingly. 14. As recorded on the Certificate of Incorporation or subsequent and latest Change of Name Certificate. 15. As recorded on the Directors Register. 16. Any person, other than a Director, who directly or indirectly exercises or can exercise control over the Company. 17. Please enter Controller/Shareholder and/or Beneficial Owner as appropriate. 18. Please enter % Shareholding and/or PEP as appropriate. A PEP is an individual who is (or has been) entrusted with prominent public functions, their immediate family and close associates. 19. A good standing certificate states that a company has been in continuous, unbroken existence since its incorporation and that no action is currently being taken to strike the company off the register and is therefore in good standing.

9 8 / 15 Section 5 Personal Information relating to any Individual Company Directors, Individual Controllers, Individual Shareholders and Individual Beneficial Owners of a Corporate Trustee, Corporate Settlor, Corporate Protector or Corporate Beneficiary For each Individual Company Director, Individual Controller, Individual Shareholder and Individual Beneficial Owner (with a shareholding greater than 10%) of a Corporate Trustee, Corporate Settlor, Corporate Protector and Corporate Beneficiary, please provide the information and a CERTIFIED copy of the relevant documents referred to below, and tick the box accordingly. 1st Individual Company Director, Individual Controller, Individual Shareholder or Beneficial Owner of a Corporate Trustee, Corporate Settlor, Corporate Protector or Corporate Beneficiary 2nd Individual Company Director, Individual Controller, Individual Shareholder or Beneficial Owner of a Corporate Trustee, Corporate Settlor, Corporate Protector or Corporate Beneficiary

10 9 / 15 3rd Individual Company Director, Individual Controller, Individual Shareholder or Individual Beneficial Owner of a Corporate Trustee, Corporate Settlor, Corporate Protector or Corporate Beneficiary 4th Individual Company Director, Individual Controller, Individual Shareholder or Individual Beneficial Owner of a Corporate Trustee, Corporate Settlor, Corporate Protector or Corporate Beneficiary

11 10/ 15 5th Individual Company Director, Individual Controller, Individual Shareholder or Individual Beneficial Owner of a Corporate Trustee, Corporate Settlor, Corporate Protector or Corporate Beneficiary 6th Individual Company Director, Individual Controller, Individual Shareholder or Individual Beneficial Owner of a Corporate Trustee, Corporate Settlor, Corporate Protector or Corporate Beneficiary N.B If there are more than 6 Individual Trustees, Individual Settlors, Individual Protectors or Individual Beneficiaries of a Corporate Trustee, Corporate Settlor, Corporate Protector or Corporate Beneficiary, please copy this page, complete accordingly and attach to the back of this form.

12 11/15 Section 6 Purpose of Account Purpose of Account What are the main reason(s) for opening an account with ABN AMRO Bank N.V., Jersey Branch; the main purpose of the account and the intended nature of the relationship that you are seeking to establish? What type of activity will the account be used for? How frequently will the account be utilised? (e.g. daily, weekly, monthly) What is the typical value of the transactions that will pass across the account? Relationship rationale for this Account Why is an offshore banking relationship required and are tax considerations a factor in this decision? Why Jersey as a jurisdiction of choice? Why is ABN AMRO Bank N.V., Jersey Branch your Bank of choice? Has professional legal/tax advice been sought with respect to any aspect of your offshore account structure? If yes, please provide a copy/extract of the said advice. Yes No

13 12 / 15 Section 7 Trust Profile Information Source of Funds What activity (activities) have/will generate the funds that will be applied to the account? In which geographical area(s) will this/has this activity (these activities) been carried out? Source of Total Net Wealth Describe the activity (activities) that have generated the total net assets In which geographical area(s) was this activity/were these activities carried out? Other relationships with ABN AMRO Details of any known existing relationships with ABN AMRO Bank N.V.

14 13/ 15 Section 8 (a) Declaration for Assets & Income subject to U.S. Withholding Tax Client Name We, the above named (hereinafter defined as the Account Holder ), in connection with requirements under United States Withholding Tax Regulations and in order to enable the Bank to correctly determine the status and qualification of ultimate Beneficiaries of the Account Holder and/or for the purpose of United States Withholding Tax as a Non-U.S. Person, or a U.S. Person, hereby make and confirm the following declarations to the Bank in connection with any account or accounts held with the Bank from time to time: 1. Non-U.S. Person Declaration Are any ultimate Beneficiary(ies) of the Account Holder U.S. citizens (sole or dual citizenship)? Yes No If your answer is NO, please continue answering the questions below, however if your answer is YES please proceed to part (b) Declaration of U.S. Persons : Are any ultimate Beneficiaries U.S. resident aliens? Yes No (lawful permanent resident, e.g. green card holder, or substantial physical presence in the United States in the current and the previous two years) Are any ultimate Beneficiaries U.S. taxpayers for any other reason? (e.g. dual resident, spouse filing jointly, rescinding U.S. citizenship or other long term residency, others) This form is only valid if all questions are answered. 2. Beneficial Ownership Yes No The undersigned Account Holder hereby declares that it is the Beneficiary according to U.S. tax principles of the assets and income to which this form relates. 3. Change of Circumstances in status as a Non-U.S. Person The undersigned Account Holder undertakes to notify the Bank if it s status as a Non-U.S. Person under U.S. tax principles changes to the status of a U.S. Person under U.S. tax principles. Name of Signatory in Full (BLOCK CAPITALS please) Signature Date To be signed in accordance with the mandate. Section 8 (b) Declaration for Assets & Income subject to U.S. Withholding Tax Client Name We, the above named (hereinafter defined as the Account Holder ), in connection with requirements under United States Withholding Tax Regulations and the holding of U.S. securities through a U.S. custodian, herewith declare that we are a U.S. Person. In connection with the U.S. withholding and reporting regulations (effective 1 January 2001) we acknowledge that ABN AMRO cannot provide to me any of its Banking Services until such time as it has received from me a duly signed IRS Form W-9 in form and substance acceptable to ABN AMRO. We undertake to provide such a form promptly to ABN AMRO, and further to inform ABN AMRO promptly in the event of any material change to the content of the Form W-9 which might reasonably affect the operation of our account with ABN AMRO. Name of Signatory in Full (BLOCK CAPITALS please) Signature Date To be signed in accordance with the mandate.

15 14/ 15 Section 9 Trust Potential Risk Factors Is commission/consultancy fees a source of wealth? If yes, please provide details. i.e. copies of relevant contracts, amounts and frequencies Yes No Is the Trust connected with a High Risk Jurisdiction 20? If yes, please provide details. i.e. name the jurisdiction(s) and the exact nature of the connection(s) Yes No Is the Trust part of a complex structure? If so, please provide a Structure Chart and a detailed explanation for such. Yes No Is the Trust involved in Trading 21 activities? If so, please provide details. Yes No 20. High risk jurisdiction A country may be considered to be high risk where it: is generally considered to be un-cooperative in the fight against money laundering and terrorist financing; has inadequate safeguards in place against money laundering or terrorism; has high levels of organised crime; has strong links (such as funding or other support) with terrorist activities; is vulnerable to corruption; or is the subject of UN or EU sanctions measures, having regard to objective data available from the IMF, FATF, World Bank, the Egmont Group, US Department of State (International Narcotics Control Strategy Report), US Office of Foreign Assets Control and Transparency International (Corruption Perception Index). 21. Trading Where an entity undertakes commercial activity of any kind, including invoicing operations.

16 15 / 15 Section 10 Declaration to be completed for and on behalf of the Trust BY SIGNING BELOW, (i) I/we warrant to you (meaning the Bank for the purposes of this Section) that all information furnished to you in this document is true and correct and that I/we will notify you immediately of any material change to this information; (ii) I/we consent to your independent collection of data for money laundering requirements and credit checks and shall not hold you liable in any way for any delay or rejection as a result. Name of Trust 22 To be signed in accordance with the mandate. Name of Signatory in Full (BLOCK CAPITALS please) Signature Date 22. As recorded on the original Trust Instrument or subsequent documents.

17 ABN AMRO Bank N.V. ABN AMRO House PO Box Castle Street St Helier Jersey JE4 8TB Channel Islands Telephone: +44 (0) SECURITIES LAW DISCLAIMER ABN AMRO Bank N.V. is not a registered broker-dealer under the U.S. Securities Exchange Act of 1934, as amended (the 1934 Act ) and under applicable state laws in the United States. In addition, ABN AMRO Bank N.V. is not a registered investment adviser under the U.S. Investment Advisers Act of 1940, as amended (the Advisers Act and together with the 1934 Act, the Acts), and under applicable state laws in the United States. Accordingly, absent specific exemption under the Acts, any brokerage and investment advisory services provided by ABN AMRO Bank N.V, including (without limitation) the products and services described herein are not intended for U.S. persons. Neither this document, nor any copy thereof may be sent to or taken into the United States or distributed in the United States or to a US person. Without limiting the generality of the foregoing, the offering, sale and/or distribution of the products or services described herein is not intended in any jurisdiction to any person to whom it is unlawful to make such an offer, sale and/or distribution. Persons into whose possession this document or any copy thereof may come, must inform themselves about, and observe, any legal restrictions on the distribution of this document and the offering, sale and/or distribution of the products and services described herein. ABN AMRO Bank N.V. cannot be held responsible for any damages or losses that occur from transactions and/or services in defiance with the restrictions aforementioned. ABN AMRO Bank N.V., Jersey Branch is regulated by the Jersey Financial Services Commission. BANKING LAW DISCLAIMER ABN AMRO Bank N.V. is not licensed to conduct banking business or sell insurance products in the United States under applicable federal and state laws. Accordingly, any solicitation of retail banking services (including accepting and/or soliciting deposits), insurance services, mortgage and/ or consumer lending services or credit card services by ABN AMRO Bank N.V. is not intended for U.S. persons. The offering, sale and/or distribution of this product or service also be limited to other persons by the laws and regulations of other jurisdictions. Every (future) client is obliged to make inquiries after and comply with such restrictions. ABN AMRO Bank N.V. cannot be held responsible for any damage that occurs from transactions and/or services in defiance with the restrictions aforementioned. Neither this document, nor any copy thereof may be sent to or taken into the United States or distributed in the United States or to a US person ABN AMRO BANK N.V. DISCLAIMER No representation, warranty, or assurance of any kind, express or implied, is made as to the accuracy or completeness of the information contained in this document and ABN AMRO Bank N.V. (ABN AMRO) accepts no obligation to any recipient to update or correct any information contained herein. The information in this brochure is published for information purposes only. It does not purport to be all inclusive or constitute any form of recommendation and is not to be taken as a substitute for the recipient exercising his own judgement and seeking his own advice. ABN AMRO accepts no liability or responsibility whatsoever for any loss arising from any use of this document or its contents. This document may not be reproduced, distributed or published for any purpose without the prior written consent of ABN AMRO. January 2015 ABN J APP TC_CDD 0115