GPBFS CORPORATE CLIENT IDENTIFICATION AND ECONOMIC PROFILE FORM

Transcription

1 GPBFS CORPORATE CLIENT IDENTIFICATION AND ECONOMIC PROFILE FORM PART A - CORPORATE CLIENT IDENTIFICATION FORM 1. COMPANY DETAILS Company Name Registration Number Date of Incorporation Country of Incorporation Supervisory Authority Type of License Nature / Types of activity Countries of activity Registered Address Postal Address 2. CONTACT DETAILS Contact 1 Full Name Position Telephone Durable Media communication: Fax Contact for sending reports Contact 2 Full Name Position Telephone Durable Media communication: Fax Contact for sending reports 1

2 1. LEGAL ENTITY IDENTIFIER ("LEI"): according to the European Regulation No 648/2012 on Over the Counter Derivatives, central counterparties and Trade Repositories, GPB Financial Services Ltd must obtain the LEI, from its client and counterparties for reporting purposes. 2. FATCA & GIIN: Under FATCA, to avoid being withheld upon, foreign financial institutions (FFIs) may register with the IRS and agree to report to the IRS certain information about their U.S. accounts, including accounts of certain foreign entities with substantial U.S. owners LEGAL ENTITY IDENTIFIER ("LEI"): Status FATCA & GIIN: CRS status 3. CLIENT CATEGORIZATION Please indicate the applicable legal status of the Company: 3.1) Does the Company fall in any of the categories listed below: Credit Institution Investment Firm Other authorised or regulated financial institution Insurance company Collective investment scheme and Management Company of such schemes Pension fund and Management Company of such fund Commodity and commodity derivatives dealers Local authorities Government institution 1 Other Institutional investor 2 3.2) Does the Company meet any two of the following size requirements (on a company basis): Balance sheet total: Net turnover: Own funds: This Includes public bodies that manage any public debt, Central Bank, International or supranational Institutions such as World Bank, the IMF, the ECB, the EIB and other similar International organization 2 This includes entities whose main activity is to invest in financial instruments, including entities dedicated to the securitization of assets or other financing transactions 2

3 4. BENEFICIAL OWNERS # Full Name Passport/ID Date & Place of Birth Nationality Residential Address Profession Respective share Should any of the Beneficial Owners acts as an authorised person for placing orders with GPBFS, this person should complete the AUTHORISED PERSONS QUESTIONNAIRE, unless the Company falls in any of the categories listed in Question 3.1 above. 5. AUTHORISED PERSONS # Full Name Acting on the basis of Passport Number Date & Place of Birth Nationality Position Telephone number Signature specimen 1 3

4 2 3 4 Should any of the authorised persons place orders with GPBFS, such persons should complete the AUTHORISED PERSONS QUESTIONNAIRE, unless the Company falls in any of the categories listed in Question 3.1 above. 6. POLITICALLY EXPOSED PERSONS 3 Do any of the Beneficial Owners, Directors, Authorised Persons and/or their immediate family members or close associates currently hold or held in previous years a position in any governmental body? No Yes If yes please provide us with the following details: Name Position Duration Relationship 3 politically exposed person means a natural person who is or who has been entrusted with prominent public functions and includes the following: (a) heads of State, heads of government, ministers and deputy or assistant ministers; (b) members of parliament or of similar legislative bodies; (c) members of the governing bodies of political parties; (d) members of supreme courts, of constitutional courts or of other high-level judicial bodies, the decisions of which are not subject to further appeal, except in exceptional circumstances; (e) members of courts of auditors or of the boards of central banks; (f) ambassadors, chargés d'affaires and high-ranking officers in the armed forces; (g) members of the administrative, management or supervisory bodies of State-owned enterprises; (h) directors, deputy directors and members of the board or equivalent function of an international organisation. No public function referred to in points (a) to (h) shall be understood as covering middle-ranking or more junior officials; family members includes the following: (a) the spouse, or a person considered to be equivalent to a spouse, of a politically exposed person; (b) the children and their spouses, or persons considered to be equivalent to a spouse, of a politically exposed person; (c) the parents of a politically exposed person; persons known to be close associates means: (a) natural persons who are known to have joint beneficial ownership of legal entities or legal arrangements, or any other close business relations, with a politically exposed person; (b) natural persons who have sole beneficial ownership of a legal entity or legal arrangement which is known to have been set up for the de facto benefit of a politically exposed person. 4

5 7. BANK INSTRUCTIONS Beneficiary Beneficiary Account No. With Bank City of Bank SWIFT Correspondent Account Correspondent Bank SWIFT Additional information For payments in US Dollars Beneficiary Beneficiary Account No. With Bank City of Bank BIC Correspondent Account Correspondent Bank Additional information For payments in Russian Rubles 5

6 PART B ECONOMIC PROFILE CLIENT INVESTMENT ECONOMIC PROFILE FOR COMPANIES QUESTION 1. What is your regular net annual income Up to USD USD USD USD USD USD USD Other (please specify) ANSWER 2. Information on client assets a) Deposits b) Immovable property c) Shares d) Cars e) Life Insurance f) Other Investments 3. Regular Financial Commitment a) Loans b) Rent c) Insurance d) Living expenses e) Medical f) Educational g) Other Expenses Total Value: Total Expenses: KNOWLEDGE & EXPERIENCE 4. Please indicate any investments you had (if applicable) with the following: a) Deposits b) Corporate Stocks c) Fixed income securities d) Treasury Bills e) Money Market Funds f) Bills of exchange 6

7 5. What is your experience with the following financial instruments? Experience Monthly/annual/ etc a) Options, futures, swaps, other derivatives b) Currencies/Forex c) Interest rates d) Derivatives on commodities 6. What type of financial instruments you have invested in (select all that apply) Percentage Cash Deposits and Government Bonds % Money market funds % Real Estate Property % Capital Guarantee Products % Bond and bond funds % Shares % Mutual Funds of Shares % Foreign Currency % Precious Metals % Derivatives % Commodities % 7. In what industries have you already invested (select all that apply) Percentage Consumer Goods % Financial % Services % Industrial Goods % Healthcare % Energy % Oil and Gas % Technology % Other % 8. In what markets have you already invested (select all that apply) Percentage None, we have not previously done any investments % Home country % USA % Russia % Eastern Europe % Western Europe % Emerging Markets % 9. By which method have you already invested (select all that apply) Execution only, we decide on our own where to invest Based on investment advice Discretionary / Asset Management 10. Overall how would you evaluate yourself as an investor Basic Investor Informed Investor Advanced Investor Expert Investor 7

8 11. What is the size of Investments Up to USD USD USD USD USD USD USD Other (please specify) 12. What is the average holding period of the investments (select all that apply) a. Very Short Term 0-1 Year b. Short Term 1-3 Years c. Medium Term 3-5 years d. Long Term > 5 years 13. What is your expected yearly return for your investments Low 3% 5% Average 5% 8% Above average 8% 12% High > 12% 14. Which of the following risk profiles corresponds better to your investment objectives and needs (tick all that apply) Preservation Growth Income Hedging Option or Leveraged Pension scheme Time horizon, reflecting the minimum holding period Maturity date May be terminated early Tax efficiency Currency protection CLIENTS TREATED AS PROFESSIONALS ON REQUEST Identification Criteria 15. Please indicate whether you meet two (2) of the following criteria: a) The size of your financial instrument portfolio, including cash deposits and financial instruments exceeds b) You carried out transactions, in significant size, on the relevant market at an average frequency of 10 per quarter over the previous four quarters c) You work or have worked in the financial sector for at least one year in a professional position, which requires knowledge of the transactions or services envisaged 8

9 16. How many financial transactions do you intend to perform with GPB Financial Services Ltd Less than Over Purpose for opening account with GPB Financial Services Ltd a) Trade listed financial instruments b) Trade unlisted financial instruments c) Trade complex products (derivatives, exotic, structure products) d) Other (please specify) 18. What is the expected volume of transactions with GPB Financial Services Ltd a) Up to USD b) USD USD c) USD USD d) USD USD e) USD USD f) Other (please specify) 19. What is the desired level of liquidity of your investment portfolio Fully liquid - all investments can be easily converted to cash Mainly liquid - a large % of the investments can be easily converted to cash Somewhat liquid - the investments are split between easily convertible to cash and not easily convertible to cash Somewhat illiquid - A large % of the investments may not be easily convertible to cash Illiquid - Most of the investments may not be easily convertible to cash or there is a penalty for doing so 20. Would you consider any level of leverage / margin for your portfolio None < 25% 25% - 50% 50% - 75% Maximum % that can be obtained 21. What would you consider to be your overall risk level profile / risk tolerance Not willing to take any investment risk which may result in any loss of initial capital even in adverse market conditions. Willing to undertake minor investment risk so that to aim mainly for capital preservation. In adverse market conditions minor losses may occur with only minimal percentage of the initial capital been unrecoverable. Willing to undertake some investment risk and small market volatility in order to achieve average returns. In adverse market conditions moderate losses may occur and a small percentage of the initial capital may be unrecoverable. 9

10 Willing to undertake a considerable risk and accept market volatility in order to enhance potential returns. In adverse market conditions, negative returns and possibly unrecoverable loss of a certain percentage of the initial investment capital may occur. Willing to undertake a large degree of investment risk in order to achieve high potential returns. In adverse market conditions a substantial and possibly unrecoverable loss of a large percentage of the initial investment capital may occur. 22. Overall how would you evaluate your financial situation with a focus on the ability to bear losses No Capital loss (Applicable for Clients that cannot afford any capital losses. Applicable products would be fully guaranteed or protected products.) Limited Capital Loss (Applicable for Clients that are willing to accept limited capital loss. Applicable products would be products with total or partial guarantee protection.) No Capital guarantee (Applicable for Clients that are willing to accept 100% loss of capital. Applicable products would be products with none, limited or full capital guarantee or protection.) Loss beyond capital (Applicable for Clients that are willing to accept losses beyond invested capital. Applicable products would be products with additional payment obligations that might exceed the amount invested as well as products with no, limited or full capital guarantee or protection.) 23. Personal Data I give my express consent to GPB-Financial Services Ltd to use my personal data (name, contact details) for its own purposes in connection with information and marketing communication relating to products, services and events. I reserve the right to revoke my consent at any time. CORPORATE CLIENT IDENTIFICATION AND ECONOMIC PROFILE FORM I, the undersigned, {full name}, {position} of {company name} (the Company), hereby confirm that the above (Part A 5) are the genuine signatures of the official persons of the Company authorised to operate the Company s account held with GPB-Financial Services Limited and that the information provided in this document is complete, true and accurate. Signature Position Date 10