Account Opening Application Form for Entities

Transcription

1 1. Is the Entity an existing BCB customer? (if you are an Existing Customer, we may already hold all relevant information required; please contact a Relationship Manager) 2. Will at least one beneficial owner or signatory of the account be available for a face to face meeting? (if, then by law BCB is required to conduct Enhanced Due Diligence) (BCB is required to obtain certified copies of Proof of ID & Address for ANY non Face-to-Face Beneficial Owner and Signatory) 3. Is the Entity connected to another group of entities? 4. Does the Entity have a global or national parent company? (if answers to 3 and/or 4 is, then please complete Supplementary Information form) 5. Is the Entity fully/partially exempt for FCPT? (if, you may be required to provide documents evidencing FCPT exemption) 6. Can the Entity issue or has in issue bearer shares? (if, then BCB may not be permitted to open the account; please contact a Relationship Manager) About Your Organisation Legal Name of the Entity Business Name (if different) Previous Names (if any) Legal Structure of your Entity: (select one only) Trust Incorporated Trust (PTC) Sole Trader Partnership Executor Listed Entity Limited Liability Partnership (LLP) Unlisted Limited Company (LTD; not Listed) Unlisted Public Company Incorporation Details (if applicable) Jurisdiction: If Listed, please provide: Number: (DDMMYY) : Name of Exchange Organisational Status (select one only) Ticker/ISIN Exempt Local Overseas About Our Services and Products Type of Service Required (select all that apply) Name of Account Banking - Current Account Banking - Call Account Custody (requires a BCB current account) Asset Management Trust Services Page 1 of 9

2 About Our Services and Products (cont.) Currency (select all that apply) USD BMD GBP AUD CAD JPY EUR CHF NZD Other: Base Currency for Custody Portfolio (select one only) USD BMD GBP AUD CAD JPY EUR CHF NZD Other: Would you be registering for online banking? (If you do not require online banking, please inform a Relationship Manager) Would you be registering for mobile banking? Contact Details of the Entity Business Address Address Line 1 Address Line 2 Address Line 3 City/Parish State Post/Zip Code Registered Address (leave blank if same as Business Address) Address Line 1 Address Line 2 Address Line 3 City/Parish State Post/Zip Code Name of Primary Contact Position Business Business Mobile Business Fax Business ne ne ne Please include country and area code for all phone and fax numbers Page 2 of 9

3 About Your Business or Operation or Activity Please select the Primary Industry in which the Entity Operates (one only) Building Society, Cooperative & Other Mutual Bank Bank Banking Multilateral Development Bank (MDB) Sovereign & Central Bank Insurance & Retirement Asset Management Corporate Service Governmental & t for Profit Property, Building & Construction Core Sectors Please describe your primary activity, product and/or service Pension & Annuities Insurance (n Life & Health) Insurance (Life & Health) Insurance Management & Brokerage Captive Re(Insurance) Reinsurance Investment/Fund Administration Investment Portfolio Management Transfer Agency Custody Corporate Trust Financial Brokers & Advisors Trust Administration Legal & Company Formation Services Actuarial, Assurance, Accounting & Bookkeeping Brokerage & Agency Services International Organisation Public Sector Entity (PSE) n-profit Institutions Serving Households (NPISH - charities, religious institutions etc ) Real Estate (Developer/Landlord) Building Contractor Design & Engineering Property (Agents/Admin) Facility Maintenance (cleaning, plumbing, electrical etc) Printing & Publishing Oil, Gas & Natural Resources Gambling & Betting Marine, Shipping & Cargo Association Society Club Other Business / Operation start date (if different from Incorporation ) (DDMMYY) Number of Beneficial Owners with controlling interest more than 10% Do the Beneficial Owners include any Incorporated Entities (including Trust Companies)? (If, please complete Supplementary Information form) Number of Signatories to be included as part of this application Would all Signatories have the same level of Signing Authority? Number of Directors/Officers Annual Turnover/Revenue/Income (provide anticipated amount if at Start-Up) Does the Entity's business deal with Cash? Anticipated Total Annual Cash Receipts Amount: Currency: Typical Cash transaction value (Receipt) Amount: Currency: Typical Cash transaction value (Payment) Amount: Currency: Initial Funding (aggregate deposits to be made within consecutive 24 hours of account opening) Source: Amount: Currency: Method of Initial Funding Cash Cheque Wire Draft Page 3 of 9

4 About Your Business or Operation or Activity (cont.) Do you hold Bank Accounts elsewhere? If, please provide names of the 1) Bank(s), 2) (ies), Also indicate if it is a Source of Initial Fund Bank Name Source of Initial Fund? US Do you Operate in any Jurisdictions Outside Bermuda and/or have International Transactions? (Select all that apply) EU (other than UK) Other India UK Canada EU (other than UK) Other India Australia China US Will you have Standing Orders/Instructions to transfer funds to/from Jurisdictions marked above? (select all that apply) Russia UK Canada Australia China Russia What is the governing legal jurisdiction (mandatory for Trusts & Executor)? Will you be claiming Double Tax Relief (Tax Treaty Benefit)? Is the Entity Resident for Tax Purposes in another Jurisdiction? (Other than Bermuda) Does the Entity have Tax ID in another Jurisdiction? (If, provide relevant forms e.g. W8) (e.g. UTR for UK; GIIN for US) Please provide name(s) of the Jurisdiction(s), if you have answered to either of the questions above Does the Entity require a licence / permission to Operate? Primary Jurisdiction of Regulator/Issuer of the Licence Please provide name(s) of Regulator/Issuer of Licence (BCB will also accept the above information on Entity's official document, certified by a Signatory) Page 4 of 9

5 Transaction Activity - Incoming Method of Funding Form of Future Transactions Value Number of Incoming Transactions Internet Banking In Bank/ Walk In Mail In Wire Transfer Bank Draft Manager Cheque Personal Cheque Cash Direct Deposit Internal Transfer Internet Banking Third Party Cheques $1 - $10,000 $10,001 - $100,000 $100,001 - $500,000 $500,001 - $1M $1M More than 20 (please specify below) Timing Currency Monthly Quarterly Semi-Annually Annually US UK EU (other than UK) Canada Australia India China Russia Other Transaction Activity - Outgoing Method of Funding Form of Future Transactions Value Number of Outgoing Transactions Internet Banking In Bank/ Walk In Mail In Wire Transfer Bank Draft Manager Cheque Personal Cheque Cash Direct Deposit Internal Transfer Internet Banking Third Party Cheques $1 - $10,000 $10,001 - $100,000 $100,001 - $500,000 $500,001 - $1M $1M More than 20 (please specify below) Timing Currency Monthly Quarterly Semi-Annually Annually US UK EU (other than UK) Canada Australia India China Russia Other Page 5 of 9

6 Additional Information How did you hear about us? Referral Advert Newsletter Search Engine Other: If Referred, please provide the name How would you like us to keep you up to date of our services? SMS Post ne Client Declaration I/We (the Client ) confirm the information contained within this Application and supplemental forms forming part of this Application are complete and accurate. I/We (the Client ) declare the Account(s) and Product(s) will only be used for legal purposes. I/We (the Client ) agree to inform you, within 30 days, of any changes in the status of the business (including legal and taxation status) and/or entity that could affect the operation of the Account, including the change of address. I/We (the Client ) confirm that the list of beneficiaries and their legal and tax status as requested in the related forms is complete and accurate. I/We (the Client ) confirm and agree that we are responsible upon receipt, to review all account statements or other notifications / advices relating to the Account and, if I/we fail to do so, the Bank will not be liable to the Client for any losses incurred after the time that such information should have been discovered and further reported to the Bank. I/We (the Client ) confirm that I/we have taken all necessary action to authorise the entry into and performance of this Application. The persons signing below have been duly authorised to the Application on behalf of the Client and such authorisations are in accordance with the applicable constitutional documents of the Client. I/We (the Client ) acknowledge, accept and agree to be bound by the Terms and Conditions of the Account(s) forming part of this Application and attached hereto. Print Name & Position/Capacity Print Name & Position/Capacity For Use by the Bank Only Account Manager Processing Team Manager/Supervisor I have obtained all essential documents in the format as I confirm that all relevant information has been processed by required by BCB Policy and confirm completeness of this the administrators accurately and completely. application. & & Page 6 of 9

7 Supplementary Information Fill this form if any of the following were answered : a) Is the Entity connected to another group of entities b) Does the Entity have a global or national parent company c) Do the Beneficial Owners include any Incorporated Entities (including Trust Companies) Parent Company (Incorporated Trusts should also be included) Name of Parent Company Jurisdiction Incorporation Is the above Company a Listed Entity If Listed, please provide: If not listed, is the above Company owned by another Company Address (refer to question below) Name of Exchange Ticker/ISIN (please complete Ultimate Beneficial Owner section below and provide certified Organisational Chart ) (please complete Beneficial Owners form) Certified copies of the Organisational Chart should also include any Organisation (including Trust Companies) owning over 10% of the Entity making the application to open a BCB Account Ultimate Beneficial Owner (Trust Companies should also be included) Name Jurisdiction Is the above entity a Listed Entity If Listed, please provide: Incorporation Address (please complete Beneficial Owners form) Name of Exchange Ticker/ISIN Does Parent and/or Ultimate Beneficial Owner have Tax IDs in Countries Other than Jurisdiction of Incorporation stated above? (e.g. UTR for UK; GIIN for US) If, please provide names List of Connected Parties (e.g. Underlying Corporate Shareholders, Sister Entities or other Related Parties) (BCB will also accept the information requested below on Organisation's official document, certified by a Signatory) Name of Entity Print Name & Position/Capacity Jurisdiction Relation Page 7 of 9

8 About the Beneficial Owners (including Anyone with Capacity on Trusts, POA and Directors/Officers of PSEs/t for Profit) (Please use additional pages of this form, if required) (To be completed for Beneficial Owners who are Individuals - Natural Persons; also include Ultimate Beneficial Owners) (If Applicant is not a Listed Entity, must include Beneficial Owners of the Ultimate Parent Undertaking) (If the Applicant is a Listed Entity, complete this only for Beneficial Owners with controlling interest over 10%) Are you an Existing Customer of BCB? Will you be a Contact Person? Title Mr Mrs Ms Miss Dr Other: First Names Last Name Gender Male Female Occupation Position/Capacity Beneficial Owner (select all that apply) Trustee Partner Signatory Grantor Enforcer Settlor Shareholder Director/Officer Executor Power of Attorney (POA) Protector Minor (Beneficial Class) Residential Address (Please do t use P.O. Box. Or "Care of") Address Line 1 City/Parish Address Line 2 Post/Zip Code Address Line 3 State Address (please include country and area code ) What is your Bermuda Residency Status? Resident (Bermudian/Spouse of Bermudian/PRC) Resident (n Bermudian) of Birth (DDMMYY) Place of Birth n Resident Nationality Do you hold any other Nationalities? If, please provide names Do you have Right of Nationality of another through Acquisition? (Through parents, birth, naturalisation, permanent resident, green card holder etc) If, please provide names of the (ies) Are you Resident for Tax Purposes in another Jurisdiction (Other than Bermuda)? Do you have Tax IDs in another Jurisdiction (e.g. UTR for UK; ITIN for US)? Please provide name(s) of the Jurisdiction(s), if you have answered to either of the questions above Do you have National ID. from any other than Bermuda? (e.g. Social Security, National Insurance, National ID Card.) If, please provide names of the (ies) Do you receive income from countries other than Bermuda? (Business income, rental income, investment income, pension, annuities, life insurance etc.) If, please provide names of the (ies) Will you be available for Face to Face meeting with Bank Staff? How would you like us to keep you up to date of our services? If not available for a Face to Face meeting, non current BCB customers will be required to provide certified copies of Proof of ID and Address SMS Post ne I (the Client ) confirm the information about the person named on this page is complete and accurate. Print Name Page 8 of 9

9 Details of Signatories who are not Beneficial Owners Are you an Existing Customer of BCB? Will you be a Contact Person? Title Mr Mrs Ms Miss Dr Other: First Names Last Name Gender Male Female Occupation Job Title in the Organisation Are you a Director or Officer of this Organisation? Residential Address (Please do t use P.O. Box. Or "Care of") Address Line 1 City/Parish Address Line 2 Post/Zip Code Address Line 3 State* Address (please include country and area code ) What is your Bermuda Residency Status? Resident (Bermudian/Spouse of Bermudian/PRC) Resident (n Bermudian) of Birth (DDMMYY) Place of Birth n Resident Nationality Do you hold any other Nationalities? If, please provide names of the (ies) Do you have National ID. from any other than Bermuda? (e.g. Social Security, National Insurance, National ID Card.) If, please provide names of the (ies) Are you Resident for Tax Purposes in another Jurisdiction (Other than Bermuda)? Do you have Tax IDs in another Jurisdiction (e.g. UTR for UK; ITIN for US)? Please provide name(s) of the Jurisdiction(s), if you have answered to either of the questions above Will you be available for Face to Face meeting with Bank Staff? How would you like us to keep you up to date of our services? If not available for a Face to Face meeting, non current BCB customers will be required to provide certified copies of Proof of ID and Address SMS Post ne I (the Client ) confirm the information about the person named on this page is complete and accurate. Print Name (Please use additional pages of this form, if required) Page 9 of 9