Attestation Packet Instructions and Reference

Similar documents
CLASS ACTION CLAIM FORM

CLASS ACTION CLAIM FORM

PLEASE TYPE OR PRINT LEGIBLY

AGGREGATE VERIFICATION GROUP Independent Student

IDENTIFICATION REQUIREMENTS FOR CORPORATIONS AND INDIVIDUALS

Account opening application form for Personal Account Customers

Verification Worksheets Dependent Student-Tracking Group V5

AGGREGATE VERIFICATION GROUP Dependent Student

DEPENDENT VERIFICATION WORKSHEET V5 (AGGREGATE)

Packet For Qualifying Income Trust

Account Opening Form. Personal

CHARITABLE SOLICITORS PERMIT APPLICATION FEE: $0

Dependent Verification Worksheet (V5) Call (334): or for questions

INDEPENDENT VERIFICATION WORKSHEET V5 (AGGREGATE)

Application for membership under 18 years of age

Legal Practitioners Liability Committee ENDURING POWERS OF ATTORNEY: WITNESSING AND CERTIFICATION ISSUES

CLIENT PERSONAL INFORMATION

West Virginia State University

Trust Application Form

THE ARC OF OHIO INC. ACCOUNT OF THE COMMUNITY FUND MANAGEMENT FOUNDATION POOLED MEDICAID PAYBACK TRUST POOLED MEDICAID PAYBACK SUB-ACCOUNT

Dependent Aggregate Verification Worksheet

DIRECT IDENTITY VERIFICATION AND AUTHORIZATION. HISP Name: Orion Health Telephone:

Power of Attorney Form

Southern Region of Teamsters Pension Fund. Fund Office Gulf Freeway, Suite 304 Houston, TX 77017

2. For Private Entrepreneurs, Individuals Assigned TIN under Armenian Legislation and Notaries

United Roosevelt Savings Bank Switch to URSB Kit

Name: CHECKLIST FOR INDIVIDUAL CLIENTS (MANDATORY)

Verification Worksheet Dependent Student- Tracking Group V5

DISCLOSURE AND ACKNOWLEDGMENT [IMPORTANT -- PLEASE READ CAREFULLY BEFORE SIGNING ACKNOWLEDGMENT] DISCLOSURE REGARDING BACKGROUND INVESTIGATION

Legal Transfer Form. Online:

Account Opening Form. Sole Proprietorship. Your Trusted and Dependable Partner

Origination Standards for Fraud Avoidance

RIGHT-OF-WAY CONTRACTOR LICENSE APPLICATION PROCESS AND FEES. Type of License Type of Fee Fees. License Fee $ License Fee $50.

Independent Aggregate Verification Worksheet

City of Aspen & Pitkin County

DEPOSITS ACCOUNT NO.: SINGLE MEMBERSHIP APPLICATION FORM Regular Account CARES Teen / Youth Account

Small Business Credit Card New Business Credit Card Account Relationship

Orange County Housing Finance Authority 2211 E. Hillcrest Street Orlando, FL

COMMUNITY FUND MANAGEMENT FOUNDATION MASTER TRUST MASTER TRUST SUB-ACCOUNT JOINDER AGREEMENT AND APPLICATION FOR ADMISSION AS GRANTOR

Youth esaver Account Application (individuals under 10)

APPLICATION PACKAGE FOR INSURANCE AGENT, BROKER AND SOLICITOR

Customer Information Updation Form (NRI)

INDEPENDENT AGGREGATE VERIFICATION FORM

VALLEY CONTRACT SERVICING

Relationship & Account Opening Form (Main applicant)

FORM 1 [See Rule 53 (1)]

Section A: Household information Please complete all boxes for persons listed

DEPENDENT AGGREGATE VERIFICATION FORM

Contract Notes in addition to ECN, an authority letter to that effect is to be given by applicant - Refer format given below)

Know Your Client (KYC) Application Form (For Individuals Only)

Institutional Investor Waiver Application Form

INDEPENDENT AGGREGATE VERIFICATION FORM

Verification Worksheets For Independent Students V-5 Aggregate Verification Group

(Applicant Name and Address) APPLICATION FOR A PERSONAL LOAN. ( Ghana Cedis) for the. against my account number

PROCESS FOR TRANSFER OF SHARES. Following documents are required to be submitted to us for transfer of shares:

Employees Provident Fund Organization

PURCHASE ASSISTANCE PROGRAM COMMUNITY DEVELOPMENT DEPARTMENT

Student s Last Name Student s First Name Student s M.I. Student s IRSC ID Number. City State Zip Code Student s Address

Application Instructions

Know Your Customer Requirements Checklist Investor Version April 2012

COMMUNITY FUND MANAGEMENT FOUNDATION POOLED MEDICAID PAYBACK TRUST POOLED MEDICAID PAYBACK SUB-ACCOUNT

Change of details form

LOAN ORIGINATOR APPLICATION INSTRUCTIONS

220 Burnham Street South Windsor, CT Vox Fax LOUISIANA MEDICAID DENTAL ELECTRONIC CLAIMS ENROLLMENT REGISTRATION

Suncorp Everyday Super TM

UTILITY CONTRACTOR S LICENSE EXAM APPLICATION

Dependent Aggregate Verification Worksheet. Student Last Name First Name MI Students Social Security Number

Sheet Metal Workers Local Union No. 292 Annuity Fund Benefit Distribution Application. Application Checklist

REINSURANCE COMPANY FORMATION Checklist and Instructions. FOR USE WITH CONTROLLED FOREIGN CORPORATIONS ( CFCs ) ONLY

Hallandale Beach Community Redevelopment Agency First Time Homebuyers Program

Mail: Section 5 Division P.O. Box Boston, MA (Phone) (Fax)

Instant Account Opening Form For Individuals (Primary Applicant) e-kyc / Non E-kyc

NEW BUSINESS LICENSE APPLICATION

VERIFICATION WORKSHEET Dependent Student - Tracking Group V5

VERIFICATION WORKSHEET Independent Student - Tracking Group V5

Bridging the Gap. Dear Prospective W/MBE:

MBE/WBE CERTIFICATION APPLICATION

Southern Region of Teamsters Pension Fund Fund Office 8441 Gulf Freeway, Suite 304 Houston, TX 77017

Australian Securities Income Fund Australian Securities Property Fund Australian Securities Term Fund All of the above

V5 Aggregate Verification Worksheet for Dependent Students

Application for Accreditation by Testing

VERIFICATION WORKSHEET Dependent Student - Tracking Group V5

LONDON BRANCH THE MORTGAGE APPLICATION FORM FOR YOUR HOME IN PORTUGAL

Sending a copy of your Power of Attorney to MLC

CLIENT AGREEMENT INDIVIDUAL / JOINT ACCOUNT MARGIN FX & CFD CONTRACT

Order form United Arab Emirates (UAE) - Ras Al Khaimah (RAK) Incorporation service FORMATION OF INTERNATION BUSINESS COMPANIES (IBC)

Customer Identification Form For Individuals, Joint Investors and Sole Traders

MANUFACTURED HOME LOAN APPLICATION CHECKLIST

Individual s Membership Application & Account Opening Form

1 ORIGINAL WILL 1 DUPLICATE WILL

Third Party Agreement for personal account(s)

Verification Worksheet Dependent Student

Sage Verification Form (V5)

Mail: Section 5 Division P.O. Box Boston, MA (Phone) (Fax)

Property located at: Monthly Rental Rate: $ Property Manager: APPICANT #1. Name: Date of Birth: Social Security #: Address: Telephone: Address:

Starting your Old Mutual - International

CLIENT PERSONAL INFORMATION

MULTI-PURPOSE CERTIFICATION FORM

Important information on identification

2017 Affordable Homeownership Program Overview

Transcription:

Attestation Packet Instructions and Reference Steps to Complete the Attestation Packet 1. The Principal (you) will print out all pages of this Packet (6 pages total, including these instructions). 2. The Principal (you) will prepare Vetting Documents to validate their identity. These Vetting Documents MUST include one government issued signed photo ID document and two secondary forms of identification. The documents MUST meet the requirements of the Requirements for Vetting Documents section below. 3. The Principal will present this Packet including their 3 Vetting Documents directly to their Validator for attestation. Depending on your jurisdiction, the Validator can be an active notary, lawyer / solicitor / advocate, chartered accountant / CPA or latin notary. NOTE: You are responsible for all fees charged by the Validator. 4. The Premium Secure Certificate Personal Statement Attestation page (Page 3) must be filled out by the Principal in the presence of the Validator. The Validator will then attest to this by signing and/or sealing the bottom of the document. 5. The Validator will, photocopy the photo ID provided and sign and date the photocopy. 6. After inspecting the Vetting Documents provided, the Validator will fill out and sign the Statement of Identity with Face-to-Face Validation and Third-Party Validator Information sections (Pages 4-5). 7. The Principal will make and retain a copy of the completed Packet in a secure location. 8. The Principal will follow the Final Checklist at the end of this document and return the completed Packet (pages 3-6 and the Photo ID Page) to the Registration Authority by uploading it directly to their application. Requirements for Vetting Documents Photo ID (1 document) A current signed government-issued identification document that includes a photo of the Principal and is signed by the Principal. A photocopy of the Photo Id used to validate Principal (attested and sealed by Validator) must be included in the documents returned to the Registration Authority. Acceptable government-issued identification documents include: A passport; A driver s license; A personal identification card (PAN Card, national ID card, etc); A concealed weapons permit; A military ID. Page 1

Secondary Documents (2 documents) At least two secondary documentary evidences that establish the identity of the Principal. These documents must include the name of the Principal. One of the documents MUST be from a financial institution. A. Acceptable financial institution documents include: A major credit card; provided that it contains an expiration date and it has not expired. A debit card from a regulated financial institution; provided that it contains an expiration date and it has not expired. A mortgage statement from a recognizable lender that is less than six months old. A bank statement from a regulated financial institution that is less than six months old. B. Acceptable non-financial documents include: Recent original utility bills or certificates from a utility company confirming the arrangement to pay for the services at a fixed address (not a mobile/cellular telephone bill). A copy of a statement for a payment of a lease provided the statement is dated within the past six months. A certified copy of a birth certificate. A local authority tax bill for the current year. A certified copy of a court order, such as a divorce degree, annulment papers, or adoption papers. There are many possible combinations of Vetting Documents, but some examples of a valid set are: Photo ID: Passport, Secondary documents: a major credit card and a debit card Photo ID: Driver s license, Secondary documents: Debit card from a regulated financial institution & a local authority tax bill for the current year Photo ID: National ID Card, Secondary documents: bank statement from a regulated financial institution less than six month old & electric bill Page 2

Premium Secure Certificate Personal Statement Attestation To be completed by the Principal Principal s Full Name: (Principals full legal name as it is shown on their government issued photo ID) Residential Address at which he/she can be located: Street Address 1: Street Address 2: City: Zip/Postal Code: State: Birth Date: ALL Other Names by which the Principal is, or has been known: I attest by my signature below that the above personal information is true and correct and that all information contained in the Premium Certificate Request submitted to the Registration Authority is true and correct. Principal s Signature: Date: Month Day Year Given under my hand and seal on Month Day Year Validator Signature: {seal} Page 3

Statement of Identity with Face-to-Face Validation The undersigned, a duly authorized (Notary Public / Lawyer / Solicitor/Chartered Accountant/CPA, Latin Notary) do hereby attest that on this day I personally met with (the Principal ) and witnessed his/her signing of the Premium Secure certificate Personal Statement of Attestation. I have sealed the Premium Secure Certificate Personal Statement of Attestation with my seal as further validation of the Principal s signature. I have reviewed the original documentation provided by the Principal used to verify his/her identity in connection with the request for a Premium Secure Certificate. I attest that the original documentation provided to me appears to be genuine and not altered in any manner, and meets the requirements of vetting documentation for a request for a Premium Secure Certificate. The documentation presented includes a current government-issued identification document that includes a photo of the Principal and the Principal s signature, which I have photocopied. I attest by my seal on the photocopy of that document that it is a full, true and accurate reproduction of the original. I have also reviewed two additional forms of personal identification presented by the Principal and have listed them below. The required financial document that identifies the Principal by name is a: (Please check the type of document below fill in any blanks. Check only one document in this section.) Major credit card (number ending in ); Expiry Date Debit card from a regulated financial institution; (number ending in ); Expiry Date Mortgage statement from a recognizable lender that is less than six months old. Bank statement from a regulated financial institution that is less than six months old. The second unique document that identifies the Principal by name is a: (Please check the type of document below fill in any blanks. Check only one document in this section.) Major credit card (number ending in ); Expiry Date Debit card from a regulated financial institution; (number ending in ); Expiry Date Mortgage statement from a recognizable lender that is less than six months old. Bank statement from a regulated financial institution that is less than six months old. Recent original utility bill or certificate from a utility company for services at a fixed address (not a mobile/cellular telephone bill). Copy of a statement for a payment dated within the past six months. Certified copy of a birth certificate. Local authority tax bill for the current year. Certified copy of a court order (divorce degree, annulment papers, or adoption papers) I also attest that I am legally registered to perform such attestations in the jurisdiction of the Principal s residency as indicated on the Premium Secure Certificate Personal Statement Attestation. Given under my hand and seal on Month Day Year Validator Signature: {seal} Page 4

Third-Party Validator Information Note to Validator: In order to use this Attestation Packet in its entirety, we must confirm your status and contact details, and then contact you to authenticate it. To ensure this goes smoothly, please fill in the applicable information below. Profession: Notary Lawyer/Solicitor/Advocate Chartered Accountant / CPA Latin Notary Printed Name: Printed Name (English): Registration Agency (Bar, Accountancy Board, etc): Registration Number: Firm: Contact Phone Number: Page 5