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AML - CFT Questionnaire For Client (Input ARP)

This document is a customer due diligence questionnaire from a financial institution. It requests information about the company's corporate details, ownership and management structure, and anti-money laundering/counter-terrorism financing practices. The questionnaire covers topics such as the company's AML compliance program, policies and procedures, transaction monitoring, sanctions screening, training, and regulatory actions. It aims to gather information to assess the company's money laundering and terrorism financing risks.

Uploaded by

Mohammad Reza
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© © All Rights Reserved
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106 views4 pages

AML - CFT Questionnaire For Client (Input ARP)

This document is a customer due diligence questionnaire from a financial institution. It requests information about the company's corporate details, ownership and management structure, and anti-money laundering/counter-terrorism financing practices. The questionnaire covers topics such as the company's AML compliance program, policies and procedures, transaction monitoring, sanctions screening, training, and regulatory actions. It aims to gather information to assess the company's money laundering and terrorism financing risks.

Uploaded by

Mohammad Reza
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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AML/CFT Customer Due Diligence Questionnaire

SECTION 1 – CORPORATE INFORMATION

1.1 Contact Details


Full legal name:
Full address of registered office: Street details:
Suburb: Postal/ZIP code:
Country:
Full mailing address (if different to Street details:
above): Suburb: Postal/ZIP code:
Country:
External Auditor:
Date of incorporation/establishment:
Number of employees:
Principal business activity:
Regulator:
Number of branches/sub branches:
Phone:
Fax:
Email:
Website:

1.2. Legal Form, Regulatory status and Other Details


What is the legal form of your Institution?
Public company Private company
State Owned Company Other (please provide full details below)

Is your Institution regulated in its activities by a Yes – Please state name of the regulator(s) below
financial services regulator?

No
License (type, number, issuing date, expire date):
Tax identification number:
What is the purpose and scope of business
arrangements with PT Hanwha Life Insurance
Indonesia?
Is your institution publicly listed? Yes – Please state below:
a) Name of stock exchange (s):
b) Full name of company’s securities:
c) Stock exchange listing code:

No
Total assets in IDR:

-1-
SECTION 2 – OWNERSHIP & MANAGEMENT INFORMATION

2.1. Please provide full name / legal entity, ownership interest and ultimate beneficial owners of your institution.

Ownership
Nature of ownership
Name interest
(direct / Indirect)
(percentage)

2.2 Please provide your management structure and full name of BOD or equivalent and Supervisory Board.

NAME POSITION

2.3 Do you have any Politically Exposed Persons in the Yes – Please state the name and function below
management?

No

SECTION 3 – GENERAL AML/CFT PRACTICES

3.1 AML overview


1. Is your Institution subject to local AML laws/regulation? Yes No
2. Is your Institution a member of a Group of companies? Does the Yes No
Ultimate Parent entity require that all members of its Group apply common
internal standards of AML controls?

3.2 Anti-Money Laundering Compliance Program


1. Does your institution have an AML Compliance Program? Yes No
2. Does your institution have a regulatory compliance program that Yes No
includes a designated compliance officer that is responsible for
coordinating and overseeing the AML framework?

If yes, please provide the name and contact information of an officer


Name:
Title:
Phone/Fax:
Email address

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3.3 AML/CFT Polices and procedures
1. Does your AML Compliance Program require the approval of your board Yes No
or a KYC committee thereof?
2. Does your AML program and written policies and procedures comply Yes No
with current AML legislations, regulations and guidelines issued by the
regulatory bodies in the jurisdiction in which you operate?
3. Does your institution have written policies that have been approved by Yes No
senior management documenting the processes that have been put in
place to prevent, detect and report suspicious transactions?
4. In addition to inspections by the government supervisors/regulators, Yes No
does your institution have an internal audit function or other independent
third party that assesses aml policies and practices on a regular basis?

If yes, how frequently are these audits/tests conducted (i.e. quarterly,


annually)?
5. Does your institution have appropriate record retention procedures Yes No
pursuant to applicable law?

If yes, how long are records retained?


6. Do you ensure that your policies, procedures and controls are Yes No
communicated and enforced effectively in your internal through the
following approaches:
 internal circulars
 procedural manuals
 internal audit
 compliance officer checks
 external audit /regulatory inspection

3.4 Reportable transactions and revention and detection of Transactions


with illegally obtained funds
1. Does your institution have policies or practices for the identification and Yes no
reporting of transactions that are required to be reported to the
authorities?
2. Does your institution have procedures to identify transactions structured Yes no
to avoid large cash reporting requirements?

3. Does your institution screen transactions for customers or transactions Yes no


you deem to be of significantly heightened risk (which may include
persons, entities or countries that are contained on lists issued by
government/international bodies) that special attention to such customers
or transactions is necessary prior to completing any such transactions?

3.5 Transaction Monitoring


1. Does your institution have a monitoring program for suspicious or Yes No
unusual activity that covers funds transfers and monetary instruments ?
2. Does your institution have a transaction monitoring system to Yes No
automatically detect suspicious activities/ transactions?

If yes, please describe name of system (software), vendor, user

-3-
departments/divisions name and number of staff.

3.6 Sanctions Screening


1. Does your institution filter payments against relevant sanctions lists? Yes No
If Yes, please describe name of the applicable sanctions list within your
institution.

UN OFAC EU others (please specify: )

3.7 AML Training


1. Does your institution provide AML training to relevant employees that Yes No
includes identification and reporting of transactions that must be reported
to government authorities, examples of different forms of money
laundering involving your products and services and internal policies to
prevent money laundering?
2. Does your institution retain records of its training sessions including Yes No
attendance records and relevant training materials used?

3.8 Regulatory Action


1. Has your institution or parent bank been the subject of any money Yes No
laundering or terrorist financing-related proceedings, investigations,
sanctions, punitive actions indictment, had fines, conviction or civil
enforcement action imposed on your institution or parent bank by a
regulator or law enforcement body during the last five years?
2. Has your institution, to your knowledge, been the subject to any Yes No
investigation, indictment, penalty, fine, conviction or civil enforcement
action related to terrorism financing in the past five years?

SECTION 4 – THIS FORM WAS COMPLETED BY:


I confirm that I am authorized to complete this document.
Name:

Position:
E-mail:

Signature

Date:

-4-

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