KYC - Template 2023
KYC - Template 2023
KYC - Template 2023
D OCUMENTATION E NCLOSED
C ORPORATION
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IN ACCORDANCE WITH ARTICLES 2 THROUGH 5 OF THE DUE DILIGENCE CONVENTION AND THE FEDERAL BANKING COM -
MISSION CIRCULAR OF DECEMBER 1998, AND UNDER THE US PATRIOT ACT OF 2002, AS AMENDED IN FEBRUARY 2003
CONCERNING THE PREVENTION OF MONEY LAUNDERING AND 305 OF THE SWISS CRIMINAL CODE, THE FOLLOWING INFOR-
MATION MAY BE SUPPLIED TO BANKS AND/OR OTHER FINANCIAL INSTITUTIONS FOR PURPOSES OF VERIFICATION OF
IDENTITY AND ACTIVITIES OF THE CLIENT DESCRIBED BELOW, AND THE NATURE AND ORIGIN OF THE FUNDS WHICH ARE TO
BE UTILIZED. THE FOREGOING IS SUBJECT TO AGREEMENT BY ALL PARTIES TO WHOM THIS INFORMATION IS PROVIDED
THAT THEY ARE OBLIGATED TO RESPECT THE PRIVACY RIGHTS OF THE CLIENT AND ALL INDIVIDUALS DESCRIBED HEREIN, AS
WELL AS THE GENERALLY ACCEPTED PROFESSIONAL STANDARDS RELATING TO THE MAINTENANCE OF CONFIDENTIAL IN-
FORMATION, AND TO TAKE ALL APPROPRIATE PRECAUTIONS TO PROTECT THE CONFIDENTIALITY OF THE INFORMATION
CONTAINED HEREIN, THIS LEGAL OBLIGATION SHALL REMAIN IN FULL FORCE INDEFINITELY WITHOUT RESTRICTION. I AM
REQUIRED TO INFORM YOU THAT UNDER THE UK MONEY LAUNDERING REGULATIONS OF 2007: TTP://WWW.LEGISLA-
TION.GOV.UK/UKSI/20072157/CONTENTS/MADE THE: PSN01AA PREVENTION OF MONEY LAUNDERING AND COUNTERING
THE FINANCING OF TERRORISM SINGAPORE
HTTPS://WWW.MAS.GOV.SG/REGULATION/NOTICES/PSN01AA---TRANSITIONAL-NOTICE-FOR-ACCOUNT-ISSUANCE-SER-
VICES
THE: HKMA ANTI MONEY LAUNDERING ACT 23/09/2019 HTTPS://WWW.ELEGISLATION.GOV.HK/HK/CAP615
WE ARE REQUIRED TO RETAIN ALL FILES AND COMMUNICATIONS REGARDING THIS CASE AND ULTIMATELY IF CALLED
UPON TO HAND OVER THE SAME TO THE RELEVANT AUTHORITIES. ANY AND ALL INFORMATION IS SAFEGUARDED UNDER
UK DATA PROTECTION ACT 1998 AND WILL NOT BE DISCLOSED UNLESS ORDERED TO DO SO BY OURT ORDER. THE CODE
STATES THAT A PERSON CONVICTED OF BANK FRAUD: MAY BE FINED UP TO ONE MILLION DOLLARS: MAY RECEIVE A
PRISON SENTENCE OF UP TO 30 YEARS AND LOSE PASSPORT PRIVILEGES FOR LIFE. THE COMPANY WE USE IS TRANSUNION
GROUP HTTP:///WWW.TRANSUNION.CO.UK/PRODUCTS-AND-SERVICES/FRAUD-AND-ID/AML-GUIDELINES
(All Documents must be signed in wet blue ink _no electronic signatures)
I, (NAME), have read and accepted the above as of this date: August 19, 2023
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_________________________________________
All Signatures to be signed in wet blue ink (no electronic signatures
Name / Title:
Company:
Passport Number:
Country of Issuance:
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Dear Sir,
I, (NAME), the undersigned, on behalf of (COMPANY NAME), do hereby affirm that I have requested
specific information about Private Placement Opportunities and or the Participation in Investment
Programs. The confidential information presented, received, and learned is not for the solicitation of
funds, nor is it an offering of any kind, but is for my general knowledge. I confirm that I have requested
the information of my own free will and choice, and further confirm that no party has solicited me in any
way. I hereby agree to keep all information received from you strictly confidential, private, and
proprietary, and that I will not disclose it to any other third party.
I, (NAME), further affirm that any funds or assets I decide to place are done so at my own specific
initiative, risk, and authorization with full consideration and without duress. I further affirm that the
information received is intended solely for my PRIVATE & CONFIDENTIAL USE ONLY. I am a sophisticated
investor by all definitions of that classification known to me; I make my own investment decisions, and
have legally acquired assets available. I, hereby reaffirm, under penalty of perjury that I have requested
information from you and your organization and that you have not solicited me in any manner.
I, (NAME), understand that the contemplated transaction is strictly one of Private Placement and is in no
way relying upon existing regulations in relation to the United States Securities Act of 1933 as amended,
or related regulations, and does not involve the buy and sell of securities. I further declare that I am not
a licensed securities broker or government employee and understand that neither are you or your
organization. I mutually agree that this Private Placement Transaction is exempt from the securities act.
I, (NAME), understand and agree that the ICC NON-DISCLOSURE and NON-CIRCUMVENTION rules apply
to this affidavit and business relationship, and hereby agree to the current application standards of the
International Chamber of Commerce, Paris, France which rules are made a part hereof by this reference.
I, (NAME), under penalty of perjury, with full corporate and individual responsibility, hereby irrevocably,
confirm that neither myself, nor anyone else associated with my organization, my corporation, or the
individual investor are working for any Agencies of any Government. I further state under penalty of
perjury that I am not involved in any Government entrapment operation.
I, (NAME), under penalty of perjury, with full corporate and individual responsibility, hereby irrevocably,
confirm that neither myself, nor anyone else associated with my organization or corporation have been
convicted of a felony, either within the United States or anywhere in the world where that crime would
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be considered equal to a US felony. To the best of my knowledge I am not nor are any of my associates
within my organization or corporation considered to be terrorists or on any watch list with the United
States Department of Homeland Security.
I, (NAME), agree that all email and facsimile transmitted documents shall be treated as original
documents. I further agree that in all cases where plural might apply where singular tense is used it is so
applied.
I, (NAME), hereby swear under penalty of perjury, that the information provided herein is accurate and
true as of this date: August 19, 2023
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Directions: This document must be completed in full. If a line item does not pertain then insert the term:
“N/A” (non-applicable).
Corporate Information
Full Name of Corporation:
Date of Incorporation:
Incorporated in (City/State/Country):
Registration Number:
Board of Directors (Name & Title):
Officers (Name & Title):
Shareholders (List all shareholders
owning more than 5 % of all
outstanding shares of Corporation):
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Languages / Translator
Languages:
Does the Signatory speak English?
If No, Name of Translator:
Telephone Number:
Email Address:
Skype ID:
Legal Advisor
Full Name:
Company:
Address:
City:
State:
Country:
Postal Code:
Telephone Number:
Email Address:
Skype ID:
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Bank coordinates for client funds to be transferred to, MUST BE CLIENTS ACCOUNT.
Beneficiary:
Bank Name:
Bank Address:
SWIFT:
Account Name:
Account No:
ABA / IBAN No:
Bank Officer:
Bank Officer Phone No.:
Bank Officer E-mail:
or to appointed Paymaster
Paymaster
Designation
Paymaster address
Nationality
Paymaster E-mail
Bank name
Bank address
Swift Code
Account name
Account No.
IBAN
Account signatory
Bank officer
Bank Officer Phone:
Bank officer e-mail
EMAIL a notification immediately upon each tranche/ transfer payment together with the
transaction code/s: ................. – ..........e-mail......... PRE ADVICE FIRST
TEXT MESSAGE:
The SWIFT or CLEARSTREAM text message covering all remittances shall clearly state the following:
“same day transfer and immediate credit. Remitter is known to us. This transfer is with full banking
responsibility and we are satisfied as to the source of the funds sent to us. Cleared, clean, lien free
and unencumbered funds, earned from financial consulting fees on commercial enterprises of non-
criminal and non-terrorist origins, known by transaction code”.
Investment
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I, (NAME), hereby swear under penalty of perjury, that the information provided herein is
accurate and true as of this date: August 19, 2023
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CORPORATE RESOLUTION
All of the directors of (COMPANY NAME) below listed were in attendance, in person or by telephone
conference. General discussion was then held concerning the issue, and all aspects of the same, were
fully explained in detail to the satisfaction of the board members.
DIRECTOR Name/Title:
Passport No.:
DIRECTOR Name/Title:
Passport No.:
DIRECTOR Name/Title:
Passport No.:
SECRETARY Name/Title:
Passport No.:
RESOLUTION 1:
It is resolved that the Board of Directors of (COMPANY NAME) hereby authorizes: (NAME) holder of
Passport Number (NUMBER) issued on (DATE).
As our Managing Member, as the (President-CEO etc) who assigned authority, on our behalf stay and
name, to instruct, negotiate, arrange, monitor, execute, manage and sign any and all agreements and/or
necessary contracts with third parties pertinent to all financial transactions with bank instruments
(securities/derivatives)
RESOLUTION 2:
It is resolved that at this meeting of the Board of Directors that our Managing Member and in fact
(NAME) acts for (COMPANY NAME) with regards to the afore said financial investment.
RESOLUTION 3:
It is resolved that (NAME) is hereby authorized to act as our Financial Director for afore said purpose.
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RESOLUTION 4:
It is resolved the Board of Directors of (COMPANY NAME) hereby authorized (NAME) to assume all
authority, powers, duties, signatory rights and responsibilities on our behalf.
RESOLUTION 5:
It is resolved that (NAME) is hereby authorized to open a personal, corporate, trading, trust and/or
custodial account in any bank, domestic or foreign and to sign such resolutions as may be required by
such bank to accomplish the objective(s) as stated herein and to give irrevocable instructions to said
bank(s) on our behalf.
I, (NAME), hereby swear under penalty of perjury, that the information provided herein is accurate and
true as of this date: August 19, 2023
SEAL OF COMPANY
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_________________________________________
All Signatures to be signed in wet blue ink (no electronic signatures
Name / Title: / Secretary
Company:
Passport Number:
Date of Issue:
Date of Expiry:
Country of Issuance:
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L ETTER OF I NTENT
Dear Sir,
I, (NAME), the undersigned, on behalf of (COMPANY NAME), hereby confirm under penalty of perjury,
my full commitment and agreement to participate in an investment opportunity, subject to my
acceptance of the terms, conditions and procedures that shall be outlined in the Private Placement
Program.
Furthermore, I hereby warrant and represent that I have available for placement into the proposed
investment, the sum of
(SPELL AMOUNT) United States Dollars/Euro
($/€_____,000,000.00 USD/EURO)
of clean, clear funds, free of any levy, liens or encumbrances and of non-criminal origin, and herewith
attach documentary evidence of same. I hereby warrant and represent that the Rule of Full-disclosure
has established these funds were legally obtained from non-criminal business or actions. I further
confirm that I am the beneficial owner of these cash funds, that I have full signatory authority and
control thereof, and that such funds are available for immediate placement at my sole discretion.
I confirm and acknowledge, with full responsibility, that neither your company nor anyone working on
your behalf has solicited me; that the documents that I shall receive shall not be deemed to be a
solicitation of funds in connection with an investment program; and, that I am approaching you
voluntarily for the purpose of securing participation in a bona fide Secure Private Placement Program.
I am prepared to instruct my bank to act upon the funds as required pursuant to the specifics of this
program. In the case of Blocked Funds, it is my understanding the funds will be blocked and or reserved)
in the account and they will remain, at all times, non-callable.
I hereby request information from you covering the terms, condition and procedures of a secured
investment and look forward to commencing the transaction, upon my acceptance of the agreement.
Email, facsimile copies or photocopies of documents or agreements pertaining to this subject are
declared and regarded as valid and equal to the original, provided they are represented by proper
signatories. Originals may be obtained upon request.
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I, (NAME), hereby swear under penalty of perjury, that the information provided herein is accurate and
true as of this date: August 19, 2023
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Dear Sir,
I, (NAME), bearing (COUNTRY) Passport No. (NUMBER), duly authorized and full legally representative
director for and on behalf of (NAME OF COMPANY), give notice to have Cease and Desist and any/other
group previous group approached in the past regarding our/my files
I, (NAME), make a clear statement and confirm under risk and penalty of perjury not to have any other
entities, associations, financial institutions, affiliates, intermediaries, groups or others with my /our
permission nor any specific authorization to handle nor process any one of my /our documents as from
August 19, 2023
And that; All previous entities, associations, financial institutions, affiliates, intermediaries, groups or
others have been notified of such by the correspondent official Cease and Desist Letter communication.
This exclusive authority and engagement shall continue fully effective until cancelled in writing by me.
I, (NAME), hereby swear under penalty of perjury, that the information provided herein is accurate and
true as of this date: August 19, 2023
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Dear Sir,
I, (NAME), bearing (COUNTRY) Passport No. (NUMBER), duly authorized and full legally representative
director for and on behalf of (NAME OF COMPANY), do solemnly swear/attest the following statements
to be true.
I, (NAME), declare under penalty of perjury and with full personal and legal responsibility under the
International Court of Law that I legally hold the sum of
and it is deposited in Account No (ACCOUNT NUMBER) at (NAME OF THE BANK), located at (ADDRESS
OF BANK).
I further declare these funds are current and valid currency lawfully obtained and constitute clean,
cleared funds of legitimate, non-criminal, commercial origin. There are no liens, contractual obligations
or encumbrances of any kind against these funds.
I have full and complete, legal ownership of, and the unrestricted right and authority to pledge or
otherwise utilize these funds. The funds are ready for transfer or release upon my instruction.
These funds are authentic and verifiable. I am not aware of any matter which could or might cause the
non-validation of these funds and I hereby indemnify the Program Manager and/or assignees,
intermediaries, or other parties involved, against any claims, demands, civil and/or criminal in nature,
and liabilities, damages, or expenses including without limitation any attorney’s fees which may arise,
whether in whole or in part, caused by reason of reliance upon this sworn declaration.
E-mail, facsimile copies or photocopies of documents or agreements pertaining to this subject are
declared and regarded as valid and equal to the original, provided they are represented by proper
signatories. Originals may be obtained upon request.
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I, (NAME), hereby swear under penalty of perjury, that the information provided herein is accurate and
true as of this date: August 19, 2023
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Know all men, by these that I, (NAME), the undersigned, on behalf of (COMPANY NAME), at the address
shown above, give you clear notice that you have my direct permission and full authority to do all
matters necessary to confirm, verify, and authenticate my beneficially owned cash funds and/or
application asset(s) and its associated good standing account status, in an amount of (SPELL AMOUNT)
United States Dollars/EURO ($/€_____,000,000.00 USD/EURO) on a bank to bank basis. The below
stated beneficially owned account is of good, clean, and cleared cash funds obtained via legal means,
and is currently available at the bank coordinates below:
In witness hereof I, (NAME), hereby swear under penalty of perjury, that the information provided
herein is accurate and true as of this date: August 19, 2023
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Dear Sir,
I, (NAME), bearing (COUNTRY) Passport No. (NUMBER), duly authorized and full legally representative
director for and on behalf of (NAME OF COMPANY), do solemnly swear/attest with full legal
responsibility, that the following named person is my actual and personal bank officer at (NAME OF THE
BANK), located at (ADDRESS OF BANK), who will be available to cooperate with the trader for blocking
of the following referenced bank account:
I, (NAME), hereby swear under penalty of perjury, that I AM THE SIGNATORY of the account, that the
funds belong to me, and the information provided herein is accurate and true as of this date: August 19,
2023
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P ASSPORT
PROVIDE COLOR COPY ENLARGED (140%) TO THIS SIZE (8½ X 11 INCHES). PICTURE MUST BE
CLEAR AND NOT DARK. ENLARGE & LIGHTEN (USING PHOTO SETTING). COLOR SCAN THE
PASSPORT INTO YOUR COMPUTER AT A HIGH RESOLUTION IN THE JPEG FORMAT AND INSERT.
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POL
proof of life photo holding passport to face and days newspaper
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PROOF OF FUNDS
A C URRENT BANK STATEMENT
fresh account statement, signed by 2 bank officers, fresh Bank Comfort Letter stating, that the
funds (amount and account number need to be mentioned) are freely available and transferrable)
signed by the same 2 bank officers with title and eventually their PIN
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685890022.docx
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▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒▒ Page 25 of 25 Date: 19 August 2023
685890022.docx