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BSA Compliance Completo

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BSA SELLER COMPLIANCE REPORT

DATE OF BIRTH
w Fax or email this REPORT and COPIES of Customer’s
Identification to Servicio UniTeller, Inc.
at 1.866.235.3279/ callcentersupervisors@uniteller.com
$

USE THIS REPORT FOR TRANSACTIONS OF $3,000 OR MORE


(SEE OTHER SIDE FOR IMPORTANT INFORMATION.)

TRANSACTION DATE TRANSACTION NUMBER TRANSACTION AMOUNT

10 / 12 / 2023 # 5343539291 $ 652.00

CUSTOMER NAME
DANIEL SANCHEZ
SOCIAL SECURITY # SOCIAL SECURITY # - (IF NO SS#, USE ALIEN ID #) DATE OF BIRTH
& DATE OF BIRTH
G27438712 25 / 07 /1981

CUSTOMER STREET
1529 RANCHO LN

CITY, STATE & ZIP CODE NORCO

CUSTOMER PHONE # 9512121041

OCCUPATION (Required) CHEF COOK

EMPLOYER NAME & RODRIGOS MEXICAN GRILL / ROD FRASER ENTERPRISES


PHONE # (Required)

PURPOSE PAY BILL MEDICAL


1 FORM OF IDENTIFICATION REQUIRED
REQUIRED
(SELECT ANY ID FORM BELOW AND COPY FRONT AND BACK OF EACH)

DRIVER’S LICENSE STATE ___________ NUMBER

PASSPORT MEXICO
COUNTRY _________ NUMBER G27438712

OTHER _____________________________ NUMBER

SELLER NAME & CODE

SELLER PHONE #

Under penalty of perjury, the Seller certifies that the information contained in this Report is complete, true, and accurate and that
the attached copies of the Customer’s identification are true copies of the original identification that was presented to the Seller.

PREPARED BY PRINT NAME SIGNATURE

DANIEL SANCHEZ

BSA SELLER COMPLIANCE REPORT SIDE 1 OF 2


SS-16.1-BSA-SCR-03 –980126 (001025) © Copyright 2007 UniTeller Financial Services, Inc.
BSA SELLER COMPLIANCE REPORT

BSA Seller Policies &


Procedures
1. What is BSA?

BSA is the short name for the Bank Secrecy Act (BSA) and US Patriot Act, federal laws that deal with
money laundering. As part of BSA, the federal government has issued regulations that we all must
comply with. These regulations are referred to as the BSA regulations.

2. Why must I comply with BSA and the BSA regulations?

Servicio UniTeller, Inc. (UniTeller) is committed to strict compliance with BSA and the BSA regulations.
UniTeller requires every Seller to comply with the BSA requirements. If you don’t comply with BSA and
the BSA regulations, you could be fined as much as $500,000 and go to prison for as long as 10 years.

3. UniTeller generally limits single or multiple transactions to below $3,000. UniTeller will not
accept any single transaction that is more than $5,000 or multiple transactions that
total more than $5,000.

4. What do I have to do for transactions of $3,000 or more?


4.1. For every money transfer of $3,000 or more, you must:

4.1.1 Complete and fax to us the BSA Seller Compliance Report (Report) that is on the
other side of this Information Sheet; and

4.1.2 Copy and fax/email to us clear copies of 1 form of the customer’s identification (ID)

4.1.3 Copy and fax/email evidence of the source of funds (pay stub, bank statement, etc.)

4.2 You should accept only the Customer ID that is described in the Report that is on the other side
of this form. No other ID should be accepted.

5. What are “multiple transactions” and how do I handle them?

Multiple transactions are money transfers that are each less than $3,000, but when added together for
the same person on the same day or for several days, their total is $3,000 or more. If you think that
you are handling multiple transactions, you must treat them as a single transaction of $3,000 or more
and follow the steps described above in Paragraph 4.

6. What are “suspicious transactions” and how do I handle them?

“Suspicious transactions” are money transfers that may be used to launder money or “structured” to
avoid the BSA reporting requirements. You should not accept “suspicious transactions”, but if you
determine after you have accepted them that they may be suspicious, you should report them to us. We
will report all “suspicious transactions” to the federal authorities. We are continually monitoring money
transfers to detect “suspicious transactions”. For security reasons, we can’t tell you exactly how that’s
done, but we use both manual reviews and computer surveillance to detect “suspected transactions”.

7. How long do I have to keep money transfer records and copies of customer identification?

All money transfer records, copies of customer identification, and any other records relating to money
transfers that you have handled must be kept for five (5) years from the transaction date of each
money transfer.

8. Who do I call if I have any questions or problems concerning BSA Compliance?

If you have any questions concerning BSA compliance, please call our Legal Affairs Department at
(800) 495.5674, Monday through Saturday 7am to 11pm CST. Sunday 9am to 9pm CST

BSA SELLER COMPLIANCE REPORT SIDE 2 OF 2


SS-16.1-BSA-SCR-03 –980126 (001025) © Copyright 2007 UniTeller Financial Services, Inc.

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