Illustrative Customer Due Diligence Templates Page 5
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25EP 200 IG 2
MAIN FORM
(For natural persons
and sole
proprietorships)
Information to be Obtained from Client
Information collected in this form should be verified. Verification can be done subsequent to completing
risk assessment.
Identification
FOR NATURAL PERSONS/SOLE PROPRIETORSHIPS ONLY
Full legal name(s),
Unique
both official and any
identification
aliases:
number:
Contact number(s):
Nationality:
Date of birth:
Residential street
address:
Address of principal
place of business (if
different from above):
Intended nature and
purpose of the
business relationship:
(Please complete Form A for each beneficial owner.)
Name of beneficial
owner(s):
Name of person(s)
(Please complete Form C for each person with executive authority.)
with executive
authority:
Additional information required
Question
Response
Are you, or any party connected to you, a politically exposed person?
Yes
No
(Please complete
Form D for each
PEP)
What country is your business based in?
What type of products does your business sell or manufacture?
Please provide further details in the box below if necessary.
Any further details:
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