Self-Certification For Common Reporting Standard (Crs) Page 3
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Section 4: Entity Declaration and Signature
I understand that the information supplied by me is covered by the full provisions of the
terms and conditions governing the Account Holder's relationship with Sharefunds
Limited setting out how Sharefunds Limited may use and share the information supplied
by me.
I acknowledge that the information contained in this form and information regarding
the Account Holder and any Reportable Account(s) may be reported to the tax
authorities of the country/jurisdiction in which this account(s) is/are maintained and
exchanged with tax authorities of another country/jurisdiction or countries/jurisdictions
in which the Account Holder may be tax resident pursuant to intergovernmental
agreements to exchange financial account information.
I certify that I am authorised to sign for the Account Holder in respect of all the
account(s) to which this form relates.
I declare that all statements made in this declaration are, to the best of my
knowledge and belief, correct and complete.
I undertake to advise Sharefunds Limited within 30 days of any change in
circumstances which affects the tax residency status of the Account Holder identified
in Part 1 of this form or causes the information contained herein to become incorrect
or incomplete (including any changes to the information on controlling persons
identified in Part 2 question 2a, and to provide Sharefunds Limited with a suitably
updated self-certification and Declaration within up to 30 days of such change in
circumstances.
Signature
Print name
Date
If you are not the Account Holder please indicate the capacity in which you are signing
the form.
If signing under a power of attorney please also attach a certified copy of the power
of attorney.
Capacity
Sharefunds Limited is authorised and regulated by the Financial Conduct Authority and is entered on the register under reference 227807
Registered in England – Number 04856420
Registered Office: Bow House, 1A Bow Lane, London, EC4M 9EE
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