An enhanced KYB form for crypto-asset businesses. It adds licensing, the travel rule and wallet questions to the full company due diligence.
Use it when your customer is an exchange, wallet provider or other crypto-asset business.
10 of 10 core requirements of EU AMLR.
Every question can be removed, reworded, reordered or made optional in the editor. You can add your own questions and fields too.
| Question | Field type | Section | Legal basis |
|---|---|---|---|
| Registered legal name * | Text | Organisation details | Art 22(1)(b)(i) |
| Trading names or brands | Text | Organisation details | Good practice |
| Legal form * | Single choice | Organisation details | Art 22(1)(b)(i) |
| Registration number and name of the register * | Text | Organisation details | Art 22(1)(b)(iii) |
| Country of incorporation or registration * | Country | Organisation details | Art 22(1)(b)(ii) |
| Year of incorporation | Number | Organisation details | Good practice |
| Registered office address * | Long text | Organisation details | Art 22(1)(b)(ii) |
| Principal place of business, if different | Long text | Organisation details | Art 22(1)(b)(ii) |
| Legal Entity Identifier (LEI), if you have one | Text | Organisation details | Art 22(1)(b)(iii) |
| Website | Text | Organisation details | Good practice |
| Countries where you operate | Text | Organisation details | Good practice |
| Contact email * | Organisation details | Good practice | |
| Contact phone | Phone | Organisation details | Good practice |
| Directors, partners or board members: full names * | Long text | Management and authority | Art 22(1)(b)(iii) |
| Senior managing official (CEO, managing director or equivalent) * | Text | Management and authority | Good practice |
| Person completing this form for the customer: full name, role and date of birth * | Long text | Management and authority | Art 20(1)(i) |
| Proof of authority (power of attorney or board resolution), if acting for someone else | File upload | Management and authority | Art 20(1)(i) |
| Are any shares or directorships held by a nominee? * | Single choice | Management and authority | Art 22(1)(b)(iv) |
| Constitutional documents (articles of association or partnership agreement) * | File upload | Management and authority | Good practice |
| Does any person own or control 25% or more of the organisation, directly or through other companies? * | Single choice | Beneficial owners | Art 51, 52 |
| For each beneficial owner: full name, date and place of birth, nationality, residential address, percentage held and whether held directly or indirectly * | Long text | Beneficial owners | Art 62(1)(a), (b) |
| People who control the organisation by other means (voting rights, right to appoint directors, agreements), or if no one meets the threshold, the senior managing official * | Long text | Beneficial owners | Art 51, 52 |
| Identity documents of the beneficial owners | File upload | Beneficial owners | Art 22(7) |
| Describe the main business activities * | Long text | Occupation and business | Art 20(1)(e), 25(e) |
| Industry * | Single choice | Occupation and business | Good practice |
| Number of employees and annual turnover | Text | Occupation and business | Good practice |
| Is the business licensed or regulated? If yes, by whom, with licence number | Text | Occupation and business | Good practice |
| Main customers and suppliers, and the countries they are in * | Long text | Occupation and business | Art 34(4)(a) |
| Are you authorised as a crypto-asset service provider (CASP) or registered as a VASP? Under which law and with which licence number? * | Long text | Occupation and business | Sector question |
| Why do you want to open this relationship, and what will you use it for? * | Long text | Purpose and expected activity | Art 20(1)(c), 25(a) |
| Which products or services will you use? * | Multiple choice | Purpose and expected activity | Art 25(a) |
| Expected value of transactions per month (EUR or equivalent) * | Single choice | Purpose and expected activity | Art 25(b) |
| Expected number of transactions per month | Single choice | Purpose and expected activity | Art 25(b) |
| Main countries you will send money to or receive it from * | Long text | Purpose and expected activity | Art 25(d) |
| Will you carry out transactions on behalf of, or for the benefit of, anyone else? * | Single choice | Purpose and expected activity | Art 20(1)(h) |
| Do you expect any large or one-off transactions? Describe them and why. * | Long text | Purpose and expected activity | Art 34(4)(d) |
| Where will the money for this relationship come from? * | Multiple choice | Source of funds and wealth | Art 25(c) |
| Bank and country of the account the funds will come from | Text | Source of funds and wealth | Good practice |
| How was your overall wealth built up? (source of wealth) * | Long text | Source of funds and wealth | Art 34(4)(c), 42 |
| Evidence of source of funds and wealth (for example payslips, sale contract, audited accounts) * | File upload | Source of funds and wealth | Art 34(4)(c) |
| Will your first payment come from an account in your own name at a bank that applies customer due diligence? * | Single choice | Source of funds and wealth | Art 34(4)(g) |
| Wallet addresses you will send from or receive to, and whether each is self-hosted or held at an exchange * | Long text | Crypto-assets | Art 40 |
| How did you acquire your crypto-assets? * | Multiple choice | Crypto-assets | Art 25(c) |
| Exchanges or service providers you use | Text | Crypto-assets | Good practice |
| Do you use privacy coins, mixers or other tools that hide transaction history? * | Single choice | Crypto-assets | Art 79 |
| How do you comply with the travel rule for crypto-asset transfers? | Long text | Financial crime controls | Sector question |
| Do you, or does any beneficial owner, director or authorised signatory, hold a prominent public function now or in the last 12 months? * | Single choice | Politically exposed persons | Art 20(1)(g), 42, 45 |
| Is any of them a family member or known close associate of such a person? * | Single choice | Politically exposed persons | Art 46 |
| If yes: name, position, country and dates in office | Long text | Politically exposed persons | Art 42 |
| Are you, or is any beneficial owner, director or related company, named on a sanctions list (UN, EU, UK or US)? * | Single choice | Sanctions and other declarations | Art 20(1)(d) |
| Is the organisation owned 50% or more, together, or otherwise controlled by sanctioned persons? * | Single choice | Sanctions and other declarations | Art 20(1)(d) |
| Do you do business in, with, or through comprehensively sanctioned countries or regions? * | Single choice | Sanctions and other declarations | Good practice |
| Has the customer, any owner or any director been convicted of, or investigated for, a financial crime? * | Single choice | Sanctions and other declarations | Art 34(4)(a) |
| Countries of tax residence | Text | Tax residency | Good practice |
| Tax identification number | Text | Tax residency | Art 22(1)(a)(iv), (b)(iii) |
| Are you a US person for tax purposes? | Single choice | Tax residency | Good practice |
| Certificate of incorporation or recent extract from the official register * | File upload | Documents to provide | Art 22(6) |
| Register of shareholders or members | File upload | Documents to provide | Good practice |
| Latest financial statements * | File upload | Documents to provide | Art 34(4)(c) |
| I confirm the information in this form is true and complete, and I will tell you promptly if it changes. * | Checkbox | Declaration and signature | Art 26 |
| I understand my information will be used to meet anti-money laundering obligations and kept for at least 5 years after the relationship ends. * | Checkbox | Declaration and signature | Art 77 |
| Name, position and signature * | Text | Declaration and signature | Good practice |
| Date * | Date | Declaration and signature | Good practice |
| Screening: sanctions, PEP and adverse media for the customer, beneficial owners and directors (date and result) * | Long text | For internal use | Art 20(1)(d), (g) |
| Customer risk rating and reason * | Single choice | For internal use | Good practice |
| Senior management approval (name and date) * | Text | For internal use | Art 34(4)(e), 42(1)(a) |
| Next review date * | Date | For internal use | Art 26(2) |
| Reviewed by (name and date) * | Text | For internal use | Good practice |
Crypto-asset services carry higher money laundering risk and are often treated as high risk by banks.
The rule that originator and beneficiary information travels with a crypto-asset transfer, like a bank wire.
A KYC form for customers of a crypto-asset exchange or wallet. It adds wallet addresses, how the customer acquired their crypto-assets and the use of privacy coins or mixers.
A merchant onboarding form for payment providers and acquirers. It combines company KYB with the website, card volume and chargeback questions a payment provider needs.
A KYC form for money transfer and remittance customers. It covers identity, the countries money goes to, cash use and the relationship with the recipients.
With complead KYC Forms your customers fill in the form online, under your logo. Answers land on the customer record and every name is screened automatically.
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