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Your company
Financial Institution KYC Form
Financial institution · Standard · EU AMLR

1. Organisation details

Registered legal name*Art 22(1)(b)(i)
Trading names or brands
Legal form*Art 22(1)(b)(i)
Private limited companyPublic limited companyLimited liability partnershipGeneral or limited partnershipFoundationAssociation or societyCooperativeBranch of a foreign companyOther
Registration number and name of the register*Art 22(1)(b)(iii)
Country of incorporation or registration*Art 22(1)(b)(ii)
Select a country ▾
Year of incorporation
Registered office address*Art 22(1)(b)(ii)
Principal place of business, if differentArt 22(1)(b)(ii)
Legal Entity Identifier (LEI), if you have oneArt 22(1)(b)(iii)
Website
Countries where you operate
Contact email*
Contact phone

2. Management and authority

Directors, partners or board members: full names*Art 22(1)(b)(iii)
Senior managing official (CEO, managing director or equivalent)*
Person completing this form for the customer: full name, role and date of birth*Art 20(1)(i)
Proof of authority (power of attorney or board resolution), if acting for someone elseArt 20(1)(i)
Upload a file (PDF, JPG or PNG)
Are any shares or directorships held by a nominee?*Art 22(1)(b)(iv)
NoYes, explain below
Constitutional documents (articles of association or partnership agreement)*
Upload a file (PDF, JPG or PNG)

3. Beneficial owners

Does any person own or control 25% or more of the organisation, directly or through other companies?*Art 51, 52
YesNo
For each beneficial owner: full name, date and place of birth, nationality, residential address, percentage held and whether held directly or indirectly*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*Art 51, 52
Identity documents of the beneficial ownersArt 22(7)
Upload a file (PDF, JPG or PNG)

4. Occupation and business

Describe the main business activities*Art 20(1)(e), 25(e)
Industry*
Financial servicesCrypto-assetsGamblingReal estatePrecious metals, stones or artLegal, accounting or company servicesImport and export, tradeManufacturingRetail or e-commerceTechnologyNon-profitOther
Number of employees and annual turnover
Is the business licensed or regulated? If yes, by whom, with licence number

5. Purpose and expected activity

Why do you want to open this relationship, and what will you use it for?*Art 20(1)(c), 25(a)
Which products or services will you use?*Art 25(a)
Current or business accountDomestic paymentsInternational paymentsCurrency exchangeCardsLendingSavings or investmentsCrypto-assetsOther
Expected value of transactions per month (EUR or equivalent)*Art 25(b)
Under 10,00010,000 to 50,00050,000 to 250,000250,000 to 1,000,000Over 1,000,000
Expected number of transactions per monthArt 25(b)
Under 1010 to 5050 to 250Over 250
Main countries you will send money to or receive it from*Art 25(d)
Will you carry out transactions on behalf of, or for the benefit of, anyone else?*Art 20(1)(h)
No, only for myself or this organisationYes, explain below

6. Source of funds and wealth

Where will the money for this relationship come from?*Art 25(c)
Salary or pensionBusiness incomeSavingsInvestmentsSale of property or assetsInheritance or giftLoanDonations or grantsOther
Bank and country of the account the funds will come from

7. Financial crime controls

Supervisor and licence number*Art 36
Name and contact details of your money laundering reporting officer*Art 36
Do you have an AML/CTF and sanctions programme approved by your board?*Art 36
YesNo
Which sanctions lists do you screen customers and payments against?*
UNEUUK (OFSI)US (OFAC)Local listsOther
Do you provide services to shell banks, or let other institutions use your accounts with us (nested or downstream relationships)?*
NoYes, explain below
Date of your last independent AML audit
DD / MM / YYYY
Your latest Wolfsberg CBDDQ, if completed
Upload a file (PDF, JPG or PNG)

8. Politically exposed persons

Do you, or does any beneficial owner, director or authorised signatory, hold a prominent public function now or in the last 12 months?*Art 20(1)(g), 42, 45
NoYes, give details below
Is any of them a family member or known close associate of such a person?*Art 46
NoYes, give details below
If yes: name, position, country and dates in officeArt 42

9. Sanctions and other declarations

Are you, or is any beneficial owner, director or related company, named on a sanctions list (UN, EU, UK or US)?*Art 20(1)(d)
NoYes, explain below
Is the organisation owned 50% or more, together, or otherwise controlled by sanctioned persons?*Art 20(1)(d)
NoYes, explain below
Do you do business in, with, or through comprehensively sanctioned countries or regions?*
NoYes, explain below

10. Tax residency

Countries of tax residence
Tax identification numberArt 22(1)(a)(iv), (b)(iii)
Are you a US person for tax purposes?
NoYes

11. Documents to provide

Certificate of incorporation or recent extract from the official register*Art 22(6)
Upload a file (PDF, JPG or PNG)
Register of shareholders or members
Upload a file (PDF, JPG or PNG)

12. Declaration and signature

I confirm the information in this form is true and complete, and I will tell you promptly if it changes.*Art 26
I agree
I understand my information will be used to meet anti-money laundering obligations and kept for at least 5 years after the relationship ends.*Art 77
I agree
Name, position and signature*
Date*
DD / MM / YYYY

13. For internal use

Screening: sanctions, PEP and adverse media for the customer, beneficial owners and directors (date and result)*Art 20(1)(d), (g)
Customer risk rating and reason*
LowMediumHigh
Next review date*Art 26(2)
DD / MM / YYYY
Reviewed by (name and date)*

About this template

A KYB form for regulated financial institutions you partner with, such as payment and e-money institutions. It covers the licence, the compliance officer and the AML and sanctions programme.

When to use it

Use it to onboard a regulated partner that is not a correspondent relationship.

Core requirements covered

10 of 10 core requirements of EU AMLR.

  • Identify and verify the customer✓
  • Verify identity from a document or eID✓
  • Identify the beneficial owners✓
  • Purpose and intended nature✓
  • Targeted financial sanctions✓
  • Nature of the customer's business✓
  • Ongoing monitoring✓
  • Politically exposed persons✓
  • On behalf of someone else✓
  • Authority of the person acting✓

Edit it before you use it

Every question can be removed, reworded, reordered or made optional in the editor. You can add your own questions and fields too.

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Send this form as a secure online form

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.