A short declaration where a customer confirms whether they, a family member or a close associate hold a prominent public function, with the source of funds and wealth that follows.
Use it at onboarding, or when screening shows a possible politically exposed person match.
This is a focused form. It collects only what this declaration needs. For full onboarding, pair it with a complete KYC or KYB form.
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 |
|---|---|---|---|
| Full legal name (all first names and surnames) * | Text | Personal details | Art 22(1)(a)(i) |
| Date of birth * | Date | Personal details | Art 22(1)(a)(ii) |
| Nationality (list every nationality you hold) * | Text | Personal details | Art 22(1)(a)(iii) |
| Country of residence * | Country | Personal details | Art 22(1)(a)(iv) |
| Where will the money for this relationship come from? * | Multiple choice | Source of funds and wealth | Art 25(c) |
| How was your overall wealth built up? (source of wealth) * | Long text | Source of funds and wealth | Art 34(4)(c), 42 |
| 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 |
| 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 |
| Name, position and signature * | Text | Declaration and signature | Good practice |
| Date * | Date | Declaration and signature | Good practice |
Someone entrusted with a prominent public function, such as a head of state, minister, senior judge or board member of a state-owned company.
No. It triggers enhanced due diligence and senior management approval.
A declaration that explains where the money for a relationship or transaction comes from and how the customer built their wealth, with the evidence to back it up.
A declaration where a company names everyone who owns or controls 25% or more of it, directly or indirectly, and anyone who controls it by other means.
A declaration where a business confirms it is not sanctioned, not owned 50% or more by sanctioned persons and does not trade with comprehensively sanctioned countries.
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.
Enter your work email and download the form as PDF, Word or a complead online form, with every edit you made. We'll remember your details for the next download.
No spam. Work email only, unsubscribe any time.