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Simplified Due Diligence Form
Individual · Simplified · EU AMLR

1. Personal details

Full legal name (all first names and surnames)*Art 22(1)(a)(i)
Date of birth*Art 22(1)(a)(ii)
DD / MM / YYYY
Place of birth (city and country)*Art 22(1)(a)(ii)
Nationality (list every nationality you hold)*Art 22(1)(a)(iii)
National identification number or passport number, with issuing country*Art 22(1)(a)(iii)
Residential address*Art 22(1)(a)(iv)
Country of residence*Art 22(1)(a)(iv)
Select a country ▾
Copy of your passport or national identity card (front and back)*Art 22(6)
Upload passport or national ID card, front and back
Email address*
Phone number

2. Management and authority

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)

3. Occupation and business

Employment status*Art 20(1)(e), 25(e)
EmployedSelf-employedBusiness ownerRetiredStudentNot workingOther

4. 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)
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

5. 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

6. 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

7. Tax residency

Tax identification numberArt 22(1)(a)(iv), (b)(iii)

8. 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

9. 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 short KYC form for individuals your risk assessment rates as lower risk. It keeps the identity and verification questions the law always requires and drops the rest.

When to use it

Use it only for products and customers your documented risk assessment rates as lower risk. Simplified does not mean no due diligence.

Core requirements covered

9 of 9 core requirements of EU AMLR.

  • Identify and verify the customer✓
  • Verify identity from a document or eID✓
  • 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.