CLIENT REGISTRATION FORM
INTRODUCTION
IMPORTANT NOTICE FOR COMPLIANCE:
• Complete the attached Registration Forms and submit it with all necessarily required documents.
• M&C Logistics and Trading LTD will scrutinize the submitted documents accordingly.
• M&C Logistics and Trading LTD will confirm acceptance of your documents for registration.
• REGISTRATION FEE IS $2,000.00 (NON-REFUNDABLE) and renewable every year.
• M&C Logistics And Trading is NOT OBLIGED to renew all applications.
• Kindly contact us for any clarifications needed on the procedures.
DOCUMENTATIONS REQUIRED
1. A Notarised/Certified copy of a Business Registration Certificate from an issuing authority.
2. A Notarised/Certified copy of relevant business license from an issuing authority.
3. A Notarised/Certified copy of the Principal’s passport (individuals).
4. A Notarised /Certified copy of proof of address (individuals).
5. A Notarise/Certified copy of Company Registration Certificate from an issuing authority.
6. A Notarised/Certified passport copies of all directors.
7. Reference letter/letters from the Bank/Banks as captured on Registration Form which;
a) Confirms that the customer is “in good standing and fully compliant with the bank’s AML and KYC
requirements”.
b) The letter should further include the account number(s) and the names of the account signatories.
c) A letter from a Chartered Accountant could be provided confirming the same.
d) If two banks are listed, a letter from each bank is required.
e) A Notarised/Certified copy of legally acquired business operating license to import or trade in Gold
to buttress application for registration, if available.
f) A Notarised/Certified copy of the principal’s Tax Registration documentation/certificate as issued by
the government tax authority.
1. COMPANY / INDIVIDUAL DETAILS
a. Name
b. Registered Business Address
c. Date of Incorporation
d. Country of Incorporation
e. Business Registration Number
f. Tax Identification/Registration Number
g. Company Website address
h. Shipping address
g) A brief profile of the individual or consultant’s Gold experience including their policy on Anti Money
Laundering/ Countering Financing Terrorism (AML/CFT).
2. CONTACT DETAILS
PRIMARY CONTACT SECONDARY CONTACT
SURNAME
FIRST NAME
POSITION
EMAIL ADDRESS
TELEPHONE NUMBER(MOBILE)
TELEPHONE NUMBER(OFFICE)
3. BENEFICIAL OWNERS (SHAREHOLDER(S) MORE THAN 25% -COMPANY ONLY
Percentage Name Address Nationality(ies) Date of Birth
Holding (%)
3. BENEFICIAL OWNERS (SHAREHOLDER(S) MORE THAN 25% -INDIVIDUALS ONLY
Percentage Name Address Nationality(ies) Date of Birth
Holding (%)
4. MANAGEMENT STRUCTURE
Names Title Nationality(ies) Date of Birth
a. Board of
Directors
b. Top
Management
5. SERVICES REQUIRED FROM M&C LOGISTICS AND TRADING
(please tick where Applicable/ Clients can tick more than one services)
EXPORT
STORAGE/SAFE KEEPING
ASSAY
TRANSPORTATION
Note:
1. Registered Clients who tick two (2) or more of the above services must have a minimum of
$15,000 on account at all times. This will enable M&C Logistics and Trading to perform
related services outlined without having to wait for the Account Holder to transfer funds.
2. Fifty percent (50%) of funds will be retained if client requests refund & closure of Account
before the end of an agreed period.
Indicate the details of the banks intended to be used to execute transactions with M&C LOGISTICS
AND TRADING. Bank details for a maximum of two (2) bank accounts per individual applicant or an
entity must be provided.
BANK DETAILS PRIMARY BANK ACCOUNT SECONDARY BANK
ACCOUNT (if applicable)
NAME OF BANK
ADDRESS OF BANK
BANK SORT CODE
SWIFT CODE
IBAN NUMBER
ACCOUNT NUMBER
BANK ACCOUNT RELATIONSHIP MANAGER
SURNAME
FIRST NAME
POSITION
EMAIL ADDRESS
TELEPHONE NUMBER
Financial Information
Own equity
SOURCE OF FUNDS Government entity)
Bank loan
Others, Specify
DECLARATION
IMPORTANT!!
COMPLETE THE DETAILS BELOW AS AN ENTITY OR AS AN INDIVIDUAL.
Have you/ your Company been convicted of any serious criminal offence in the last 10 years? YES/NO
If YES, please provide full details on your letter-headed form.
If you are applying on behalf of a Company, have any of the directors/partners of your YES/NO
company been convicted of any serious criminal offence in the last 10 years?
If YES, please provide details on your letter-headed form.
Have you/ your company dealt, either directly or indirectly, with any conflict Gold in the last YES/NO
10 years?
If YES, please provide details on your letter-headed form.
Have you/ your company been involved in any Money Laundering or Terrorist Financing YES/NO
activities in the last 10 years?
If YES, please provide details on your letter-headed form.
Have you/ your YES/NO
Company been involved in serious abuses of Human Rights in the last 10 years?
If YES, please provide details on your letter-headed form.
We/I hereby confirm that all the information contained in this Registration Form and its ASSOCIATED
DOCUMENTS are True and Correct having emanated from a source of authority. I therefore have the
authority/mandate to append my signature to this Registration Form.
COMPANY NAME
NAME OF REPRESENTATIVE
POSITION
DATE
SIGNATURE AND STAMP
M&C LOGISTICS AND TRADING REPRESENTATIVE
NAME OF REPRESENTATIVE
POSITION
DATE
SIGNATURE and STAMP
OUR BANKERS
1. FIRST ATLANTIC BANK LIMITED
NAME OF BANK First Atlantic Bank Limited
Plot # 18 Dadeban Road, North Industrial Area, Accra,
ADDRESS OF BANK Ghana
SWIFT CODE FAMCGHAC
ACCOUNT NAME M&C Logistics and Trading Limited
ACCOUNT NUMBER(USD) 0216671132024
BANK ACCOUNT RELATIONSHIP MANAGER
NAME Nana Agyiri Boadu-Appiah
EMAIL ADDRESS
[email protected]TELEPHONE NUMBER +233 307 079 299 /+233 266784209
Correspondent Bank Details (USD)
BANK NAME Deutsche Bank
BANK ADDRESS 60 Wall Street, New York, N! Y 10005, USA
SWIFT CODE BKTRUS33
Beneficiary Bank Details
BANK’S NAME First Atlantic Bank Limited
BANK’S ADDRESS Box CT 1620, Atlantic place, No. 1 Seventh Avenue,
Ridge West, Accra, Ghana
SWIFT CODE FAMCGHAC
2. ECOBANK GHANA LIMITED
NAME OF BANK Ecobank Ghana Limited
19th Seventh Avenue, Ridge West, P.M.B GPO, Accra,
ADDRESS OF BANK Ghana
BRANCH Haatso
SWIFT CODE ECOCGHAC
ACCOUNT NAME M&C Logistics and Trading Limited
ACCOUNT NUMBER(USD) 244100177143
ACCOUNT RELATIONSHIP MANAGER AT BANK
NAME Ransford Asante
EMAIL ADDRESS
[email protected]TELEPHONE NUMBER +233 243781025
Correspondent Bank Details (USD)
BANK’S NAME CITI BANK NEW YORK
BANK’S CODE CITIUS33
Beneficiary Bank Details
BANK’S NAME ECOBANK GHANA LIMITED
BANK’S CODE ECOCGHAC
3. ZENITH BANK GHANA LTD
NAME OF BANK ZENITH BANK GHANA LTD
Zenith Heights, No 31 Independence Avenue, PMB CT
ADDRESS OF BANK 393 Accra Ghana
SWIFT CODE ZEBLGHAC
ACCOUNT NAME M&C LOGISTICS AND TRADING LTD
ACCOUNT NUMBER (USD) 6040159154
BANK ACCOUNT RELATIONSHIP MANAGER
NAME Edith Boamah
EMAIL ADDRESS
[email protected]TELEPHONE NUMBER (+233) 302 784179, 782671/ +233 502220889
Correspondent Bank Details (USD)
BANK’S NAME CITIBANK NEW YORK
BANK’S ADDRESS CITI NA WALLSTREET NEW YORK CITY, NY
10005, USA
ACCOUNT NUMBER 36250618
FED ABA //FW021000089
SWIFT CODE CITIUS33
Beneficiary Bank Details
BANK’S NAME Zenith Bank Ghana Ltd
BRANCH HEAD OFFICE
ACCOUNT NUMBER 6040159154
SWIFT CODE ZEBLGHAC
