CORPORATE CLIENT
INFORMATION
Customer Name:
Reference No:
NEC B.S.C (c)
Licensed by C.B.B.
1. CORPORATE CUSTOMER REGISTRATION FORM
1.1 CORPORATE CUSTOMER’S DETAILS
Nature of entity: WLL Company Partnership Firm Limited Liability Sole Proprietorship
Entity Name:
Nature of Business:
REGISTERED ADDRESS:
P.O. Box Road No.
Shop/Bldg. No. Block No.
Office Telephone Office Fax
Contact Person
1.2 COMMERCIAL REGISTRATION (CR) DETAILS
CR No: CR Issue Date:
CR Issued at: CR Expiry Date:
Date of Incorporation:
1.3 BUSINESS TURNOVER(MONTHLY)
Below BD 10000 BD 10000 TO 20000
BD 20000 TO 50000 BD 50000 TO 100000 ABOVE BD 100000
1.4 NAMES OF DIRECTORS / PARTNERS / OWNERS
Name ID No. Percentage
1
2
3
If the above individuals are not ultimate Beneficial owners(UBO). Yes No
If yes, please specify the name of UBO, ID document.
1.5 DISCLOSURE
Do any of the (owners/directors/partners)hold any official Government position? Yes No
If yes, Please specify the position and function/sector
1.6 LOCAL BANK ACCOUNT DETAILS
Bank Account No. Bank Name Branch
1.7 NAME OF EXTERNAL AUDITOR (IF APPLICABLE)
1.8 AUTHORIZED SIGNATORIES
If Authorized Signatories are same as Section 1.4
Name Designation Signature CPR MOBILE
Company Seal
2. LETTER OF REPRESENTATION
To Date
The manager
NEC BSC (C)
Branch:
Dear sir,
Undertaking for Business Transactions / Remittances
2.1 We hereby authorize the following persons to send / receive/exchange money on behalf of our company,
and to sign the necessary transaction vouchers. His/ her original identity documents will be produced by him/her
at the time of transaction.
Name of the Employee ID Details of the Employee Specimen Signature Mobile
Authorized Signatory
Name
Designation Date
Company Seal
3. CUSTOMER ACTIVITY PROFILE
3.1 TYPE OF SERVICE
Remittance Foreign Exchange Gold
3.2 ANTICIPATED TRANSACTION ACTIVITY
REMITTANCES:
a. Estimated value of monthly transactions(BHD) 5000 to 10000 10000 to 25000 25000 & above
b. Estimated number of transactions per month : 1 to 10 10 to 20 20 & above
FOREIGN EXCHANGE:
a. Estimated value of monthly transactions(BHD) 5000 to 10000 10000 to 25000 25000 & above
b. Estimated number of transactions per month : 1 to 10 10 to 20 20 & above
GOLD:
a. Estimated value of monthly transactions(BHD) 5000 to 10000 10000 to 25000 25000 & above
b. Estimated number of transactions per month : 1 to 10 10 to 20 20 & above
4. CUSTOMER RISK RATING (For Office Use Only)
a. Is the customer a Politically Exposed Person, or does he/she have any substantial connections to one?
No Yes If yes, indicate name and type of connection
b. Does the customer have any substantial connection to a high risk geographic location?
No Yes If yes, indicate name and type of connection
c. Does the customer have any substantial connection to a high risk activity?
No Yes If yes, indicate name and type of connection
LOW MEDIUM HIGH
AML Risk Rating
DOCUMENTS REQUIRED:
CR Copy ID Copy of Directors/ Partners/ Proprietor
ID Copy of Authorized signatory ID Copy of the Representative
Copy of the Certificate of Incorporation. Copy of MOA / Articles of Association
Copy of Partnership Agreement Bank statement
Copy of Audited financial statement License from regulatory body(If any applicable)
Board resolution seeking financial services
Authorizing Officer’s Name and Signature: Compliance Officer’s Signature:
Date
NEC B.S.C (c)
Licensed by C.B.B.
