Please fill the form in English and in BLOCK Letters.
Please fill the dates in DD-MM-YYYY format. It is imperative that the last page bears the physical signature of the relevant individual. For section update, the fields not required to be updated as 'Not Applicable'
File Ref: NO:
KNOW YOUR CLIENT (KYC) – ONBOARDING FORM- CORPORATE CLIENT
Company name as per the Trade
License
Type of Entity o LLC o Partnership o Sole Proprietorship o Other
Purpose of the business relationship
with HLB (service availed)
Major source of income o Investments o Business income
Other: please specify
Trade name (if different from the
registered name) Date of incorporation
Address as per trade license
License number and issuing authority Expiry date
Nature of the business as per trade
license
Entity Activities as per trade license:
Entity Website ID:
Telephone number(s)
Is your organisation owned by a
Politically Exposed Person?
Are you a non-profit organization?
Page 1 of 3 Know Your Client (KYC) - Onboarding Form Are you Any otheroperating in aorsubstantially information comments cash-based business.
Mode of Payment: o Cash o Bank -Online Transfer o Cheque
Country/countries registered and
operating in (other than UAE):
Is the company owned by any
o Yes o No corporate shareholder?
If YES, please attach the structure
of the entity including shares/ownership breakdown here (incorporation certificate/ MOA)
INFORMATION OF UBOS/ SHAREHOLDERS/ PARTNERS/ DIRECTORS
1 2 3
Full names of all beneficial owners,
partners, Position of the person (UBO, Partner, Director, etc) Please Specify:
Shareholding %:
Nationality
Date of birth:
Identification document number
Date of expiry
Correspondence address(es)
E-mail address(es)
(Use separate attachment if the
space is not sufficient to fill above information’s).
Any other information or comments
Page 2 of 3 Know Your Client (KYC) - Onboarding Form INFORMATION OF AUTHORIZED SIGNATORIES, POA, LEGAL REPRESENTATIVES
In case of Power of Attorney/Authorised Signatory provide below details, and attach a copy of the ID document.
Name of the Authorized Signatory/ POA Holder:
ID number & Issuing authority Date of expiry Contact Number: Email
Client Declaration:
I hereby certify that the information provided in this Client KYC Form is accurate and complete, and I agree to promptly notify HLB HAMT in writing of any changes.
I give my unconditional and irrevocable written consent for HLB HAMT, its affiliates, and authorized staff, to disclose, share, use, process, and access my KYC information and records as required by the UAE Anti Money Laundering and Counter Terrorism Laws.
I agree to indemnify and hold harmless from any claims arising from the sharing, accessing, use, processing, or disclosure of my account information and data.
Signature and Company Seal: ____________
Date: ___________________
Office Use only:
DOCUMENTS CHECKLIST – TO BE COMPLETED BY HLB EXECUTIVE
Trade license/certificate of incorporation of Entity.
ID documents of shareholders / Partners / Ultimate Owner/ Authorized signatories/ Legal representatives The shareholding structure of the entity including /ownership breakdown (Incorporation Certificate/ MOA) If any corporate shareholder/s.
Copy of POA /Authorisation letter in case of dealing with the
representatives of the Entity.
Note: As per UAE Federal Decree Law No. (20) of 2018 and its implementation regulation and Cabinet Decision No (58) of 2020 Regulating the Beneficial Owner Procedures, “As an entity operating in the Designated Non-Financial Businesses and Professions sector, HLB HAMT is obliged to identify customers, including the Beneficial Owners, beneficiaries, and controlling persons, whether permanent or walk-in, and whether a natural or legal person or Legal Arrangement, and to verify their identity using documents, data or information obtained from reliable and independent sources”.
Page 3 of 3 Know Your Client (KYC) - Onboarding Form
