KYC Questionnaire For Entities

IDENTIFICATION DATA
Company name
Register address
Physical address
Indicate a web site of your company?
Indicate date and number of Registered License, if exists
Please indicate the authority that regulate your activity /name, country/
Indicate if The Legal Entity is "United States Person" or have address in the U.S.	☐ Yes ☐ No
Indicate if The Legal Entity have any “United States Person” hold, directly or indirectly, solely or in aggregation with one or more “FATCA Related Party”, interests in the Legal Entity of 10% or above (by vote or by value) and thus is considered to be a “Substantial United States Owner”	☐ Yes ☐ No
Indicate if The Legal Entity have any “United States Person" signatories or representatives (Mandators) and they have indicators of the “United States Person”	☐ Yes ☐ No
Indicate if The Legal Entity have any US bank account	☐ Yes ☐ No
Indicate if The Legal Entity center of interest is the USA	☐ Yes ☐ No
Indicate if The Legal Entity revenues are effectively connected with the conduct of a trade or business in the US	☐ Yes ☐ No
Number of employees at the company
Indicate in which country is the main governing body of your company.
Indicate the purpose of account opening in Armenia
Indicate the purpose and intended nature of business relationship
Indicate countries where company has branches / daughter companies/ representatives
Intended type of transactions (in case of a fill in I.14 in case of b fill in I.15)	a.cashless money transactions ☐ b.cash transactions ☐
Indicate average monthly turnover	USD ☐ EUR ☐ RUR ☐ AMD ☐ Other ☐
Indicate average monthly turnover of cash transactions	USD ☐ EUR ☐ RUR ☐ AMD ☐ Other ☐
Indicate maximum amount of one transaction.
Indicate banks where your company has bank accounts
Indicate the country/ies you intend to cooperate with

I.I DUE DILIGENCE
I.I 1Source(s) of funds (several may be indicated): Field of business (both main and secondary areas of operation, if any)
☐ administration and support	☐ legal services
☐ banking, insurance and finance	☐ fuel trading
☐ real estate services and operations	☐ crafts and other skilled manual labor
☐ economics and corporate finance	☐ services
☐ energy industry	☐ government and public administration
☐ pharmacy services	☐ construction
☐ food and chemicals	☐ mechanical engineering
☐ IT	☐ technology, electrical engineering and development
☐ casino business	☐ telecommunications
☐ culture, the arts and creative work	☐ mining, quarrying and other minerals extraction
☐ quality control	☐ accommodation, food services and hospitality
☐ logistics and transportation	☐ science and research
☐ marketing	☐ water industry
☐ media, advertising and PR	☐ education, training and schools
☐ procurement	☐ arms industry
☐ human resources management	☐ health care and social care
☐ sales and commerce	☐ manufacturing
☐ motor vehicle repair and maintenance	☐ agriculture, forestry and fishing
☐ churches and religious societies / associations	☐ trade in high-value commodities (precious metals, jewels, etc.)
☐ virtual currency trading (e.g. Bitcoin)	☐ charitable foundations, trust funds and similar legal arrangements, specify the purpose for which established in point (b)
☐ commerce involving a high proportion of cash funds (e.g. currency exchange)	☐ other – please specify in point (b)
b) Add text here
I.I.2 More detailed information about the legal entity’s field of business, e.g. goods/services involved, structural scheme of business activity etc.

Partners
Indicate the main partner/s
Register address
Physical address
Beneficial owner (optional)
Information about partner/partners:
How long is your cooperation going on?
The sphere of activity of your partner/s
How the business relations have been established (internet, advertisement, business partners or by other means)?
Indicate web-sites of mentioned company/ies

Information on the beneficiary owner of the company.
Name, surname, patronymic
Date and place of birth
Registration address
Physical address
Source of income (provide detailed information)
Place of work (provide detailed information)

The list of additional documents, which can be requested

Short version of CV of the beneficial owner,

Documents confirming professional experience of beneficial owner (recommendation letters from partner organizations, concluded agreements with partners etc.),

Recommendation of the Bank in which he has settlement account,

Documents confirming possession of movable and immovable assets, vehicles etc by beneficial owner.

The letter of recommendation from Bank, which holds organization`s account/s.

Signature ___________________________________

Stamp

Date ______/________/20______