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Beneficial owner details

Beneficiary Selection *

Individual beneficial owner

Other legal entity beneficial owner

Government or public authority beneficial owner

How many Beneficiary owner the entity have? *

Beneficiary owner

What is their first name? *

What is their last name? *

What is their date of birth? *

What is their nationality? *

Property Name or Number *

Address Line 1 *

Address Line 2

City & Town *

State

Country *

Postal code / Zip code

Is their correspondence address the same as their home address? *

Yes

Property Name or Number (correspondence) *

Address Line 1(correspondence) *

Address Line 2 (correspondence)

City & Town (correspondence) *

State (correspondence)

Country *

Postal code / Zip code (correspondence)

When did they become a beneficial owner for the overseas entity? *

What is their nature of control? *

The Beneficial Owner

The Beneficial Owner is a trustee of a trust and

The beneficial owner is a member of a firm that is not a legal person under its governing law, and

The Beneficial Owner

holds, directly or indirectly, more than 25% of the shares in the entity.

holds, directly or indirectly, more than 25% of the voting rights in the entity.

holds the right, directly or indirectly, to appoint or remove a majority of the board of directors of the entity.

has the right to exercise, or actually exercises, significant influence or control over the entity.

The Beneficial Owner is a trustee of a trust

the trustees of that trust (in their capacity as such) hold, directly or indirectly, more than 25% of the shares in the entity,

the trustees of that trust (in their capacity as such) hold, directly or indirectly, more than 25% of the voting rights in the entity.

the trustees of that trust (in their capacity as such) hold the right, directly or indirectly, to appoint or remove a majority of the board of directors of the company.

the trustees of that trust (in their capacity as such) have the right to exercise, or actually exercise, significant influence or control over the company.

The beneficial owner is a member of a firm that is not a legal person under its governing law

the members of that firm (in their capacity as such) hold, directly or indirectly, more than 25% of the shares in the entity,

the members of that firm (in their capacity as such) hold, directly or indirectly, more than 25% of the voting rights in the entity.

the members of that firm (in their capacity as such) hold the right, directly or indirectly, to appoint or remove a majority of the board of directors of the company.

the members of that firm (in their capacity as such) have the right to exercise, or actually exercise, significant influence or control over the company.

Are they on the Sanction List? *

Yes

Second Beneficiary owner

What is their first name?

What is their last name?

What is their date of birth?

What is their nationality?

Property Name or Number

Address Line 1

Address Line 2

City & Town

State

Country

Postal code / Zip code

Is their correspondence address the same as their home address?

Yes

Property Name or Number (correspondence)

Address Line 1(correspondence)

Address Line 2 (correspondence)

City & Town (correspondence)

State (correspondence)

Country

Postal code / Zip code (correspondence)

When did they become a beneficial owner for the overseas entity?

What is their nature of control?

The Beneficial Owner

The Beneficial Owner is a trustee of a trust and

The beneficial owner is a member of a firm that is not a legal person under its governing law, and

The Beneficial Owner

holds, directly or indirectly, more than 25% of the shares in the entity.

holds, directly or indirectly, more than 25% of the voting rights in the entity.

holds the right, directly or indirectly, to appoint or remove a majority of the board of directors of the entity.

has the right to exercise, or actually exercises, significant influence or control over the entity.

The Beneficial Owner is a trustee of a trust and:

the trustees of that trust (in their capacity as such) hold, directly or indirectly, more than 25% of the shares in the entity,

the trustees of that trust (in their capacity as such) hold, directly or indirectly, more than 25% of the voting rights in the entity.

the trustees of that trust (in their capacity as such) hold the right, directly or indirectly, to appoint or remove a majority of the board of directors of the company.

the trustees of that trust (in their capacity as such) have the right to exercise, or actually exercise, significant influence or control over the company.

The beneficial owner is a member of a firm that is not a legal person under its governing law, and:

the trustees of that trust (in their capacity as such) hold, directly or indirectly, more than 25% of the shares in the entity,

the trustees of that trust (in their capacity as such) hold, directly or indirectly, more than 25% of the voting rights in the entity.

the trustees of that trust (in their capacity as such) hold the right, directly or indirectly, to appoint or remove a majority of the board of directors of the company.

the trustees of that trust (in their capacity as such) have the right to exercise, or actually exercise, significant influence or control over the company.

Are they on the sanction list?

Third Beneficiary owner

What is their first name?

What is their last name?

What is their date of birth?

What is their nationality?

Property Name or Number

Address Line 1

Address Line 2

City & Town

State

Country

Postal code / Zip code

Is their correspondence address the same as their home address?

Yes

Property Name or Number (correspondence)

Address Line 1(correspondence)

Address Line 2 (correspondence)

City & Town (correspondence)

State (correspondence)

Country

Postal code / Zip code (correspondence)

When did they become a beneficial owner for the overseas entity?

What is their nature of control?

The Beneficial Owner

The Beneficial Owner is a trustee of a trust and

The beneficial owner is a member of a firm that is not a legal person under its governing law, and

The Beneficial Owner, and;

holds, directly or indirectly, more than 25% of the shares in the entity.

holds, directly or indirectly, more than 25% of the voting rights in the entity.

holds the right, directly or indirectly, to appoint or remove a majority of the board of directors of the entity.

has the right to exercise, or actually exercises, significant influence or control over the entity.

The Beneficial Owner is a trustee of a trust, and;