ENHANCED DUE DILIGENCE – Regulation 3(2) of FTRR (No. 1) 2000

PETER D. MAYNARD & COMPANY

 

For Company – provide the following documents:

1. a)       Certificate of Incorporation (certified copy)
2. b)       Memorandum & Articles of Association (certified copy)
3. c)       Resolution of Directors

                             (i)       authorising opening of account &

                             (ii)      naming individual authorised to operate account

Name of Company:                                                                                                   

Address of:

Registered Office                                              Registered Agent                                 

                                                                                                                            

Date of Incorporation:                                                                                              

Directors & Officers of the Company

 

Directors                                    Names                              Addresses

1                                                                                                                          

 

 

2                                                                                                                          

 

 

                                                                                                                            

 

Officers:

                                                                                                                            

 

 

                                                                                                                            

 

Beneficial Owners: (except a Publicly Traded Company)

                                                Names                              Addresses

                                                                                                                            

 

 

                                                                                                                            

 

 

                                                                                                                            

The company is:

          in good standing:  yes / no

          in the process of being wound up:  yes / no

                                                                                                       cont. on page 2

For Company                                                -2-

 

 

Description & Nature of the Business including:

Date Business stated:                                                                                               

 

 

Products or Services provided:                                                                                   

 

 

Location of Principal Business:                                                                                    

 

 

Purpose of the Account & the potential parameters of the account including:-

 

(i)  Size, in the case of investment and custody accounts:                                              

 

 

(ii)  Balance ranges, in the case of deposit accounts:                                                     

(iii)  The expected transaction volume of the account:                                                   

 

 

We (Company & Director(s))

1. a)       agree that Peter D. Maynard & Co. may obtain independent verification of the
   information provided.

1. b)       confirms that all credits to the account are and will be beneficially owned by
   the facility holder:

Date:                                                            Signature:                                          

This information is required in compliance with Regulations to safeguard against money laundering and will remain confidential unless there is reason to suspect that the named party is involved in illegal activities.