GPIQ

GLOBAL PARTNERS INTERNATIONAL

Client Identity & Know Your Client Information Form

Due Diligence Requirement

Personal Information

Addresses, Employer and Banking

KYC Details

6. Have you ever been criminally convicted? *
7. Have you ever received a financial judgement against you? *
8. Are there any financial judgements currently existing against you? *
9. Have you ever been professionally suspended or disciplined by a professional body or committee? *
10. Are you a politically exposed person? *
11. Have you ever applied for refugee status in any jurisdiction? *

Certified Identification

Attach certified copies of two forms of picture identification, such as a national ID card, passport or driver’s licence.

Declaration and Signature

I declare that the information stated herein is accurately submitted, and I release A.C. Elliot Attorneys, ACE Corporate Services and their agents or representatives from liability arising out of the information presented herein.