Please fill out forms online then print them and sign. The signed forms should then be scanned and emailed to mail@ccpbvi.com.

STRICTLY CONFIDENTIAL


RELEVANT INDIVIDUAL
DUE DILIGENCE INFORMATION FORM


(Required To Be Completed By All Persons Applying To Do Business)



AND

GUIDANCE NOTES


PERSONAL INFORMATION

ANTI-MONEY LAUNDERING LEGISLATION CURRENTLY IN FORCE IN THE BRITISH VIRGIN ISLANDS AND AMENDED FROM TIME TO TIME, IMPOSES DUTIES AND OBLIGATIONS REGARDING THE VERIFICATION OFIDENTITY OF APPLICANTS FOR BUSINESS WHICH CCP IS OBLIGATED TO UPHOLD.

EACH RELEVANT INDIVIDUAL MUST COMPLETE AND SUBMIT A SEPARATE PERSONAL INFORMATION FORM. YOUR APPLICATION MAY BE DELAYED UNTIL THE REQUIRED INFORMATION ON ALL RELEVANT INDIVIDUALS IS RECEIVED



Company/Ship/Trademark Name:

Name

Position in Company:

Date of Birth: Place of Birth



Full Physical Address

Street Address:

Street Address:

City: State/County:

Country: Zip Code:

Phone: Fax:

Cell: Email:

Nationality: Passport #

Nationality: Passport #

(In case of dual nationality include the information for both passports)



OCCUPATION:

Please provide a specific and identifiable business activity and your current position . Vague references such as “Businessman” or “Manager” will not be accepted and will delay the Application for Business process. In the case of no employment please describe the normal day to day activities such as “House Wife” In case of retirement please provide details of previous occupation and your last position.

SOURCE OF FUNDS DECLARATION
BY SHAREHOLDERS /ULTIMATE BENEFICIAL OWNERS

DATE.

CCP FINANCIAL CONSULTANTS LIMITED
ELLEN L. SKELTON BUILDING,
FISHERS LANE, ROAD TOWN
TORTOLA, BVI

In connection with the Application for Business for (Insert Name of Company/Ship/Trademark) I confirm that I am (Insert A Shareholder or A UBO or if not applicable enter "Not a Shareholder or UBO" )



I hereby declare and confirm the following.

  • I am making this declaration for the protection of myself as well as CCP Financial Consultan ts Limited.
  • The funds or assets totaling the sum of which were initially transferred to the company/entity or which I intend to transfer into the company/entity after this application for business has been effected and any other funds which from time to time I may thereafter transfer into the company/entity, whether directly or via other entities under my control and direction, represent funds obtained by me from the following sources:*** (If not applicable simply enter $0.00 above and NONE below)
  • That the funds or assets referred to above are my personal property and at the time of transfer I was / am legally entitled to transfer such funds or assets.
  • That no funds or assets have been derived from any criminal activities of any nature whatsoever.


Shareholder / Ultimate Beneficial Owner / Relevant Individual Name


Signature

*** Please be specific and refrain from vague statements such as simply “Personal Savings” Instead elaborate on how the savings were accumulated. Similarly instead of just stating "Business Profits" you should identify the name of company which generated the profits and indicate your level of participation in the company for example "accumulated dividends from XYZ Limited where I am a director and 40% shareholder."



ANY OTHER INFORMATION: (If there is no other important or relevant information simply enter NONE below)

Please provide details of any other information you consider important and relevant in terms of expediting the approval of our Compliance Department so that the Application for Business can be approved.



TAX ADVISORS (If no legal or tax advisors were used simply enter NONE below)

Please provide the full name and address of any individual or professional body that has provided legal or tax advice to you with regards to the current Application for Business request (if applicable)



Completed and Submitted By

Name: Title:

Signature: Date :



The above information should be completed with reference to the Guidance Notes. Each relevant individual should print and sign this form and submit their package of information initially via email to mail@ccpbvi.com with a copy to zdyett@ccpbvi.com with the original being sent via mail or courier to



CCP Financial Consultants Limited
Ellen L. Skelton Building
Fishers Lane,
Road Town, Tortola,
British Virgin Islands, VG 1110

GUIDANCE NOTES

DOCUMENTARY EVIDENCE REQUIRED FOR ALL RELEVANT INDIVIDUALS

The following information is required for each Relevant Individual

  • Proof of Physical Address
  • One Professional Reference letter
  • One Bank Reference letter
  • Certified copy of an Approved Government photo ID Document (passport or drivers licence)
  • Full name, address and contact details of any individual or professional body that has provided legal or tax advice to each Relevant Individual with regards to the current Application for Business request.

Notarization and Certification

A duly appointed Notary Public under seal of his or her office may notarize copies of all documents as evidence of their authenticity. However as an alternative, copies of documents may be certified by a CCP Employee, Lawyer, Banker, Accountant or other regulated person. See Required Standards for Certification of Documents



Proof of Physical Address

A notarized or certified copy of a recent utility bill or statement from a financial institution (e.g. a bank, credit union, building society), will fulfill this requirement as long as the physical address is shown thereon. Note that the copies should be legible and utility bills or statements older than three months will not be accepted. See Required Standards for Certification of Documents



References

The Professional Reference must be from a respected professional who knows the Relevant Individual in a professional capacity (i.e. not simply an acquaintance) for at least five (5) years and who must not be a relative of the Relevant Individual. The Bank reference must be from a bank with which the Relevant individual has maintained a long term banking relationship. The references must be current (i.e. not older than one month) and be addressed directly to CCP. References addressed “To Whom It May Concern” are not acceptable. (At the discretion of the CCP Compliance Officer for qualifying Relevant Individuals only one reference may be required i.e. either a Professional Reference OR a Bank Reference).



Identification Documents

Identification documents (valid passport and/or driver’s license) must be notarized or certified and have a clear and legible photograph along with the specimen signature of the Relevant Individual. The notary public or other person certifying should legibly sign the copy of the document and state his capacity or position on the document and must state that the photograph bears a true likeness of the Relevant Individual. See Required Standards for Certification of Documents.

REQUIRED STANDARDS FOR CERTIFICATION OF DOCUMENTS

Where documents verifying identity or residential address are required to be certified they shall not be accepted by CCP unless they are properly certified in accordance with the following:

CCP shall not accept a certified copy of a document presented for a Business Relationship or transaction unless it is satisfied that the Person certifying the document:

  • is independent of the Individual or Legal Person whose documents are being certified.
  • is subject to professional rules of conduct or statutory compliance measures which carry penalties for breach

Attached as EXHIBIT 1 is a template which can be used to provide acceptable certification for a Passport or other Government Issued Photo Identification

Attached as EXHIBIT 2 is a template which can be used to provide acceptable certification for a proof of address.


In all cases if the above templates are not used the person certifying the documents MUST :

  • Insert the date of certification
  • Sign the document and affix a seal of stamp
  • Provide adequate contact details to enable further queries or clarification

EXHIBIT 1

PASSPORT / PHOTO ID CERTIFICATION

Date:

COUNTRY OF PASSPORT / PHOTO ID:

PASSPORT / PHOTO ID NUMBER:

IN THE NAME OF



In my capacity as (insert description of capacity of person certifying) I hereby certify that the holder of the passport / photo ID the details of which are provided above, appeared before me on the above date and that the attached document which I have duly initialed and dated is a true copy of the original and the picture that appears thereon is a true likeness of the holder.



Name:

Capacity:

Address:

Address:

Address:

Telephone:

Email:

Please affix your official seal or stamp (if applicable)
and also sign and date where indicated below.

Signed :

Date :

If preferred or if more space is needed you can also affix
your stamp or seal directly on the document being certified



Documents may be certified by a CCP Employee with signing authority, A Lawyer, Accountant or other Qualified Professional Advisor, An Officer or Employee of a Bank or other regulated financial institution, A Commissioner of Oaths, A Police Officer or any other person authorized to provide certification according to local legislation.

EXHIBIT 2

UTILITY BILL OR OTHER ADDRESS CERTIFICATION

Date:

UTILITY COMPANY / BANK NAME / ETC :

ACCOUNT NUMBER:

IN THE NAME OF

DATE OF RECORD:



In my capacity as (insert description of capacity of person certifying) I hereby certify that the original utility bill / bank statement etc, the details of which are provided above was presented to me for certification on the above date and the attached document which I have duly initialed and dated is certified as a true copy of the original.



Name:

Capacity:

Address:

Address:

Address:

Telephone:

Email:

Please affix your official seal or stamp (if applicable)
and also sign and date where indicated below.

Signed :

Date :

If preferred or if more space is needed you can also affix
your stamp or seal directly on the document being certified



Documents may be certified by a CCP Employee with signing authority, A Lawyer, Accountant or other Qualified Professional Advisor, An Officer or Employee of a Bank or other regulated financial institution, A Commissioner of Oaths, A Police Officer or any other person authorized to provide certification according to local legislation.