CLIENT DUE DILIGENCE OVERVIEW FORM
Entity /

In all cases the beneficial owner (see client due diligence guidance) must be identified.

Client Information
Full legal name of client
Registration number/code
Date of formation/creation / Year end
Type / Private company / ☐ / Listed company / ☐ / Subsidiary of listed company / ☐
LLP / ☐ / Partnership / ☐ / Estate of a deceased individual / ☐
Pension Scheme / ☐ / Charity / ☐ / UK/Irish Accountant or Lawyer / ☐
Trust / ☐ / Sole trader / ☐ / Other (specify)
Regulated by / Charities Commission / ☐ / Charities Commission (EU equivalent) / ☐
Financial Conduct Authority (FCA) / ☐ / Financial Conduct Authority (FCA) (EU equivalent) / ☐
Pensions Regulator / ☐ / Pensions Regulator (EU equivalent) / ☐
Prudential Regulation Authority (PRA) / ☐ / Prudential Regulation Authority (PRA) (EU equivalent) / ☐
Solicitors Regulation Authority (SRA) / ☐ / Solicitors Regulation Authority (SRA)(EU equivalent) / ☐
Contact Information
Current registered address
Postcode
Other address
Postcode
Telephone number / Website address
Other contact information
Main contact at client name
Telephone number / Email address
If the client acting for another person (e.g.broker, attorney, insolvency practitioner) complete the below section and obtain the relevant documentation
Reason for relationship
Title / Mr ☐ / Mrs☐ / Miss☐ / Ms☐ / Dr☐ / Other (specify)
Full legal name of client
Date of birth / Gender / M☐ / F☐
Current residential address
Postcode
Telephone number / Mobile number
Ownership and control (please refer to the client due diligence guidance for full details on who should be verified by entity type)
  • Corporation: own or control more than 25% of shares or voting rights
  • Partnership: own or control more than 25% of the capital, profits or voting rights
  • Trust or foundation: are trustees and/or settlors and those entitled to 25% or more of the capital
  • Deceased estate: are the executors and those entitled to 25% or more of the estate
  • Other legal entities: own or control more than 25% of shares or voting rights

If the client is part of a group detail the ultimate holding company
Please detail the individuals that have been verified in accordance with the client due diligence guidance:
List Directors, Partners, Trustees or Sole Traders within the direct client
Name / Reason for association (e.g. director or 25% shareholder)
List the Ultimate Beneficial Owners, Trustees, Beneficiaries or Settlors from the parent entity
Name / Reason for association (e.g. director or 25% shareholder)

To be completed by the manager or Partner:

Engagement InformationNote if this is a high risk engagement a comprehensive description should be provided.
Services to be provided
Nature of Business/Business activities
Describe the key sources of the client's capital
Internal Checks
Did the World-Check, Smart Search or URU searches return any matches? / Y☐ / N☐
If yes, confirm whether the hit was a positive match to the individual/entity? / Y☐ / N☐ / N/A☐
Risk Assessment
AML risk rating of proposed engagement (to establish a rating please review the risk matrix appendix)
Standard☐ / High☐
If this is a high risk engagement please detail the reasons why and mitigating actions
Select those that apply:
Politically exposed person ☐ / High profile individual☐ / Client money account☐ / Sanctions List☐
In light of your knowledge of the client and the engagement are there any other factors (not previously disclosed in this form) that present a high risk or money laundering or terrorist financing to the firm?
Declaration
I confirm that I have carried out the verification procedures according to the firm’s policy and I am satisfied as to the client’s identity
Checklist completed by / Date
Partner/Manager / Date
The completed version of this form should be stored in the relevant DMS correspondence: client due diligence folder, alongside the required verification documents for the client. Once stored in the correct place they should be ticked for compliance approval through the Intranet.