Client Profile Form Individuals (Fill one per client)
 
 I hereby declare that I am or will be the beneficial owner of shares in the company named below an d that the following information correct and true:
     
  Name of Company
  No. of shares owned
     
  PERSONAL DETAILS:  
  Name
  Sex
  Phone No.
  Phone No. (other)
  Fax
  Email
  Occupation
  If self employed, nature of self employment:
  Principal Place of Business
  Business Address
  Mailing address
(if different from above)
     
 

IDENTIFICATION

  
 
Attach notarized copy of relevant pages of passport or other photo identification showing number and country of issuance, issue and expiry date and signature.
     
 

REFERENCES:

  
  2 references as to reputation and standing enclosed from:
 
 
   
  I hereby authorize you to independently verify any information provided herein and undertake to inform you of any changes to the above as soon as reasonably possible.
  Client signature
  Date
     
 
Click for Guidance Notes
The Client Profile form should be completed in respect of every beneficial owner. The supporting documents required, namely the notarized photo identification and the two references, must be returned to us with this form.

With regard to the references, they may consist of one as to reputation and standing of the client (beneficial owner) and the other may be a financial reference:

1. If a character reference:
  1. The reference should be current, from a professional (e.g. Lawyer, accountant, doctor or banker and should be presented on original letterhead.
  2. The referee should have known the client for a minimum of 3 years. The actual number of years must be stated.
  3. The referee should outline what he knows of the educational and employment history of the client.
  4. The reference must be addressed to the Compliance Officer, C.F. Butler & Associates P.O. Box N-1462 Nassau, Bahamas.


2. If a financial reference:
  1. The reference should include the manner in which the client conducts his personal banking business.
  2. The nature of the relationship between the client and the bank.
  3. The duration of the relationship between the client and the bank, which must be a minimum of 3 years.
  4. The reference must be addressed to the Compliance Officer, C.F. Butler & Associates. P.O. Box N-1462 Nassau, Bahamas.
     
 
 
 
 
 
 
 
Privacy Policy | Legal Disclaimer
Become a Fan
 Copyright © 2009 C.F. Butler & Associates. All Rights Reserved