Client Due Diligence — KYC / AML Onboarding

PART A

Client Type & Identification

Identity of the natural or legal person entering the business relationship

I am completing this form as a: *

Individual (natural person) Company / Legal entity

PART B

Address & Contact Details

Registered and correspondence details

Residential address (individuals) or registered office address (entities) *

City / Emirate *

Country of residence / operation *

Mobile number *

Email address *

PART C

Financial Profile

Source of funds, source of wealth and expected activity

Source of funds for this relationship * Select all that apply

Source of wealth How the overall wealth was accumulated (career, business history, family wealth, etc.) *

Purpose of the business relationship *

Expected annual transaction volume (AED) *

Countries from which funds will originate or be sent to *

PART D

Ownership & Control

Ultimate Beneficial Owners, directors and authorised signatories (entities only)

Ultimate Beneficial Owners (UBOs) * Any natural person owning or controlling 25% or more of the entity, directly or indirectly (Cabinet Resolution No. 109 of 2023). If no person meets the threshold, list the person(s) exercising control or holding senior management responsibility.

Directors / Managers *

Authorised signatory completing this form (name & position) *

PART E

PEP, Sanctions & Risk Declarations

Required screening declarations under UAE AML regulations

1. Are you, any beneficial owner, director, or an immediate family member or close associate of any such person, a Politically Exposed Person (PEP)? * A PEP is a person entrusted with a prominent public function (e.g. head of state, minister, senior government/military/judicial official, senior executive of a state-owned enterprise, or senior political party official), in the UAE or abroad.

No Yes

This declaration will require Enhanced Due Diligence, including source of wealth verification and senior management approval, before the relationship can proceed.

2. Do you, the entity, any UBO or director have residence, citizenship, business operations or significant financial ties in any country subject to UN, UAE or other international sanctions, or identified by FATF as high-risk or under increased monitoring? *

No Yes

3. Have you, the entity, or any UBO or director ever been convicted of, or are currently subject to any investigation or proceedings relating to, money laundering, terrorist financing, fraud, bribery, corruption or tax evasion? *

No Yes

4. Are you acting on your own behalf? *

Yes, on my own behalf / on behalf of the entity named above No, on behalf of another person or entity

PART F

Documents & Declarations

Supporting documents, consent and signature

Supporting documents Clear colour copies. If uploads fail or are unavailable, please email the documents separately — your form will still be submitted.

Declarations *

I declare that the information and documents provided in this form are true, accurate and complete to the best of my knowledge, and that the funds involved in this relationship are derived from legitimate sources.

I undertake to notify you promptly of any change to the information provided, including changes in ownership, control, PEP status or contact details.

I understand that this information is collected to meet obligations under UAE Federal Decree-Law No. (20) of 2018 (as amended) and related regulations, that it will be retained for at least five years after the relationship ends, and that suspicious activity may be reported to the UAE Financial Intelligence Unit without notice to me, as required by law.

I consent to the processing of the personal data in this form for client due diligence, screening (including sanctions and PEP screening) and ongoing monitoring purposes, in accordance with UAE Federal Decree-Law No. (45) of 2021 on the Protection of Personal Data.

Full name of signatory *

Date *

Client Due Diligence Questionnaire

Client Type & Identification

Address & Contact Details

Financial Profile

Ownership & Control

PEP, Sanctions & Risk Declarations

Documents & Declarations

Submission received