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KYC APPLICATION:

           
Minerals Mining Operator:
Minerals refinery:
Minerals Seller/Broker:

KNOW YOUR CUSTOMER (KYC) FORM STRICTLY CONFIDENTIAL

S.N. Particulars
Details
7. In case of Individual
   
8. In case of Others
   
   
       
19. Contact Details of Customer

20. Copies* of Customer Identification Documents

Please submit the documents and tick (x) against the documents attached

(i)

Individual

ID Card/Passport/Driving License (DL)

Proof of Domicile Country**

(ii)

Company

Company Registration

List & Passport copies of Authorised Signatories

Major Shareholders:

List of Major Shareholders

Shareholders who, directly or indirectly

List & Proof of Domicile Country** of Directors

owns or controls more than5% of the shares or voting rights

(iii)

Partnership

Certificate of Registration

Partnership Deed

List & Passport copies of Authorised Signatories

List & Proof of Domicile Country** of Partners

(iv)

Trust

Certificate of Registration

Trust Deed

List & Passport copies of Settlor, Trustees, Protector

List & Passport copies of Authorised Signatories

List of Major Beneficiaries

Major Beneficiaries:

Beneficiary who is to receive at least 25% of the funds of the Trust

(v)

Any other Legal Person

Registration Document

List & Passport copies of Authorised Signatories

List of the Individuals/Entities who ultimately owns, or exercises effective control over such person

Declaration

I/We hereby confirm that the above information provided to you is true and correct to the best of our knowledge.

I/We acknowledge that if the information provided is found to be false or misleading then the business relationship may be annulled anytime at your discretion. I/We hereby agree to provide any additional information/documentation that may be required.

Date

Signature of Authorised Signatory

*Certified copies of documents clearly signed, stamped and dated by any of the following: -

(1) A representative of an embassy, consulate, or high commission of the country; or

(2) A lawyer or attorney; or

(3) A notary public or commissioner of oaths; or

(4) A chartered or certified accountant.

The date of signatory should not be older than 3 months.

Copies of certified copies is not acceptable.

**Any document to show the residential address like utility bill, tenancy agreement