Submission Successful!

Thank you for completing this comprehensive Know Your Customer (KYC) form, meticulously designed by Integra. Your efforts are genuinely appreciated, whether you're a real estate professional securing property transactions, a legal expert protecting client interests, or an accountant conducting detailed financial due diligence.

What Happens Next

Your submission is now on its way to our dedicated team for a thorough review, following the regulations set forth by the Central Bank of Aruba. Should additional information or clarity be required, rest assured we'll contact you using the details provided. As soon as the review concludes successfully, we will get in touch with you to confirm.

Your Privacy Matters Most

We want you to be confident that your data is in safe hands. Please be assured, your information will remain entirely confidential. We're dedicated to maintaining high levels of data security, fostering a transparent and safe environment for your operations.

For any queries or further assistance, feel free to Contact Us. We're committed to making this process as smooth as possible.

Thank you once again for trusting Integra. We look forward to continuing serving you, guiding, and supporting you each step of your professional journey.

Integra Corporate Solutions
Oranjestad, Aruba

t : +297 561 4900
e : [email protected]
w : www.integraaruba.com

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Accounting Firm
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Client Discovery
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Services
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LWTF Questionnaire
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LWTF Applicability
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Client Information | Natural Person Individual
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Client Information | Legal Entity
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Directors | Natural Person
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Directors | Corporate Entity
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Directors | Other
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Source of Funding
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Source of Revenue
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Source of Wealth
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MOT | Reporting Unusual Transactions
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Risk Assesment
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Statement

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Accounting Firm Details

This form serves as the foundational building blocks that facilitate clear communication, ensure compliance with regulatory requirements, and document essential information in a structured manner. Should we have any questions, or need clarification on inaccurate or incomplete information entered, please share with us your contact details along with the preferred point of contact;

Firm's Name

Accountant's Name

Phone Number

Client Discovery

Date Intake Client

File Number #

Client Name

Select Type of Client

Individual - Natural Person

Corporation - Legal Entity

Contact Information | Corporate - Legal Entity

Please provide the contact information details below of the representative involved in this transaction;

Established in Aruba

Offshore*

Legal Entity Name

Representative's Name

Role/ Function

Phone Number

Email Address

Contact Information | Individual - Natural Person

Please provide the contact information details below of the individual involved in this transaction;

Resident

Non-resident*

First Name

Last Name

Residential Address

Country

Contact Phone Number

Email Address

* Enhanced due diligence is required based on Art. 11 of the LWTF/ because by its nature carries a Higher Risk. Exception in the cases referred to in Article 10 of LWTF.

Services

Please provide a concise summary that includes the objectives and assignment(s) of the financial and business services you are providing

Determination of LWTF Applicability for Provided Services

Please answer the following questions to determine if the services provided fall under Article 2, Paragraph 2 and or Article 6 Paragraph 2 of the LWTF. Indicate 'Yes' or 'No' for each service based on its relevance to the activities provided. Should none of these apply, please select OTHER and provide a detailed explanation.

Questionnaire on Services Relating to Article 2, Paragraph 2, LWTF

Is the service concerned with determining the client's legal position?

Yes

Does the service involve representing the client legally?

Yes

Does the service include providing advice before, during, or after legal proceedings?

Yes

Is the service about providing advice on how to initiate or avoid legal action?

Yes

Is the service about something else?

Yes

Please explain below;

If you have answered 'Yes' to any of the above questions, the LWTF DOES NOT apply to the services in question, and no further action as per LWTF regulations is required for these services.

Questionnaire on Services Relating to Article 6, Paragraph 2, LWTF

Does the service involve the purchase and/or sale of registered goods, as well as managing the rights to which these registered goods are subject?

Yes

Does the service include managing money, securities, or other assets?

Yes

Is the service related to managing bank, savings, or securities accounts?

Yes

Does the service involve the organization of contributions for the incorporation, operation, or management of businesses?

Yes

Does the service involve the incorporation, operation, or management of legal persons or equivalent legal entities, and the purchase and sale of businesses?

Yes

Is the service about something else?

Yes

Please provide explaination below;

If you have answered 'Yes' to any of the questions above, the LWTF DOES apply to the services in question. Please proceed with the appropriate actions in compliance with LWTF regulations.

LWTF Applicability Declaration

This applies if the services involve representing and defending a client's legal position in court, offering advice before, during, and after legal proceedings, or advising on initiating or avoiding litigation.

The signatory below, in their capacity as the client's file manager, affirms following an assessment per the LWTF, that the accounting services provided fall under:

Under LWTF Supervision (related to Article 6)

Exempt (related to Article 2)

Signature

Accountant/Compliance Officer's Name:

Date

The 'Client' refers to the individual/entity benefiting directly from our services, not the intermediary (e.g., referring accountant) who brings the case to our firm. Invoices may be addressed to the intermediary for convenience, but the 'Client' designation remains with the ultimate beneficiary of our services.

Client Information | Natural Person - Individual

In accordance with Article 6 of the LWTF, we are required to complete the following form for each client we are onboarding. This form is an essential compliance measure to ensure adherence to the legal and regulatory obligations that govern our services. It is designed to collect specific information that helps us in conducting due diligence, mitigating risks, and maintaining the integrity of our operations in line with established norms. We kindly ask for your detailed and accurate responses to each query presented. Your cooperation is vital in helping us fulfill our commitment to regulatory compliance and overall service excellence. Please proceed to fill out the form as instructed.

If the client in question is a LEGAL ENTITY, please scroll down the page and click on the "Next" button to proceed with access the subsequent section of the form.

To add more individuals - natural people, CLICK ON THE PLUS (+) ICON found on your right ->

First Name

Last Name

Residential Address

Country

Contact Phone Number

Email Address

Birth Date

Place of Birth

Government Issued IDPlease select

Upload: Government IDPlease upload clear, high-resolution scans. We accept the following formats: PDF, JPG, JPEG, PNG

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Govenment Issued ID #

Issue Date

Expiry Date

Politically Exposed Person (PEP)

To comply with international regulations and ensure the highest standards of practice, we need to collect information about Politically Exposed Persons (PEPs) for our Know Your Customer (KYC) obligations.

Requirements of PEPs are part of international Anti-Money Laundering (AML) and Counter-Terrorist Financing (CTF) guidelines. They are not meant to dissuade PEPs from utilizing our services. Instead, they help us maintain a more detailed risk profile and apply enhanced due diligence where necessary.

Is this person a Politically Exposed Person (PEP) or connected to a PEP as a family member or close associate?

Yes

Please help us categorize your potential PEP status more accurately.A "Related Individual" in the context of a Politically Exposed Person (PEP) typically includes spouse/partner, family members or close associates of the person currently or previously holding a significant public role. Due to this relationship, related individuals may also be regarded as PEPs.

Director / Shareholder

A Related Individual

If RELATED INDIVIDUAL is selected, please indicate relationship

What is the Employment Title and Position

Country of Employment

To comply with legal requirements, we kindly ask you to report your PEP status. Please choose the appropriate category below that best reflects your current standing.

Active PEP: An individual presently holding a significant public position, involved in key responsibilities such as tax-related matters. This includes politicians, government officials, judiciary members, military personnel, or executives from state-owned corporations.

Inactive PEP (More than two years): A PEP who has not held an active role for more than two years.

Inactive PEP (Less than two years): A PEP who has been inactive for less than two years.

Client Information | Legal Entity

If the client in question is not a LEGAL ENTITY, please scroll down the page and click on the "Next" button to proceed with access the subsequent section of the form.

In accordance with Article 6, you, as our client, are required to complete the following form. This form is an essential compliance measure to ensure adherence to the legal and regulatory obligations that govern our services. It is designed to collect specific information that helps us in conducting due diligence, mitigating risks, and maintaining the integrity of our operations in line with established norms. We kindly ask for your detailed and accurate responses to each query presented. Your cooperation is vital in helping us fulfill our commitment to regulatory compliance and overall service excellence. Please proceed to fill out the form as instructed.

To add more legal entities, CLICK ON THE PLUS (+) ICON found to the right ->

Company Name

Trade Name DBA

Registration / Incorporation Date

Registration / Incorporation #

Registered Address

Phone Number

Country

URL must include http://

Supporting Documents

Please upload clear, high-resolution scans. The file size should not exceed 2MB. We accept the following formats: PDF, JPG, JPEG, PNG

Upload: Chamber of Commerce Extract or Similar e.g. Certificate of Incumbancy

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Upload: Certificate of Incorporation

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Upload: Article of Incorporation

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Upload : Certificate of Good Standing

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Individual (Physical Person) Shareholders, Ultimate Beneficial Owner & Board Directors

To maintain our commitment to transparent corporate governance and compliance with regulatory standards, we require detailed information about each registered shareholder and board member. Should this section not apply, please scroll down the page and click on the "Next" button to proceed with accessing the subsequent section of the form.

Add a Board Director and/or Shareholders and/or UBO

To list more persons: Click on the plus (+) icon found to the right ->

Please specify this person's titleSelect all that apply

Board Director

Shareholder

Ultimate Beneficial Owner

Ownership PercentagePlease indicate the percentage of the company's ownership held by the Ultimate Beneficial Owner (UBO)/ shareholder. Enter a numeric value representing the percentage (e.g., enter '25' for 25%). This figure should reflect the total ownership stake of the individual in relation to the entire business.

Full Name

Residential Address

Country

Contact Phone Number

Passport #

Passport Expiration Date

Upload: Photo Page of PassportPlease upload a clear, high-resolution scan or photograph. The file size should not exceed 2MB. We accept the following formats: PDF,JPG, JPEG, PNG)

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Government IDPlease select

Government Issued ID #

ID Expiration Date

Upload: Valid Government IDPlease upload a clear, high-resolution scan or photograph. The file size should not exceed 2MB. We accept the following formats: PDF,JPG, JPEG, PNG)

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Residency Status

Please let us know about your residency status in Aruba. Determining whether you are a resident or non-resident of Aruba is crucial for many transactions, as it affects legal and tax obligations. We need the following documents to ensure that your records accurately reflect your residency status in Aruba.

ARUBA RESIDENT | Censo Papel - 5 FlorinIssued less than 90days from today's date. ** Please upload a clear, high-resolution scan or photograph.The file size should not exceed 2MB. We accept the following formats: PDF,JPG, JPEG, PNG)**

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ARUBA NON RESIDENT | Proof of Permanent Residence Utility Bill or Government issued document clearly stating your name and residential address. Issued no less than 90 days from today's date. ** Please upload a clear, high-resolution scan or photograph.The file size should not exceed 2MB. We accept the following formats: PDF,JPG, JPEG, PNG)**

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Politically Exposed Person (PEP)

Is this person a Politically Exposed Person (PEP) or connected to a PEP as a family member or close associate?

Yes

Director / Shareholder

A Related Individual

If RELATED INDIVIDUAL is selected, please indicate relationship

What is the Employment Title and Position

Country of Employment

To comply with legal requirements, we kindly ask you to report your PEP status. Please choose the appropriate category below that best reflects your current standing.

Inactive PEP (More than two years): A PEP who has not held an active role for more than two years.

Inactive PEP (Less than two years): A PEP who has been inactive for less than two years.

Corporate Entity Shareholders & Board Directors

To maintain our commitment to transparent corporate governance and compliance with regulatory standards, we require detailed information about each registered shareholder and board member.

Should this section not apply, please scroll down the page and click on the "Next" button to proceed with accessing the subsequent section of the form.

Add a Board Director and/or Shareholders and/or UBO

To list more persons: Click on the plus (+) icon found to the right ->

Please specify this person's titleSelect all that apply

Shareholder

Board Director

UBO

Company Name

Trade Name / DBA

Registered Address

Country

Date of Registration / Incorporation

Upload: Articles of Incorporation

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Director's Shareholders Name

Passport #

Phone Number

All documents must be scanned copies, clear and legible. Acceptable file types are: .pdf, .jpg, .png, Maximum file size should not exceed 2MB per document.

Upload: Share register or similar K-1 and 1020/1160 form, list of members

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Upload: Annual ReturnMost recent Year

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Upload: Chamber of Commerce Extract, Certificate of Incumbency or SimillarNot older than 3 months

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Representatives / Intermediaries / Authorized Persons

Please provide information relevant to identifying the Representatives / Intermediaries / Authorized Persons. If this does not apply click 'Next'.

Click on the (+) icon located in the right corner to include additional profiles.

Natural Person

Role/Function

First Name

Last Name

Residential Address

Birth Date

Place of Birth

Nationality

Government Issued IDPlease select

Issue Date

Government Issued ID #

Expiry Date

Click on the (+) icon located in the right corner to include additional profiles.

Legal Entity

Role/Function

Name

Address

Country

Chamber of Commerce Number

Tax ID / Persoons Nr.

Represented by

Title

Source of Funds

In cases where a transaction is conducted via a third-party payer, including a legal entity on your behalf, we are required to completely identify the involved third party. Additionally, we require a statement explaining why the third party is making the payment on your behalf. Finally, we will need to collect the relevant supporting documents (such as a loan agreement, in many instances).

Payment Method

Cash

Bank Transfer

Select Currency

Transaction Value

Is this transaction on behalf of a Third Party?

Yes

Is the third party involved in conducting this transaction on your behalf a(n);

Individual

Corporate Entity

Full Name of Third Party

Can you explain the reason for this third party's involvement in the transaction?

Please upload relevant supporting documents (such as a loan agreement, other documentation pertaining to third party funds

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Funds Utilization PurposePlease provide a detailed explanation of how the declared funds will be utilized. Describe the specific purpose(s) for which these funds are intended, including any relevant activities, projects, or goals to be supported by this financing. Your clarity will assist in ensuring compliance and facilitating a smoother transaction process.

Banking / Transaction Details

Should this be a bank transfer, please provide information concerning the banking details for this transaction for Know Your Customer (KYC) compliance.

Name of Financial Institution

Financial Institution Address

Name of Account Holder

Account Number #

Account Type

Please Specify

Please Attach a Recent Statement from Your Bank or Investment Portfolio, Indicating the Account from which the Funds Will be Transferred.

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Source of Revenue

What Are the Source(s) of Revenue for This Transaction? Please Select One or More Applicable Options

Salary Revenue

Investment Revenue

Business Revenue

Inheritance Revenue

Loan Revenue

Other Revenue Sources

Salary Revenue DetailsDescription: Please indicate your current salary details. This includes your gross salary, any deductions, bonuses, other allowances and benefits, and your net salary

Upload: Proof of Salary Revenue Pay stubs or payslips from your employer Employment contract specifying your salary and other benefits Bank account statements highlighting salary deposits

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Business Revenue DetailsDescription: Please provide information on the income you receive from your business operations. This should include the nature of the business, your role, tenure, and the business's financial performance

Upload: Proof of Previous Business RevenueFinancial statements, including Profit and Loss, and Balance Sheet Business tax returns Business registration documents Bank account statements for the business

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Loan Revenue DetailsDescription: If applicable, please provide details on any monetary returns derived from lending money or other loan-related activities.

Upload: Proof of Loan RevenueLoan agreement or promissory note outlining the terms and conditions Bank or lending institution statements showing loan disbursements or repayments Borrower's repayment schedule

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Investment Revenue DetailsDescription: Please provide information on any income sources originating from your financial investments. This can include dividends, interest, rental income, or capital gains from your investment portfolio.

Upload: Proof of Investment RevenueStock dividend statements or brokerage account statements Capital gains reports or statements Real estate property rental income receipts or lease agreements Bank interest statements

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Upload: Proof of Inheritance RevenueWill or probate documents Trust documents, if assets were received through a trust Inheritance tax documents, if applicable Bank statements showing inheritance funds or asset transfer documents for inherited property

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Inheritance Revenue DetailsDescription: Please share details on any earnings or financial benefits that have originated from inheritance. This can include cash, properties, stocks, bonds, or any other inherited assets.

Other Revenue DetailsDescription: Please specify any other revenue streams that have not been accommodated in the above categories. This could include any freelance work, royalties, alimony, lottery winnings, etc. Please elaborate on the nature, frequency, and amount of this income.

Upload: Proof of Other RevenueFreelance work: Invoices, payment receipts, or contracts with clients Royalties: Royalty statements from publishers, agents, or distributors Alimony: Divorce settlement agreements stating alimony amounts, payment records Lottery winnings: Official lottery win confirmation, bank account statements, or winnings declaration and tax payment documentation

Cadushi Fest 2023 Poster with bleed.pdf

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Source of Wealth

What Are the Source(s) of Wealth for This Transaction? Please Select One or More Applicable Options

Family Wealth

Previous Business Ownership

Company Revenue

Real Estate Sales

Employment Income

Family Wealth DetailsPlease provide information about the wealth accumulated by your immediate family. Include details of the source of the wealth, such as inheritances or businesses owned by your family.

Upload: Proof of Family WealthFamily Trust documents Wills and probate documents from family members Family business financial statements Inheritance documentation and bank records of inheritance deposits Bank statements or other financial documents indicating wealth (assets, properties, investments, etc.)

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Previous Business Ownership DetailsDetail any businesses you've owned or had a significant stake in the past, including business name, nature of the business, your role in it, and timeframe of your involvement.

Upload: Proof of Previous Business OwnershipBusiness registration or incorporation documents Shares or stock certificates, if the business was a corporation, indicating your ownership stake Past business tax returns and financial statements (Profit & Loss Account, Balance Sheet) Sale or transfer contract if you sold your stake in the business

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Company Revenue DetailsProvide information regarding profits generated from your current business or businesses. This should include profit reports or statements for the recent financial period.

Upload: Proof of Company RevenueCurrent business Profit & Loss Statements Balance Sheets or statement of financial position Business bank account statements showing revenue deposits Recent business tax return documents

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Real Estate Sale DetailsPlease provide information on any recently sold property. Include specifics such as the type of property (e.g., residential, commercial), the sale price, date of sale, and location of the property.

Upload: Proof of Real Estate SaleSale deed or property transfer documents Bank account statement showing proceeds from the sale Property appraisal report before selling, if available Documentation of property advertising (real estate listing, newspaper ads, online ads), if relevant Real estate agent or broker statement or agreement, if used

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Employment Income DetailsDescription: Please indicate your current employment income details. This includes remuneration received from any source in the form of cash, dividends, shares, profits etc

Upload: Proof of Employment IncomePaystubs, W2s or other wage statements. IRS Form 1099s. Tax filings. Bank statements demonstrating regular income. Attestation from a current or former employer etc.

Cadushi Fest 2023 Poster with bleed.pdf

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MOT/FIU Framework

This section helps in identifying transactions that may require reporting under the MOT framework. Carefully review each indicator and mark whether the specified transactions have occurred and if they have been reported as necessary.

Objective Indicators

130101 - A transaction that has been reported to the police or judiciary.

Yes

130102 - Transactions by individuals or entities from listed countries or areas under sanctions

Yes

130103 - A wire transfer transaction worth Afl. 500,000 or more.

Yes

130104 - A cash transaction worth Afl. 25,000 or more.

Yes

130105 - A cash transaction worth Afl. 5,000 or more (this indicator is applicable only to casinos).

Yes

Subjective Indicators

130201 - A transaction that gives reason to assume it could be related to money laundering.

Yes

130202 - A transaction that gives reason to assume it could be related to terrorism financing.

Yes

Additional Explainations

Under the MOT framework, do the services need to be reported?

Yes ➜ The case must be forwarded to the Compliance Officer.

No ➜ The services are exempt from further compliance verification.

Risk Assesment

Assessment of risk should take both client and transaction risk into consideration and will dictate whether Standard or Enhanced Client Due Diligence (CDD) is required.

Risk Rating

1-Star: LOW (Standard CDD)
2-Stars: MEDIUM (Standard CDD)
3-Stars: HIGH (Enhanced CDD)
4-Stars: Unacceptable

This is an Initial Assessment of accountant/ staff member during intake interview. This will be verified and further elaborated in a risk profile.

Accountant/ Staff Member

Date

Initials

Management (if high)

Date

Initials

Remarks

Statement

"I DECLARE THAT THE INFORMATION CONTAINED IN THIS FORM IS TRUE, COMPLETE AND PROPORTIONATE. RELIABLE AND UP-TO-DATE INFORMATION ON ALL ASPECTS ON WHICH QUESTIONS HAVE BEEN ASKED."
The applicant hereby declares that they:

Have not been involved in, convicted of, or are currently under investigation anywhere in the world for offenses related to the production, trafficking, or consumption of drugs; or any other crime associated with drugs; additionally, they have not been involved in or convicted of money laundering.

Confirm that they have performed and verified the due diligence evidence for all beneficial owners, attorneys, beneficiaries, directors, officers, and signatories of the services required by INTEGRA, and agree to provide any additional information and/or documentation requested by INTEGRA.

Solemnly declare, under penalty of perjury, that this statement has been thoroughly examined and, to the best of their knowledge and belief, is true, correct, and complete.
By submitting this statement, the applicant acknowledges their understanding of the legal implications and potential consequences of providing false or misleading information.

Signature

Date

Submitter Name

Phone Number

By submitting this form, you can trust that your information is safe with us, as we adhere to all regulations and follow stringent security measures, ensuring the protection and confidentiality of your data, as outlined in our Privacy Policy and Terms of Service