Due-Diligence Onboarding Natural Person

Contact information

1

Personal information

2

Some More information

3

Civil/Marital status

4

Politically exposed person

5

Source of funds("SoF") information

6

Source of wealth(“SoW”) information

7

Documentation

8
CONTACT INFORMATION:
Primary Contact?
Last Name(s)
Given Names(s)
Email
TRANSACTION INFORMATION:
Real Estate Agent Name?
Property Description
PERSONAL INFORMATION:
Type of Client
Last Name(s)
Given Names(s)
Physical address
Country of Residence
Birthdate(dd/mm/yy)
Country of birth
Nationality
Other info:
Passport number
ID Card Number
Issue Date
Expire date
Other passport?
Maintains another nationality
Tax identification Number
Profession
Employer
Position
Phone number(mobile)
Phone number(landline)
Marital Status:
Civil/Marital Status:
Spouse or Partner information
Complete name
Passport number
ID number
TAX ID number
Employer
Position
Birthdate(dd/mm/yy)
Nationality
POLITICALLY EXPOSED PERSON (PEP):

PEP is a Political Exposed Person who is, or has had at any time, in the past 5 years, a prominent public function, or who has been elected or appointed to such a function, its direct family members and close associates of the persons who are or have been charged with the listed prominent political functions as PEPs.

You are or have been a Politically Exposed Person (PEP)?:
PEP Status
SOURCE OF FUNDS (“SoF”) INFORMATION

1. Description of Revenue Source

The Source of the Funds is the following:









Other revenue

Please provide a detailed description of the source of the funds (e.g. if you checked the option ‘loan’ you should confirm the name of the Bank / financial institution that is extending the loan and the total amount of the same, if this is ‘salary’, the name of your employer, the nature of the company etc.):

2. The Transfer has been done from the following account:

Name of the Bank
Address of the Bank
Name account holder
Account number
Copy of recent bank or investment portfolio statement, where the funds will be transferred from (required if buyer):

3. The funds are to be used for:

4. Third Party Declaration (if applicable)

When paying by a third party (including a (your) legal entity), we must fully identify this third party. In addition, we need a statement explaining the reason why this third party is paying on your behalf. Lastly, we need underlying documents (in many cases for example a loan agreement).

The funds have been transferred on behalf of:



SOURCE OF WEALTH (“SoW”) INFORMATION

Confirmation Sources of Wealth

Description of Source(s) of Wealth Necessary Information Please describe the requested information or refer to attachments (mandatory)

  • Specify: e.g. (former) entrepreneurial, inheritance, other resources; if possible detailed and documented description

  • Company name
  • Short description of business activities
  • Statutory seat
  • Name company website (if applicable)

  • If “sold to a third party”: Name of purchaser and approximate date
  • If other: Detailed and documented description

  • Name and address of company
  • Nature of company
  • Amount of annual profit
  • Copy of latest audited financial statement

  • name of lender
  • amount of loan
  • date received

  • Sold property address
  • Date of Sale
  • Total Sale amount

Please provide us copy of the relevant information and supporting documentation, which support the sources of wealth that have been mentioned by you.

The following documents have been sent to support the above:

DOCUMENTATION REQUIRED

Only files type jpeg, png, pdf, xls or xlsx. Max 1Mb per file

Client documents required
Color copy of valid passport of Client
Color copy of valid second identification document of Client, either driver's license or ID
Proof of permanent residence document - e.g. utility bill or government issued document - for local Aruban resident Censo Papel 5 florin (not older then 3 months)
Source of Funds/Source of Wealth Documents
Source of Funds supporting documents
Source of Wealth supporting documents
Property Documents (Kadastraal uittreksel, deed of purchase (provided by current owner), etc.). If applicable.
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 declares that:

  • Has not been involved in, has not been convicted of or is under investigation anywhere in the world for offences related to the production, trafficking, consumption of drugs or any other offence associated with drugs; or money laundering.
  • I (we) confirm that I (we) have and verify the due diligence evidence of all beneficial owners, attorneys, beneficiaries, directors, officers and signatories of the services necessary for INTEGRA; and agree to provide such information and/or documentation requested by INTEGRA.
  • I declare under penalty of perjury that this statement has been examined by me and is true, correct and complete to the best of my knowledge and belief.
Name of submitter
Last Name of submitter
Name of submitter (if any other)
Last Name of submitter (if any other)

I Confirm