Client details (businesses) Legal name of the company Date of incorporation KKF number Foundation register number Registered Address Phone Type of entity Limited (N.V.)Cooperatives (C.V.)Partnership (V.O.F./ Maatschap)UnlimitedSole proprietorship (Eenmanszaak)IncorporatedFoundation (Stichting)Religious organization Identification of businesses a. Incorporated, Limited, Unlimited, Cooperatives an authentic stamped extract of the registration document from the chamber of commerce in Surinamearticles of incorporation, partnership agreements and/or business certificates drawn up by a notary established in Suriname b. Identification of Foundations a signed statement of the Board of Directorsa signed statement of authorized persons indicating the source of funds and purpose of the foundation (e.g. Non-profit or Profit) c. Identification of public legal person a signed statement of the Board of Directorsa signed statement of authorized persons d. Identification of Religious organization a signed statement coming from the organization whereof the religious organization takes part ina signed statement of the religious organization itself, not older than 6 (six) months Ultimate Beneficial Owner (UBO) Name of UBO Address of UBO Date of birth ID type/ number Please attach document Client details (individual Legally representing the company) Last name name Registered Address Date of birth Phone Your email Identification a valid Surinamese ID Carda valid Surinamese Driver’s Licensea valid PSA Carda valid Passporta legitimate Residence Certificate approved by country of origin Please attach document Transactional expectations Purpose of transaction(s) Type of transaction(s) expected to be executed incoming (receive)outgoing (send) Incoming (receive) transactions Number of expected incoming transactions per month 1-56-1011-1516-2021-2526-30 Average amount (in USD) of incoming transactions 1-500500-1.5001.501-3.0003.001-4.5004.501-6.000> 6.001 Countries where funds are expected to come from USANETHERLANDSHAITICOLOMBIABRAZILOTHER Other Outgoing (send) transactions Number of expected outgoing transactions per month 1-56-1011-1516-2021-2526-30 Average amount (in USD) of outgoing transactions 1-500500-1.5001.501-3.0003.001-4.5004.501-6.000> 6.001 Countries where funds are expected to go to USANETHERLANDSHAITICOLOMBIABRAZILOTHER Other
