Entity form

1. Company Information

Company Name:

Company Registration No.:

Date of Incorporation

Date of expiry (if applicable)

Country of Incorporation / Registration:

Email address

Contact Number

Entity Type (optional)

Registered Office Address

Postal Code, Country

Principal address of business Principal address of business (if different from registered office address) Principal address of business

Postal Code, Country

Principal business activity (optional)

Website (optional)

Please list the main (top 5) jurisdictions of your customers, i.e that your customers are located in (optional)

2. Beneficial owners of the Company

The purpose of obtaining beneficial owner's information is to:

Identify the natural persons (whether acting alone or together) who ultimately own all the assets or undertakings of the client;
If there is doubt as to whether the natural persons who ultimately own all the assets or undertakings of the client are the beneficial owners or where no natural persons ultimately own all the assets or undertakings of the client, to then identify the natural persons (if any) who ultimately control the business entity or have ultimate effective control over the client;
Where no natural persons are identified above, to identify the natural persons having executive authority in the client, or in equivalent or similar positions.

#01 Beneficial owners of the company

Identification Number (Identity Card, Passport No.)

Full Name of Beneficial Owner

Nature of Beneficial Ownership*

*Provide information on the nature of beneficial ownership (e.g. more than 10% ownership of the proposed company) and control structure of the proposed company.

#01 Senior management of the company

Identification Number (Identity Card, Passport No.)

Full Name of Beneficial Owner

Nature of Beneficial Ownership*

For EACH beneficial owner and member of the senior management or person with executive authority, please provide information in Customer Onboarding (Individual). Please also provide documents of identification and authorization as required.

3. Documents Required

Please upload the Certificate of Incorporation (optional)

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Please upload the Memorandum and Articles of Association (optional)

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Please upload the Certificate of Good Standing

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Please upload the Certificate of Incumbency

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Please upload the Register of Members

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Please upload the Register of Directors

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Please upload the Organization Chart

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4. Declaration

I hereby declare that the information provided in this form is accurate and complete.
I confirm that any information is found incorrect and/or incomplete that leads a violation of regulations may initiate legal actions, and I accept that I am the responsible party for any and all charges, penalties and violations.
I understand and agree that all documents supplied (including this form) will not be returned to me.
I undertake to notify Prime Shan Asia Limited of any future changes to the above information.
I understand that Prime Shan Asia Limited reserves the right to request for additional documentation/information.

Prefix

First Name

Last Name

Signature

Sign here

Date Signed

Customer Onboarding

#01 Beneficial owners of the company

#01 Senior management of the company

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