Onboarding Questionnaire

Planned business activity

Description of the Company’s business activities *

Please briefly list products and service Company offers

Representative of the Company

Full name *

First

Last

Phone number *

Date of birth *

E-mail *

Citizenship *

Residential address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Head of the Company

Only applicable if Representative is not Head of the Company

The Representative is also the Head of the Company *

Yes
No
Yes but, there are other Heads of the Company

Full name

First

Last

Phone number

Date of birth

E-mail

Citizenship

Residential address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Head of the Company (additional)

Leave blank if not applicable

Full name

First

Last

Phone number

Date of birth

E-mail

Citizenship

Residential address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Head of the Company (additional)

Leave blank if not applicable

Full name

First

Last

Phone number

Date of birth

E-mail

Citizenship

Residential address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Ultimate Beneficial Owner

Please provide detailed information about natural person(s) who controls the Company by directly or indirectly holding or controlling 25% or more shares or voting rights, or the natural person(s) who otherwise exercises control over the Company.

The Representative is also the Ultimate Beneficial Owner of the Company *

Yes
No

Full name *

First

Last

Date of birth *

Citizenship *

Residential address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Ownership / control size (%) *

Are there other UBOs?

Yes
No

Select Yes if the other UBOs have more than 25% of the Company else, select No

Ultimate Beneficial Owner (additional)

Please provide detailed information about natural person(s) who controls the Company by directly or indirectly holding or controlling 25% or more shares or voting rights, or the natural person(s) who otherwise exercises control over the Company.
Leave blank if not applicable

Full name *

First

Last

Date of birth *

Citizenship *

Residential address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Ownership / control size (%)

Ultimate Beneficial Owner (additional)

Please provide detailed information about natural person(s) who controls the Company by directly or indirectly holding or controlling 25% or more shares or voting rights, or the natural person(s) who otherwise exercises control over the Company.
Leave blank if not applicable

Full name *

First

Last

Date of birth *

Citizenship *

Residential address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Ownership / control size (%)

Ultimate Beneficial Owner (additional)

Please provide detailed information about natural person(s) who controls the Company by directly or indirectly holding or controlling 25% or more shares or voting rights, or the natural person(s) who otherwise exercises control over the Company.
Leave blank if not applicable

Full name *

First

Last

Date of birth *

Citizenship *

Residential address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Ownership / control size (%)

Confirmation *

I hereby certify that the information provided in the Questionnaire is complete, true and accurate and I undertake to inform Huch immediately in writing about any changes in the information provided as well as provide additional information or documentation upon Huch’s request. I undertake to use Huch services for legitimate purposes only and I understand that if the information in this Questionnaire turns out inaccurate or misleading, it may lead to unilateral termination of business relationship.

Date *

Onboarding Questionnaire

Company information

Planned business activity

Representative of the Company

Head of the Company

Head of the Company (additional)

Head of the Company (additional)

Ultimate Beneficial Owner

Ultimate Beneficial Owner (additional)

Ultimate Beneficial Owner (additional)

Ultimate Beneficial Owner (additional)

Disclaimer

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