A. Company Information

1. Company Name *

2. Country of Incorporation *

Country

3. Date of Incorporation *

Date

4. Entity Type *

5. Registered Address *

Unit, Floor, Building, Street

Postal Code, Country

6. Business Address (if different from registered office address):

Unit, Floor, Building, Street

Postal Code, Country

7. Please describe the principal business activity *

8. Company URL *

9. Name of main representative *

First Name

Last Name

10. Passport Number of main representative *

11. Mobile Number of main representative *

Country Code

Phone Number

12. Email address of main representative *

example@example.com

B. Director and Shareholder Information

13. List of full name and identification number (identification card number or passport number) of all directors *

For EACH director of the corporate applicant, please provide information in CGT – Director And/Or Shareholder Questionnaire. Please also provide documents of identification and authorization as required.

14. List of full name and identification number (identification card number or passport number) of all shareholders and their respective shareholdings *

For EACH shareholder of the corporate applicant, please provide information in CGT – Director And/Or Shareholder Questionnaire. Please also provide documents of identification and authorization as required.

C. Financial Information

15. Are there complex structures such as trust arrangements, multi-tiered shareholdings (3 layers of shareholdings or more) involved, etc? *

Yes

No

16. Are there any Nominee Directors / Shareholders? *

Yes

No

17. What is the reason for choosing to use an offshore company?

18. What is the reason for choosing to open the trust account with us? *

19. What will the Trust account be used mostly for? (eg. investments or operational account) *

20. Background of the beneficial owner(s): *

The purpose of obtaining beneficial owner's information is to: a) Identify the natural persons (whether acting alone or together) who ultimately own all the assets or undertakings of the client; b) 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; and c) Where no natural persons are identified above, to identify the natural persons having executive authority in the client, or in equivalent or similar positions.

21. What is the source of wealth of the beneficial owners? *

22. Background of the directors: *

23.a Name of One of Your Suppliers: *

23.b Name of Another Suppliers:

24.a Name of One of your Customers: *

24.b Name of Another Customers:

25. Name of Some of Your Counterparts / Sister Company:

26. Expected Turnover per Year (Expressed in USD): *

27. Initial Deposit (Expressed in USD): *

28. Source of Funds: *

29. Source of Wealth: *

30. Average Balance to be maintained in Trust Account (Expressed in USD): *

D. Amount and Frequency of Expected Transactions (Inflow)

31. Frequency: *

32. Amount (in USD): *

33. Source of Funds: *

34. Purpose: *

E. Amount and Frequency of Expected Transactions (Outflow)

35. Frequency: *

36. Amount (Expressed in USD): *

37. Intended destination of outgoing funds from the account: *

38. Purpose: *

F. Documents Required

Please upload the following documents if available. All fields in this section are optional at this stage.

Please upload the Certificate of Incorporation

Click to upload

or drag and drop files here

Please upload the Articles of Association

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or drag and drop files here

Please upload the Certificate of Good Standing

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or drag and drop files here

Please upload the Business Registration Certificate

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or drag and drop files here

Please upload the Certificate of Incumbency

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or drag and drop files here

Please upload the Register of Directors

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or drag and drop files here

Please upload the Register of Shareholders

Click to upload

or drag and drop files here

Please upload the Organization Chart

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or drag and drop files here

Please upload the Address Proof (e.g. utility bills, bank statement)

Click to upload

or drag and drop files here

G. 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 Golden Brix of any future changes to the above information.

I understand that Golden Brix reserves the right to request for additional documentation/information.

Name of the main representative *

Prefix

First Name

Last Name

Signature of the main representative *

Sign here

Date Signed *

Date

Onboarding (Corporation)

A. Company Information

B. Director and Shareholder Information

C. Financial Information

D. Amount and Frequency of Expected Transactions (Inflow)

E. Amount and Frequency of Expected Transactions (Outflow)

F. Documents Required

G. Declaration

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