Form A4 - Particulars of Legal Person

Form A4

Particulars of Legal Person

Annex F: Customer Due Diligence Forms for Clients

1. Entity Details / Legal Person Information

Name of Legal Person (Company Name)

Registration Number (UEN)

Date of Registration

Country of Registration

Type of Entity

Registered Address

Principal Place of Business (if different from above)

2. Contact Information

Contact Person Name

Designation

Contact Number

Email Address

3. Beneficial Ownership / Directors

Please list the Directors or Partners of the entity.

4. Declaration & Signature

I hereby confirm that the particulars provided in this form are true, correct, and complete.

Signature of Authorised Signatory

Clear Signature

Name of Signatory

Date