HELM TRUST COMPANY LIMITED COMPANY MANAGEMENT APPLICATION FORM

Transcription

1 HELM TRUST COMPANY LIMITED COMPANY MANAGEMENT APPLICATION FORM PLEASE NOTE THAT IN ACCORDANCE WITH ANTI MONEY LAUNDERING LAWS NEW BUSINESS CANNOT BE ACCEPTED BY ANY JERSEY TRUST AND COMPANY BUSINESS SERVICE PROVIDER UNTIL ALL REQUIRED DUE DILIGENCE HAS BEEN COMPLETED UPON RECEIPT OF RESPONSES TO THIS APPLICATION FORM IT MAY BE NECESSARY TO REQUEST ADDITIONAL CLARIFICATION AND / OR SUPPORTING DOCUMENTATION PART A INFORMATION ABOUT THE COMPANY 1. Name of Company: 2. Jurisdiction: Please specify the Jurisdiction where the Company is incorporated or is due to be incorporated: If a Jersey Company, do you / have you had * any interest in any other Jersey company? YES / NO * (*Delete as applicable) If yes please provide details of the company name and percentage shareholding held: If not Jersey, has the company issued or is it intended to issue any bearer shares? (NOTE: it is our general policy not to accept Companies with bearer shares) 1

2 3. Expected activities and transactions: a. What are the main activities of the Company? Please detail the nature of these activities (generic terms such as consultancy services are to be avoided). b. Please state the countries where these activities will take place. c. Please provide an indication of the following per annum: Turnover: Value range of the transactions: Volume of the transactions: d. If the Company has been set up for tax purposes, please give full details of the structure and benefits obtained and that advice has been obtained in relation to your domicile and any tax consequences that may arise: 2

3 e. Please attach a copy of the legal / tax advice received and / or provide us with the details of the relevant professional advisor (including all relevant contact details): NOTE: HELM DOES NOT PROVIDE TAX ADVICE AND YOU MUST ENSURE THAT YOU HAVE OBTAINED APPROPRIATE ADVICE 4. Reason for using Jersey as an offshore jurisdiction for Company administration services: Please provide the reason why Jersey was / has been chosen as an offshore jurisdiction for the Company: 5. Services to be provided: Our domiciliary fee covers the provision of the following combined services (unless you specify otherwise): o Directors and Secretary o Nominee Shareholders o Registered / Administrative Office Day to day administration is charged on top of the above domiciliary fee, unless otherwise specified. NOTE: It is our policy to only accept Companies when we have control of the Board of Directors. If in special circumstances, additional Directors are to be appointed alongside of our in house Directors, please complete the details below for each proposed appointee: 3

4 6. Details of any additional Director(s): (Please photocopy this section before completion and use further copies if more than one Director is to be appointed) Full Name: Residential Address (permanent physical address, P.O. Box is not acceptable): House Name: Street Town Post code Country Telephone: Home Office: Facsimile: Home Office: Mobile: address: Mailing address if different to above (PO Box is acceptable) Country of Tax Domicile Occupation (role and business sector): For the purposes of The Foreign Account Tax Compliance Act ( FATCA ) please confirm if the Director has any of the following: USA place of birth YES / NO USA nationality YES / NO USA domicile (including tax domicile) YES / NO USA residential address or US correspondence address (inc. US PO Box) YES / NO USA telephone number YES / NO USA contact details YES / NO USA bank account YES / NO If YES to any of the above, please provide your USA Federal Taxpayer Identification number: For the purposes of reporting under the UK/Jersey Intergovernmental Agreement ( UK IGA ) please provide the Director s UK National Insurance number 4

5 Please indicate all countries in which you are resident for tax purposes and the associated Tax Reference Numbers in the table below. If you are a US citizen or resident, please include United States in this table along with your US Tax Identification Number. Country/Countries of Tax Residency Tax Reference Number* *If you are a UK, Jersey, Guernsey, Isle of Man or Gibraltar resident then please supply your National Insurance or Social Security Number as appropriate, in addition to your Tax Reference Number. If you are not resident in any country for tax purposes, please tick this box. Please attach a certified true copy of the director(s) passport(s). Please refer to the last four pages of this Application Form for full details of our Client Due Diligence requirements 5

6 6. Source of Funds: Please provide full details of the origin of funds to be added to the Company. Please include specific details regarding the type and current geographical location of these assets and any existing bank accounts (including name and address of bank / financial institution and account balance) to be transferred into the Company. Please attach supporting documentation if available: 7. Address for Correspondence: Name: Address: Telephone: Facsimile: E mail: 8. Accountancy / Audit: Our standard service includes bookkeeping and the preparation of annual financial statements, unless otherwise specified. Please note however, that this work is not covered by our annual domiciliary fee and will be separately charged for on a time spent basis. Accounting records are a requirement of Jersey Law. 6

7 The appointment of Auditors for any jurisdiction can be arranged if required, but this is not a legal requirement for Jersey or for most other offshore jurisdictions. Is any particular financial year end required YES / NO * (* Delete as applicable) If yes, please specify Is any particular currency required YES / NO * (* Delete as applicable) If yes, please specify Audited accounts required YES / NO * (* Delete as applicable) 9. Your preferences (if any) for the choice of bankers, tax advisers, investment advisers, lawyers or other professional advisers: Bankers: Tax advisers (address and contact name): Stockbrokers / investment advisers (address and contact name): Lawyers (address and contact name): Other advisers (address and contact name): 7

8 PART B INFORMATION ABOUT YOU / BENEFICIAL OWNER(S) Client Identification: We are required to verify the identity of all Beneficial Owners, Ultimate Clients and External parties. Our requirements are detailed in the last four pages of this Application Form. 1. Details of Beneficial Owner(s) / Ultimate Client(s): (Please photocopy this section before completion and use further copies if more than one Beneficial Owner / Ultimate Client, and describe the nature of the relationship between them) Full Name: Country of Tax Domicile: Residential Address (permanent physical address, P.O. Box is not acceptable): House Name: Street Town Post code Country Telephone: Home Office: Facsimile: Home Office: Mobile: address: Occupation (role and business sector): Percentage Interest in the Company: Nature of relationship with other Beneficial Owner(s) (as applicable) For the purposes of The Foreign Account Tax Compliance Act ( FATCA ) please confirm if the Beneficial Owner / Ultimate Client has any of the following: USA place of birth YES / NO USA nationality YES / NO USA domicile (including tax domicile) YES / NO USA residential address or US correspondence address (inc. US PO Box) YES / NO USA telephone number YES / NO USA contact details YES / NO USA bank account YES / NO If YES to any of the above, please provide your USA Federal Taxpayer Identification number: For the purposes of reporting under the UK/Jersey Intergovernmental Agreement ( UK IGA ) please provide the Beneficial Owner / Ultimate Client s UK National Insurance number 8

9 Please indicate all countries in which you are resident for tax purposes and the associated Tax Reference Numbers in the table below. If you are a US citizen or resident, please include United States in this table along with your US Tax Identification Number. Country/Countries of Tax Residency Tax Reference Number* *If you are a UK, Jersey, Guernsey, Isle of Man or Gibraltar resident then please supply your National Insurance or Social Security Number as appropriate, in addition to your Tax Reference Number. If you are not resident in any country for tax purposes, please tick this box. Please attach a certified true copy of your / Beneficial Owner(s) passport(s). Please refer to the last four pages of this Application Form for full details of our Client Due Diligence requirements. 9

10 2. Source of Wealth: Please explain in full how the total net worth of the Beneficial Owner(s) / Ultimate Client(s) was generated. If funds are from family wealth (i.e. inheritance / gift) please provide details of how this wealth was originally generated. In the case of earnings please provide details of the level of wealth accumulated during this employment / occupation (generic terms such as sale of business, property sale or company sale etc are not sufficient). Please include the geographical sphere of the activities which have generated the wealth and attach supporting documentation if available: 3. Bankruptcy and Other Information: Have any of the Beneficial Owners / Ultimate Clients / External associated parties such as External Directors / Secretary been declared bankrupt in any part of the world? Have any of the Beneficial Owners / Ultimate Clients / External associated parties been concerned with the management of any company which has been the subject of an insolvent liquidation or judicial enquiry? Are any of the Beneficial Owners / Ultimate Clients / External associated parties aware of any claims, existing or potential, in relation to personal creditors? Have any of the Beneficial Owners / Ultimate Clients / External associated parties ever been convicted of any criminal offence or been subject to an investigation of whatever nature anywhere in the world? Do any of the Beneficial Owners / Ultimate Clients / External associated parties or their immediate family members hold any Government, Civil Service or senior Military position or consider that they are a Politically Exposed Person? YES / NO * YES / NO * YES / NO * YES / NO * YES / NO * (* Delete as applicable) If the answer to any of the above is YES, please provide full details below: 10

11 4. Declaration: To be signed by all Beneficial Owners / Ultimate Clients jointly (as applicable). I / We * confirm that: a. the Beneficial Owner(s) / Ultimate Client(s) have taken or are taking such legal, tax, exchange control or other professional advice appropriate to the setting up of this Company; b. I / We * understand Helm Trust Company Limited are not tax consultants and they are not able to provide tax advice; c. the provision of company management services by Helm Trust Company Limited are subject to the standard terms and conditions and fee scales in force from time to time, a copy of which I / we * have received, read and understood; d. the information provided in this application form and on any attachments is true and accurate to the best of my / our * knowledge and belief; and e. the Company will not be used for any criminal activity (including tax fraud or market abuse such as insider dealing) or money laundering purposes contrary to any applicable legislation. I / We * further confirm that I am / we * are acting for myself / ourselves * as your client and not as a nominee for any undisclosed third party. (* Delete as applicable) SIGNED PRINT NAME SIGNED PRINT NAME DATE DATE If not signed by the Beneficial Owner / Ultimate Client, please state in what capacity. 11

12 HELM TRUST COMPANY LIMITED GUIDE TO CLIENT DUE DILIGENCE ( CDD ) Jersey prides itself on being one of the most respected of the offshore jurisdictions. In order to maintain this position, and to keep in line with more stringent Client Due Diligence regimes we are required by our Regulator, the Jersey Financial Services Commission, to maintain up to date records on all clients and the transactions that are undertaken by them or on their behalf. Only in this way can we help to ensure that both the Island and Helm Trust Company Limited ( Helm ) are not used for money laundering and / or financing of terrorism purposes. Helm is obliged to identify all elements of a structure, to include the relevant corporate bodies, their related parties, their activities, and the ultimate beneficial owners or controllers. The purpose of this Guide is to explain what is required in the way of due diligence documentation. If complete and satisfactory CDD is not forthcoming then Helm is not able to continue with the business relationship. INDIVIDUAL CDD 1 x Identity Verification ( IDV ) A certified true copy (also confirming the true likeness of the individual) of one of the following documents is acceptable (where it provides an expiry date and photographic evidence of identity): Passport; Identify Card ; Driving Licence. 2 x Residential Address Verification ( ADV ) Original or certified true copies of two documents, as detailed below, are acceptable providing they detail the full permanent physical residential address of the individual. These should be from different service providers and must not be more than three months old: Correspondence from a central or local government department or agency; Current driving licence indicating full address details (where it has not been used as IDV as above); A letter (of introduction) confirming residential address from a regulated financial services business operating in an equivalent jurisdiction for AML purposes, or an acceptable certifier (see Certification Requirements); A bank statement*; A utility bill* (or a utility bill in the name of the spouse so long as this is accompanied by a certified true copy of the marriage certificate); A certified true copy of a Tenancy contract or agreement or property deed showing both name and address; An Affidavit signed by a practising lawyer or advocate confirming the full residential address. *Online utility bills and bank statements may be acceptable provided they include: i) the covering enclosing the invoice / statement which details both the sender s address, the recipient s address and the date, or ii) the statement / invoice detailing the URL address (e.g. along the bottom of the page together with the date it was printed. Please note: Mobile, store card and / or credit card bills are not acceptable. The documents must provide evidence of the individual s permanent physical residential address. For this reason a document showing only a P O Box address will not be acceptable. Those address verifications which are sent to the P O Box address, must also include the service address as confirmation of the individual s permanent physical residential address. 12

13 CORPORATE CDD This section provides details regarding the information and documentation required in respect of Trusts, Companies and Foundations or similar corporate structures. For any legal entity or corporate body, certified true documentation which provides details of: The name, date and country of incorporation or registration, official identification number, registered office address, principal place of business or operation, names of all Directors, and individual CDD for all ultimate Beneficial Owners and controllers, together with information about assets, source of funds and wealth. The following is a list of the types of documents required. Please tick those you have enclosed in the pack, but kindly note that we may request further documentation to satisfy our requirements under Anti Money Laundering / Countering the Financing of Terrorism ( AML / CFT ) legislation. Companies Certified true copy of the Certificate of Incorporation and Memorandum and Articles of Association (or relevant constitutional documentation). Current signed Certificate of Incumbency confirming the name and identification number of the Company, that it is in good standing, the current registered office address, the current Directors and Shareholders and the ultimate Beneficial Owners or controllers of the Company, along with their addresses and dates of birth. (This should be used where original Corporate CDD has previously been provided but updates are required). Certified copies of the share certificates or extract from the share register together with relevant Declarations of Trust (if shares held by nominee shareholders). Documentary proof of the ultimate beneficial ownership. Individual CDD for all ultimate Beneficial Owners holding more than 10% share ownership. Full name, address, date of birth, and occupation for Beneficial Owners /holding less than 10% share ownership. Individual CDD for at least two Directors, any controlling parties and any regular contacts or intermediaries. Latest set of Financial Accounts or details of the activities undertaken, together with the source and movement of funds. Trusts Extract of the constitutional Trust Deed and any other addendums which detail the name of the Trust, date of its establishment, the Trustees and their address, the Settlor, the Beneficiaries, the official ID number (for Registered Charitable Trusts). Individual CDD for the Settlor (i.e. any person who adds assets to the settlement regardless of whether they are named in the deed). Individual CDD for any principal Beneficiary (i.e. life tenant). Individual CDD for any other Beneficiary who receives benefit. (Prior to any distribution made to a Beneficiary, individual CDD will be required unless already provided and still current). Individual CDD for a Protector with power to direct, influence or guide the Trustees. Identification of Trustees including CDD of corporate bodies or individuals and mailing address information. Latest set of Financial Accounts or details of the activities undertaken, together with the source and movement of funds. Foundations Extract of the Foundation Charter and Regulations and any other addendums which details the name of the Foundation, the date and country of incorporation, the official number, the Foundation Council and their address, the Founder, Guardian and Beneficiaries. Individual CDD for the Founder (or any person who adds assets to the Foundation). CDD (Corporate and individual) for the Foundation Council Members. Individual CDD for any Beneficiary who receives benefit. (Prior to any distribution made to a Beneficiary, individual CDD will be required unless already provided and still current). Individual CDD for any external party that has power to instruct (i.e. Guardian, Protector, Enforcer, Power of Attorney). Latest set of Financial Accounts or details of the activities undertaken, together with the source and movement of funds. Included: Included: Included: 13

14 CERTIFICATION REQUIREMENTS: We are required by law to adhere to a prescribed certification format which covers both who can sign and the wording which is required. Where the original documentation is not handed to a member of Helm staff at a face to face meeting for certification, it must be certified by someone suitable and qualified (as further detailed below) and should, where applicable, confirm that the photographic IDV is a true likeness to the individual. The certifier should also add their official stamp (where available) and must provide their contact details and date the document accordingly. For ease of verification, a Cover Sign Off Form has been supplied overleaf, which can be completed and attached to the copy documents being verified. Acceptable persons to certify identity and address documentation may include: A member of the judiciary, a senior civil servant, or a serving police or customs officer; An officer of an embassy, consulate or high commission of the country of issue of documentary evidence of identity; An individual who is a member of a professional body that sets and enforces ethical standards not limited to the finance industry but this would be preferable. Note verification by a doctor, dentist or teacher is not acceptable; An individual who is qualified to undertake certification services under authority of the Certification and International Trade Committee (such as Chamber of Commerce) i.e. Notary Public; A Director, Officer or Manager of a regulated financial services business which is operating in an equivalent well regulated country or territory, or of a branch or subsidiary of a group headquartered in an equivalent well regulated country or territory and which applies group standards to subsidiaries and branches worldwide, and tests the application of and compliance with such standards. PLEASE NOTE: The certifier must not be connected (business or family) to the individual whose identification is being certified. ADDITIONAL INFORMATION AND DOCUMENTATION: To complete our due diligence investigations, we also require the principal client (i.e. the Settlor / Beneficial Owner) to provide us with information and suitable supporting documentary evidence relating to: Rationale i.e. obtaining information on the purposes and intended nature of the business relationship together with the type, volume and value of activity expected. Source of Funds i.e. the nature and details of the principal client s occupation or employment. Source of Wealth i.e. the activities which have generated the total net worth of the principal client, i.e. those activities which have generated a client s funds and property. These additional points form part of our standard Trust / Company / Foundation Application Form. If there are any changes during the relationship with Helm, up to date information should be provided to your regular Helm contact on an arising basis. We would appreciate your assistance in providing the necessary documentation at an early stage to prevent additional delays and resultant costs being incurred as a result. 14

15 HELM TRUST COMPANY LIMITED COVER SIGN OFF FORM FOR VERIFIERS OF DILIGENCE IMPORTANT THIS FORM CAN BE PRINTED AND ATTACHED TO THE DOCUMENTS BEING VERIFIED. BUT THE VERIFIER MUST ALSO SIGN AND DATE THE DOCUMENT BEING VERIFIED Name of person being verified: Items being verified: I confirm that the copies attached are true and complete copies of the original documents that I have seen and I confirm that where applicable the photograph contained in the document bears a true likeness to the named individual. Signed: Name: PLEASE ALSO SIGN AND DATE THE DOCUMENT BEING VERIFIED Date: Qualification: Address: Office stamp: 15