APPLICATION FORMS AND NOTICES (AFN) – AML

Form - AML

Annual AML Return

Name of Relevant Person
DFSAregistration number
Return for the period
(Year End Date)

1 of 9AML/VER2/04-1

APPLICATION FORMS AND NOTICES (AFN) – AML

Purpose of this Return

This AML Return must be submitted by every Relevant Person who isrequired to under Rule 14.5.1 of the AML module of the DFSA Rulebook. The AML Return is required to be completed annually and submitted to the DFSA within four months of the end of the submitter’s financial year end, and be signed by the Governing Body and/or senior management of the Relevant Person.

This AML return is one of the supervisory tools used by the DFSA to assess a Relevant Person’s compliance with its AML obligations. The form will also allow the DFSA to identify and action any relevant AML issues and trends that emerge in the DIFC. Similarly, this AML Return may also form a part of a Relevant Person’s systems and controls for monitoring compliance with its AML obligations.

Notes for completing this Return

  • You should familiarise yourself with the AML module before completing this return.
  • All sections must be completed, where appropriate.
  • Questions must be answered in full and the use of abbreviations should be avoided.
  • Do not leave any questions blank – if a question is not applicable this should be indicated in theresponse section.
  • If there is insufficient space to answer a question, please attach the answer in an appendix.
  • Answers must be typed.
  • Please ensure that any supporting documentation is clearly labelled and attached.
  • The AML Return includes, where appropriate, the relevant AML moduleRule reference. These references should assist in framing the context of your answer. The Rule reference should also assist in determining if the question is applicable.
  • If the answer to all or part of any question is covered within your AML Policies and Procedures, please provide the relevant reference and page number to that information in your response.

Contents of AML Return

  1. Relevant Person Details
  2. Compliance with AML Obligations
  3. Applying a Risk Based Approach
  4. Customers and Customer Due Diligence
  5. Reliance and Outsourcing
  6. Audit
  7. Sanctions and Other International Obligations
  8. AML Training and Awareness
  9. Suspicious Activity Reports
  10. Governing Body/ Senior Management Declaration
  1. Relevant Person Details

A1 / Full Name of Relevant Person
A2 / Registered Office Address
A3 / Telephone Number
A4 / Relevant Person Type
[Authorised Firm, DNFBP, Auditoretc.]
A5 / Firm Prudential Category (where applicable)
A6 / Website Address
  1. Compliance with AML Obligations

Senior management
B1 / Name/s of all individuals forming thesenior management of the firm. Refer to definition in AML Glossary.
AML Rule 1.2.1
Money Laundering Reporting Officer (MLRO) Details
B2 / Name of appointed MLRO.
AMLRule 11.2.1
B3 / Is the MLRO role outsourced?
B4 / Describe the MLRO’s role within, or association with, the Relevant Person, including any other roles within the Relevant person.
B5 / Name of appointed deputy MLRO, where applicable.
AML Rule 11.2.3
B6 / Describe the arrangements if any within the Relevant Person to deal with absences of the MLRO.
AML Responsibilities
B7 / Explain how the Relevant Person’s senior management comply with the requirements of AML Rule 1.2.1(2) providing examples from the relevant period.
  1. Applying a Risk Based Approach

Assessment of Business Risk
C1 / Please provide the latest version of the Relevant Person’s business AML risk assessment.
AML Rule 5.1.1(a) & (b) & (c)
AML Systems and Controls
C2 / Attach the Relevant Person’s AML Policies and Procedures.
AML Rule 5.2.1(a)
C3 / Please state the date or dates when the risk assessment was last carried out by the Relevant Person on the adequacy of its AML systems and controls?
Provide or attach a summary of the findings of this assessment.
AML Rule 5.2.1(c)
Assessment of Customer Risk
C4 / Explain how the risk assessment of the Relevant Person’s customers has been undertaken.
AML Rule 6.1.1
C5 / Explain how the Relevant Person has documented the risk assessment of its customers.
It is sufficient to provide any blank templates used by the Relevant Person when documenting the risk assessment of its customers.
AML Rule 4.1.1(b)(iii)
  1. Customers & Customer Due Diligence

D1 / How many customers does the Relevant Person have as at the date of this Return?
Refer to definition in AML Glossary.
D2 / Please summarise how the Relevant Person determines the money laundering risk of a customer and assigns the customer an appropriate risk rating.
AML Rule6.1.1(1)(b))
D3 / Explain the Relevant Person’s risk categories and provide the number of customers assigned to each risk category.
Politically Exposed Persons (PEP)
D4 / Explain the systems and controls used by the Relevant Person to determine whether a customer or beneficial owner is a PEP.
AML Rule 5.2.1(b)(ii)
D5 / How many customers or beneficial owners have been identified as a PEP as at the date of this Return.
Customer Due Diligence (CDD)
D6 / Explain the steps undertaken by the firm in conducting CDD including Simplified and Enhanced CDD.
AML Rule 7.3.1, 7.4 & 7.5
Ongoing CDD
D7 / Explain how the Relevant Person undertakes ongoing monitoring of its customers and their transactions?
AML Rule 7.6.1
D8 / When was the last time that the Relevant Person reviewed the adequacy of the CDD information it holds on customers and beneficial owners?
What were the material outcomes or findings of this review, if any?
AML Rule 7.6.1(d)
Failure to conduct or complete CDD
D9 / Has the Relevant Person been unable to conduct or complete CDD within the 30 day period specified in AML Rule 7.2.1(3)(d)for any customer?
If yes, please provide details of the event and what steps were taken or are being taken by the Relevant Person to conduct or complete CDD or to dispose of the matter. Please list in a separate appendix if there is insufficient space?AML Rule 7.2.1(4)
D10 / Has the Relevant Person been unable to conduct or complete CDD for any customer during the relevant period? If yes, explain the resulting action taken by the Relevant Person.
AML Rule 7.7.1(1)
  1. Reliance & Outsourcing

E1 / Does the Relevant Personrely on any third parties to conduct one or more elements of CDD on its behalf?
AML Section 8.1.1
If yes, please describe the circumstances in which such reliance is placed.
E2 / Does the Relevant Person outsource any one or more elements of its Customer Due Diligence obligations?
AML Section 8.2.1
If yes, please describe the arrangements.
  1. Audit (this section is only applicable to Authorised Persons)

F1 / When was the last time the Authorised Person’s audit function conducted a review of its money laundering policies, procedures, systems and controls and its compliance with the obligations under the AML module?
AML Section9.4.
F2 / Please attach the relevant findings of the last audit?
F3 / What action was taken by the Authorised Person in response to these findings and by whom?
  1. Sanctions and Other International Obligations

G1 / Describe the Relevant Person’ssystems and controls to obtain and make use of relevant resolutions or sanctions issued by the United Nations Security Council.
Your response should address the frequency of checks? Who is checked? What sorts of payments are checked?
AML Rule 10.2.1.
G2 / Describe the Relevant Person’ssystems and controls for making appropriate use of findings, recommendations, guidance, directives, resolutions, sanctions, notices or other conclusions of government , regulatory and international standard setting bodies.
AML Rule 10.3.1
  1. AML Training and Awareness

H1 / Explain how the Relevant Person complies with the requirement to provide AML training to all relevant Employees.
AML Rule 12.1.1
H2 / Summarise the methods of training used, whom it is provided by; the frequency of training and the means in which the Relevant Person ensures the effectiveness of the training.
H3 / Indicate the number of Employees that have received anti money laundering training for the year in question, broken down by positions held in the Relevant Person e.g. management, staff, etc.
H4 / Indicate the number of relevant Employees that have not received training and provide an explanation for this.
  1. Suspicious Activity Reports

I1 / Describe the Relevant Person’s policies, procedures, systems and controls to monitor and detect suspicious activity.
AML Rule 13.2.1
I2 / How many internal Suspicious Activity Reports have been reported within the Relevant Person in the relevant period?
AML Rule 13.2.2
I3 / How many Suspicious Activity Reports have been reported to the AMLSCU by the Relevant Personin the relevant period?
AML Rule 13.3.4
  1. Governing Body/Senior Management Declaration

The contents of this AML return are required to be acknowledged and signed by every member of the Relevant Person’s Governing Body and/or senior management prior to submission to the DFSA.

Declaration by the signatories

  1. I declare that, to the best of my knowledge and belief, having made due enquiry, the information given in this form, the supplements and documents attached, as well as any applicable supporting documents, is complete and correct. I understand that it is an offence under Article 66 of the Regulatory Law 2004 to provide to the DFSA any information which is false, misleading or deceptive or to conceal information where the concealment of such information is likely to mislead or deceive the DFSA.
  1. I confirm that I have the authority to complete this return, to declare as specified above andsign this form for, or on behalf of, the Relevant Person.
  1. For the purposes of complying with DIFC Data Protection Law 2007, I understand that anyPersonal Data provided to the DFSA will be used to discharge its regulatory functions underthe Regulatory Law 2004 and other relevant legislation and may be disclosed to third partiesfor those purposes.

Name: / Name:
Position: / Position:
Signature: / Signature:
Date: / // / Date: / //
Name: / Name:
Position: / Position:
Signature: / Signature:
Date: / // / Date: / //
Name: / Name:
Position: / Position:
Signature: / Signature:
Date: / // / Date: / //

Please submitthe completed AML Return to the DFSA electronically via email to:

Relevant Persons are advised to retain a copy of the completed form and all relevant attachments for their records.

1 of 9AML/VER2/04-1