To Be Completed by the Manager Or Partner

CLIENT DUE DILIGENCE OVERVIEW FORM
Individual /

Please refer to the client due diligence guidance document for a comprehensive list of the verification documents that are required for an individual.

Client Information
Title / Mr☐ / Mrs☐ / Miss☐ / Ms☐ / Dr☐ / Other (specify)
Full legal name of client
Date of birth / Gender / M☐ / F☐
Residency / Nationality
Contact Information
Current residential address
Postcode
Telephone number / Mobile number
Email address / Website address
Other contact information
Employment information
Occupation
Employment status
Is the individual directly associated to a potential or existing client of the firm (please state below if applicable otherwise provide details of the employer and business address)
Potential /existing client of firm
Employer
Business address
(if different to home address)
Postcode
Telephone number / Mobile number
Email address / Website address
If the client is acting for another person (e.g.broker, attorney, insolvency practitioner) complete the below section and obtain the relevant documentation.
Reason for relationship
Title / Mr ☐ / Mrs☐ / Miss☐ / Ms☐ / Dr☐ / Other (specify)
Full legal name of client
Date of birth / Gender / M☐ / F☐
Current residential address
Postcode
Telephone number / Mobile number

To be completed by the manager or Partner:

Engagement Information
Services to be provided
Describe the sources of the client's wealth - including a description of the nature of their business, key assets and sources of income. Note if this is a high risk engagement a comprehensive description should be provided
Internal Checks
Did the World-Check, Smart Search or URU searches return any matches? / Y☐ / N☐
If yes, confirm whether the hit was a positive match to the individual/entity? / Y☐ / N☐ / N/A☐
Risk assessment
AML risk rating of proposed engagement (to establish a rating please review the risk matrix appendix)
Standard☐ / High☐
If this is a high risk engagement please detail the reasons why and mitigating actions
Select those that apply:
Politically exposed person ☐ / High profile individual☐ / Client money account☐ / Sanctions List☐
In light of your knowledge of the client and the engagement are there any other factors (not previously disclosed in this form) that present a high risk or money laundering or terrorist financing to the firm?
Declaration
I confirm that I have carried out the verification procedures according to the firm’s policy and I am satisfied as to the client’s identity
Checklist completed by / Date
Partner/Manager / Date
The completed version of this form should be stored in the relevant DMS correspondence: client due diligence folder, alongside the required verification documents for the client. Once stored in the correct place they should be ticked for compliance approval through the Intranet.