Important information This Anti Money Laundering ( AML ) Questionnaire is used by the Registration Authority to assess the company s compliance with the relevant AML regulations and its awareness to its obligations and requirements. It should be submittedaspartoftheregistrationprocess. Section 1: Company Details Companyname Allfieldsspecifiedorindicatedby*aremandatory. AddressofHeadOffice UnitNumber/Level Number BuildingName Street/Area Emirates/State/ Province Country Section 2: Money Laundering Reporting Officer (MLRO) Title Forename Surname Nationality Address UnitNumber/Level Number BuildingName Street/Area
State/Province Emirates Country JobTitle TelephoneNumber EmailAddress PassportEvidence CopyofPassportenclosed. Pleaseenclosecopyofpassport. Profile/CV CopyofCVenclosed. PleaseencloseCurriculumVitae. Section 3: Designated non-financial Business or Profession Pleaseindicatethe typeofdesignated non FinancialBusiness orprofession* Realestatedeveloperoragencytransactinginthebuying/sellingofrealproperty Dealerinpreciousmetalsorpreciousstones DealerinanysaleableitemofapricegreaterthanorequaltoUS$15,000 Lawfirm Notaryfirm Otherindependentlegalbusiness Accountingfirm Auditorinsolvencyfirm CompanyServiceProvider SingleFamilyOffice Other:Pleasespecify: Section 4: AML Policies, Procedures, Systems and Controls Haveyouestablishedthefollowing:effectiveAMLpolicies, procedures,systemsandcontrolstopreventopportunities formoneylaunderinginrelationtothebusinessactivities ofthecompany? Yes No Dothesepoliciesprocedures,systemsandcontrolsenable suspiciouscustomersandtransactionstobedetectedand reported? Yes No Dothesepolicies,procedures,systemsandcontrolsensure thepersonsareabletoprovideanappropriateaudittrailof transactions? Yes No
Section 5: Review Process Doesthecompanyconductreviewstoensureeffectiveness ofitsamlpolicies,procedures,systemsandcontrolsat leastannually? Whoconductsthereviewprocess? Yes No InternalAudit ComplianceFunction AuthorisedFirm KnowYourCustomer sampletesting. Analysisofallsuspicioustransactionreportsto highlighttrainingneeds Areviewofthenatureandfrequencyofthe dialoguebetweenthegoverningbodyandsenior managementwiththemlrotoensurethattheir responsibilityforimplementingandmaintaining adequatecontrolsissatisfactory. Weconfirmthatthecompanyisabranchora subsidiaryoperatinginanotherjurisdiction.we ensurethatitsamlpolicies,procedures,systems andcontrolsapplytoanybranchorasubsidiary operatinginanotherjurisdiction. WeconfirmthatIfanotherjurisdiction'slawsor regulationspreventorinhibitthecompanyfrom complyingwithuaelawno.4of2002,uaelaw No.1of2004orwithanyADGMregulationsor rulesrelatedtoantimoneylaundering provisions,thecompanywillpromptlyinform theregistrationauthority. Weconfirmthatthecompanymayreceive requestforinformationinrelationtoamlor potentialmoneylaunderingfromanother jurisdictionoranotherregistraroranother regulator,relatedtoservicescarriedoninor fromtheadgm,mustpromptlyinform RegistrationAuthority. Whatdoesthereviewprocesscover? Pleasetickappropriatebox ComplianceinOtherJurisdictions DisclosuretotheRegistrar Co operationwiththeregistrar
MLRO Declaration Ideclarethat,IhavereadandunderstoodtherelevantantimoneylaunderingregulationsandIamawareofthe obligationsandrequirementsimustadheretoasamlro.inparticular,ihavereadandunderstoodthatuaecriminal lawappliesintheadgmand,therefore,personsinadgmmustbeawareoftheirobligationsinrespectofthecriminal lawaswellasadgmregulations.criminalizationofmoneylaundering,federallawno.1of2004regarding CombattingTerrorismOffencesandthePenalCodeoftheUAE.IfurtherconfirmthatIunderstandthatunderArticle3 ofthefederallawno.4of2002,apersonmaybecriminallyliablefortheoffenceofmoneylaunderingifsuchan activityisintentionallycommittedinperson'snameorforperson'saccount. Signature Date Name Designation Party Lodging this application ContactName Designation Company Address TelephoneNumber EmailAddress Where to submit the form? Completedformalongwithrelevantsupportingdocumentscanbesubmittedto: Address: TheRegistrationAuthority Level3 AbuDhabiGlobalMarketBuilding, ADGMSquare, AlMaryahIsland, P.O.Box111999 AbuDhabi,UAE
For Further Information, please contact us. TelephoneNumber: +97123338888 EmailAddress: ra@adgm.com