Client QuestionnaireIndividual 01 Personal DetailsEnter your details exactly as they appear in your identity document. Identity verification itself is completed separately, through a secure link we send you — no document copies are needed here. 02 Tax Residence & StatusAre you tax resident in more than one country?YesNo Any relation to PEP / RCA?YesNo Related to the U.S.?YesNo Include positions you left within the last twelve months, and positions held by close family members or business associates. 03 Occupation & Source of WealthFor example: sold a company in 2019, income from a dental practice since 2004, inheritance received in 2021. Supporting documents may be requested. 04 Account UsageDescribe why you are opening this account and how you plan to use it (e.g. receiving consultancy fees from clients abroad and paying suppliers in the EU) CADUSDEURGBPCHFOther Will anyone other than you pay money into, or receive money from, this account?YesNo Will anyone other than you operate this account, or act for you under a power of attorney?YesNo 05 Definitions1 PEP — Politically Exposed PersonPolitically Exposed Persons (PEPs) are individuals who are or have been entrusted with a prominent public function, domestically or in a foreign state, or in an international organisation, as defined in the Company's AML/ATF Policy and FINTRAC Guidance (April 2024). Immediate family members of a PEP include the spouse, a person with whom a registered partnership or cohabitation exists, parents, brothers, sisters, children, children's spouses, and children's cohabitants. 2 RCA — Related / Close AssociateClose Associates (RCAs) are natural persons known to have close business or personal relationships with a PEP, including persons who have joint beneficial ownership of a legal entity or legal arrangement with a PEP, or who have sole beneficial ownership of a legal entity or arrangement known to have been established for the benefit of a PEP. 3 U.S. PersonA U.S. person is an individual or entity associated with the United States who meets at least one of the following conditions: identified as a U.S. citizen or U.S. resident; unambiguous indication of a U.S. place of birth; current U.S. mailing or residential address (including a U.S. post office box); current U.S. telephone number; standing instructions to transfer funds to an account maintained in the United States; or a currently effective power of attorney or signatory authority granted to a person with a U.S. address. 4 TIN — Tax Identification NumberTax identification number or other official ID number used for tax purposes in your country (e.g. personal code, national insurance number, social security number, etc.). 5 Source of WealthSource of wealth describes how your total wealth was built up over your lifetime — for example a business you sold, a career in a profession, property you inherited or investments held over many years. 6 Source of FundsSource of funds describes where the specific money going into this account comes from — for example your monthly salary, the proceeds of a particular sale, or a transfer from your own account at another bank. It is a narrower question than source of wealth. 06 Applicant DeclarationI hereby confirm that the information provided in this questionnaire is true, accurate, and complete. I confirm that I am opening and will use this account for myself, and not on behalf of any other person. I undertake to inform Montelux without delay if any of this information changes. I acknowledge and accept the Montelux Terms and Conditions available at montelux.com. APPLICANT Sign here — draw with your mouse, or with a finger on a phone Montelux Canada Inc · 18 King Street East, Suite 1400, Toronto, ON M5C 1C4 · MSB C100000903montelux.com
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