COMPLIANCE FORM

Company Name *

Add shareholder *

Number of Shareholders

Individual

Share Holder 1

Full Name

DOB

Contact number

Nationality

Place of birth

Director/secretary

Directorsecretary

Residential address

Street Name

House/Apartment No.

Building Name

P.O. Box

City/State

Country

For Dual CitizenShip

Street Name

House/Apartment No.

Building Name

P.O. Box

City/State

Country

Proof of address (Utility bill/Bank statement)

No file chosen

Passport details (Upload valid passport required)

No file chosen

Email ID

Updated CV

No file chosen

The number of shares

Bank Name/Location

Bank reference letter/ Bank statements (latest – 6 months)

No file chosen

Share Holder 2

Full Name

DOB

Contact number

Nationality

Place of birth

Director/secretary

DirectorSecretary

Residential address

Street Name

House/Apartment No.

Building Name

P.O. Box

City/State

Country

For Dual CitizenShip

Street Name

House/Apartment No.

Building Name

P.O. Box

City/State

Country

Proof of address (Utility bill/Bank statement)

No file chosen

Passport details (Upload valid passport required)

No file chosen

Email ID

Updated CV

No file chosen

The number of shares

Bank Name/Location

Bank reference letter/ Bank statements (latest – 6 months)

No file chosen

Share Holder 3

Full Name

DOB

Contact number

Nationality

Place of birth

Director/secretary

DirectorSecretary

Residential address

Street Name

House/Apartment No.

Building Name

P.O. Box

City/State

Country

For Dual CitizenShip

Street Name

House/Apartment No.

Building Name

P.O. Box

City/State

Country

Proof of address (Utility bill/Bank statement)

No file chosen

Passport details (Upload valid passport required)

No file chosen

Email ID

Updated CV

No file chosen

The number of shares

Bank Name/Location

Bank reference letter/ Bank statements (latest – 6 months)

No file chosen

Share Holder 4

Full Name

DOB

Contact number

Nationality

Place of birth

Director/secretary

DirectorSecretary

Residential address

Street Name

House/Apartment No.

Building Name

P.O. Box

City/State

Country

For Dual CitizenShip

Street Name

House/Apartment No.

Building Name

P.O. Box

City/State

Country

Proof of address (Utility bill/Bank statement)

No file chosen

Passport details (Upload valid passport required)

No file chosen

Email ID

Updated CV

No file chosen

The number of shares

Bank Name/Location

Bank reference letter/ Bank statements (latest – 6 months)

No file chosen

Share Holder 5

Full Name

DOB

Contact number

Nationality

Place of birth

Director/secretary

DirectorSecretary

Residential address

Street Name

House/Apartment No.

Building Name

P.O. Box

City/State

Country

For Dual CitizenShip

Street Name

House/Apartment No.

Building Name

P.O. Box

City/State

Country

Proof of address (Utility bill/Bank statement)

No file chosen

Passport details (Upload valid passport required)

No file chosen

Email ID

Updated CV

No file chosen

The number of shares

Bank Name/Location

Bank reference letter/ Bank statements (latest – 6 months)

No file chosen

Share Holder 6

Full Name

DOB

Contact number

Nationality

Place of birth

Director/secretary

DirectorSecretary

Residential address

Street Name

House/Apartment No.

Building Name

P.O. Box

City/State

Country

For Dual CitizenShip

Street Name

House/Apartment No.

Building Name

P.O. Box

City/State

Country

Proof of address (Utility bill/Bank statement)

No file chosen

Passport details (Upload valid passport required)

No file chosen

Email ID

Updated CV

No file chosen

The number of shares

Bank Name/Location

Bank reference letter/ Bank statements (latest – 6 months)

No file chosen

Share Holder 7

Full Name

DOB

Contact number

Nationality

Place of birth

Director/secretary

DirectorSecretary

Residential address

Street Name

House/Apartment No.

Building Name

P.O. Box

City/State

Country

For Dual CitizenShip

Street Name

House/Apartment No.

Building Name

P.O. Box

City/State

Country

Proof of address (Utility bill/Bank statement)

No file chosen

Passport details (Upload valid passport required)

No file chosen

Email ID

Updated CV

No file chosen

The number of shares

Bank Name/Location

Bank reference letter/ Bank statements (latest – 6 months)

No file chosen

Share Holder 8

Full Name

DOB

Contact number

Nationality

Place of birth

Director/secretary

DirectorSecretary

Residential address

Street Name

House/Apartment No.

Building Name

P.O. Box

City/State

Country

For Dual CitizenShip

Street Name

House/Apartment No.

Building Name

P.O. Box

City/State

Country

Proof of address (Utility bill/Bank statement)

No file chosen

Passport details (Upload valid passport required)

No file chosen

Email ID

Updated CV

No file chosen

The number of shares

Bank Name/Location

Bank reference letter/ Bank statements (latest – 6 months)

No file chosen

Share Holder 9

Full Name

DOB

Contact number

Nationality

Place of birth

Director/secretary

DirectorSecretary

Residential address

Street Name

House/Apartment No.

Building Name

P.O. Box

City/State

Country

For Dual CitizenShip

Street Name

House/Apartment No.

Building Name

P.O. Box

City/State

Country

Proof of address (Utility bill/Bank statement)

No file chosen

Passport details (Upload valid passport required)

No file chosen

Email ID

Updated CV

No file chosen

The number of shares

Bank Name/Location

Bank reference letter/ Bank statements (latest – 6 months)

No file chosen

Share Holder 10

Full Name

DOB

Contact number

Nationality

Place of birth

Director/secretary

DirectorSecretary

Residential address

Street Name

House/Apartment No.

Building Name

P.O. Box

City/State

Country

For Dual CitizenShip

Street Name

House/Apartment No.

Building Name

P.O. Box

City/State

Country

Proof of address (Utility bill/Bank statement)

No file chosen

Passport details (Upload valid passport required)

No file chosen

Email ID

Updated CV

No file chosen

The number of shares

Bank Name/Location

Bank reference letter/ Bank statements (latest – 6 months)

No file chosen

Corporate

Share Holder 1

Certificate of Incorporation

No file chosen

Memorandum & Articles of Association

No file chosen

Incumbency

No file chosen

Good Standing

No file chosen

Authorized signatory passport

No file chosen

Head office address

Proof of address (Utility bill/Bank statement)

No file chosen

Share Holder 2

Certificate of Incorporation

No file chosen

Memorandum & Articles of Association

No file chosen

Incumbency

No file chosen

Good Standing

No file chosen

Authorized signatory passport

No file chosen

Head office address

Proof of address (Utility bill/Bank statement)

No file chosen

Share Holder 3

Certificate of Incorporation

No file chosen

Memorandum & Articles of Association

No file chosen

Incumbency

No file chosen

Good Standing

No file chosen

Authorized signatory passport

No file chosen

Head office address

Proof of address (Utility bill/Bank statement)

No file chosen

Share Holder 4

Certificate of Incorporation

No file chosen

Memorandum & Articles of Association

No file chosen

Incumbency

No file chosen

Good Standing

No file chosen

Authorized signatory passport

No file chosen

Head office address

Proof of address (Utility bill/Bank statement)

No file chosen

Company details( Please mention the details of the company incorporated in Dubai)

Share Capital of the company *

Place of business (City and Country) *

Top 3 clients *

Top 3 countries involved in the business *

Local Bank Name ( Customer needs to mention UAE bank name associated with) *

UBO (Ultimate Beneficiary Ownership)

Certified Passport copy *

No file chosen

Nature of ownership *

Date of the ownership *

Latest Financial statements of the respective companies your company has invested in *

No file chosen

Bank reference letter/ Bank statements (latest – 6 months) *

No file chosen

Director/ Secretary Details section ( if not shareholder)

Full Name

DOB

Contact number

Nationality

Place of birth

Residential address

Street Name *

House/Apartment No. *

Building Name *

P.O. Box *

City/State *

Country *

Dual Citizenship

Street Name

House/Apartment No.

Building Name

P.O. Box

City/State

Country

The information provided on this form is presumed to be accurate and correct for compliance purposes. Motei & Associates assumes no responsibility or liability of whatsoever nature or type or to any party for (a) any error or omission in this form or (b) any loss or damage of whatsoever arising out of the accuracy or authenticity of the information on this form.