Know Your Customer - Carmex Expert

ul. 3 Maja 10/2 | 40-096 Katowice

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Email: sprzedaz@carmexexpert.com

Zadzwoń: +48 789 989 914

Nasza Siedziba

ul. 3 Maja 10/2, 40-096 Katowice
Polska

Biuro Sprzedaży

+48 789 989 914

Email

biuro@carmexexpert.com

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Kontakt

Dla Klientów
Dla Dostawców
- Formularz KYB
Logistyka
Baza Wiedzy
O Nas
- Dla Mediów
Kariera
Kontakt

Telefon

+48 789 989 914

Email

sprzedaz@carmexexpert.com

Know Your Customer (KYC) Questionnaire

Identification form for individual clients. Confidential — for due diligence, AML and compliance purposes only.

Step 1 – Personal details

1 / 7

1. Details

2. Identity

3. Tax

4. Profile

5. Compliance

6. Bank

7. Declaration

Section 1 – Personal and contact details

Full name *

Previous name / other used details (if applicable)

Date of birth *

Place of birth

Nationality *

Second nationality (if applicable)

PESEL / tax identification number

E-mail address *

Phone *

Residential address *

Correspondence address (if different)

Section 2 – Identity document and proof of address

Document type *

Document number *

Issuing country

Issue date

Expiry date *

Attachments

Identity document

Multiple files can be added. Accepted formats: PDF, DOC, DOCX, JPG, PNG. Max. 10 MB per file.

Proof of residential address (<=3 months)

Multiple files can be added. Accepted formats: PDF, DOC, DOCX, JPG, PNG. Max. 10 MB per file.

Section 3 – Tax residency / FATCA / CRS

Country of tax residency *

Tax identification number / TIN

Is the Client a U.S. person for FATCA purposes? *

Yes No

Other tax residencies / additional CRS information

Attachments

Tax residency confirmation / Tax ID (if available)

Multiple files can be added. Accepted formats: PDF, DOC, DOCX, JPG, PNG. Max. 10 MB per file.

Section 4 – Client profile, purpose of relationship and source of funds

Occupation / position

Employer / business activity

Purpose of relationship / transaction *

Expected products / services / scope of cooperation

Estimated transaction value / volume *

Source of funds *

Source of wealth (if different from source of funds)

Attachments

Document confirming source of funds (if required)

Multiple files can be added. Accepted formats: PDF, DOC, DOCX, JPG, PNG. Max. 10 MB per file.

Section 5 – Compliance, PEP, sanctions and beneficial owner

Does the Client act on their own behalf and for their own account? *

Yes No

If not, provide details of the person / entity on whose behalf the Client acts

Is the Client or an immediate family member / close associate a PEP? *

Yes No

If yes, provide PEP status details

Are the Client, beneficial owner or funds linked to sanctions, criminal proceedings or adverse media? *

Yes No

If yes, provide details

Attachments

Power of attorney / authorisation (if the Client does not act on their own behalf)

Multiple files can be added. Accepted formats: PDF, DOC, DOCX, JPG, PNG. Max. 10 MB per file.

Section 6 – Bank account and payments

Bank name

Bank country

SWIFT / BIC

Account currency

IBAN / account number

Is the account held in the Client's full name? *

Yes No

Attachments

Bank account confirmation (e.g. statement with hidden balances)

Multiple files can be added. Accepted formats: PDF, DOC, DOCX, JPG, PNG. Max. 10 MB per file.

Section 7 – Declaration and consents

I confirm that the information provided in this form is true, current and complete and may be verified.
I acknowledge that Carmex Expert Sp. z o.o. may conduct due diligence checks, including sanctions screening, PEP screening and adverse media checks.
Personal data is processed in accordance with GDPR (EU 2016/679) for client identification, AML, compliance, risk assessment and business relationship management purposes.

Full name of the person making the declaration *

Date *

Signature / e-signature *

Additional notes (optional)

I consent to KYC/AML/compliance verification, including PEP, sanctions and adverse media screening. *

I confirm that I have read the personal data processing information and consent to data processing for due diligence and compliance purposes. *

I confirm the accuracy of the data and undertake to notify Carmex Expert promptly of any material change. *

Please complete all required fields in this step.

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Zadzwoń do Nas

+48 789 989 914

Nasza Siedziba

ul. 3 Maja 10/2
40-096 Katowice

Email

biuro@carmexexpert.com

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