BENEFICIAL OWNER DECLARATION
To establish the identity of the ultimate beneficial owner as at: Account Number (For existing clients): Account Name: The undersigned hereby declares that the ultimate beneficial owner(s) of the assets is/are: Family name(s): First name(s): Date of birth: Residential address: ZIP Code / City: Country of residence: Nationality(ies): The Account Holder undertakes to notify the bank immediately in writing of any changes.
Forms - Beneficial Owner Declaration - September 2016
CAPITAL SECURITY BANK LIMITED 1