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Fidei Limited
2nd Floor, 67 Strand Street
Douglas, Isle of Man
IM1 2EN
British Isles
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  • Ref: FC-
    CUSTOMER DUE DILIGENCE FORM
    (please complete and return to the address above)
    1. Your Details
    First Name(s) Last Name
    Permanent Residential Address
    City
    Country

    Post Code
    Home Telephone Mobile/Business Telephone
    Date of Birth Place of Birth
    Nationality Occupation
     
    2. Purpose of company/trust? 3. Source of wealth and/or funds:
       
    4. Estimated annual turnover (GBP or equivalent)
    5. Estimated number of bank transactions per month
     

    6. Signature and date

     

     

    SIGNED: (by Client) ________________________________________________

    DATE: _________________________

     
    7. Client Information - I attach:
     

    (i) A certified true copy of my current passport/or driving licence. Please read the notes here.
    (ii) AND a recent original utility or rates or council tax bill - "recent" being less than 3 months old showing my name and address.
    (iii) OR a recent original bank statement - "recent" being less than 3 months old showing my name and address.


    Copyright © 2003 Fidei Limited. All rights reserved.
    Fidei Limited is licenced by the Isle of Man
    Financial Supervision Commission as a Corporate Service Provider