Commercial Banking Questionnaire

Contact Name *

First

Middle

Last

Business Number *

Email *

What is the full legal name of the commercial business or entity? *

Does the entity trade under another name? If yes, what is trading name? *

Yes
No

What is trading name? *

What is the legal status of the account applicant: *

Please state the legal status of the account applicant. *

Corporate or Trust: Date and country of incorporation or formation? *

Country *

Unincorporated: Trading since when and where? *

Country *

What countries/jurisdiction(s) does the entity do business (receive/disburse funds)? *

Is the entity listed on any stock exchange? *

Yes
No

Stock Exchange *

Ticker *

Does the entity have any connection with Bermuda? *

Yes
No

PLEASE NOTE - Unfortunately we do not establish banking services for entities that do not have a connection to Bermuda at this time and would discourage you from proceeding with this questionnaire.

Why does the entity desire to bank in Bermuda? *

Does the entity have a website? *

Yes
No

Entity website / URL *

Please provide a clear summary of the entity’s purpose; products and services. *

Supplemental information can be attached for your ready reference.

Click or drag a file to this area to upload.

Only Word, PDF files accepted.

Does business or entity have another active (or previous) bank? *

Yes
No

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

What service(s) do/did you have with the bank listed above? *

Please list currencies held: *

What banking services do you require with Clarien Bank Limited? *

What is the anticipated average monthly balance in the account(s)?

Incoming: $ *

Outgoing: $ *

Cash Deposits: $ *

Cash Withdrawals: $ *

Standing Balance Average on Deposit: $ *

Top five sources of incoming and outgoing payments into the account in the first year?

Incoming *

Outgoing *

Are there any related entities? *

Yes
No

Please list related entity names: *

Please attach the following supporting documents/information:

Organization chart showing full ownership structure; noting % of ownership and ultimate beneficial owner(s)

Click or drag a file to this area to upload.

Only Word, PDF files accepted.

Start-up entities: Business plan or Business Marketing Materials

Click or drag a file to this area to upload.

Only Word, PDF files accepted.

Existing entities: Financial Statements

Click or drag a file to this area to upload.

Only Word, PDF files accepted.

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