IBC Due Diligence Form

Due Diligence Form

(A) Name of Company:

(B) Nature of Business for which company is intended (Please be specific):

(C) Where will the Company be operating?

(D) Director (s) - if not providing nominee director.
(i) Director(s) are as follows: (Please provide all necessary information on each Director)

Copy the following text below into the text area and fill out
for each director.
-----------------------------------------------------
Director Name:
Address:
Tel.:
Fax:
Email Address:
Passport sent via email attachment : Yes or No
-----------------------------------------------------  


* In the case of a company being the Director, we will require a Certificate of Good Standing for the company, and a Certificate of Incumbency stating the names and addresses of its officers/directors and those authorized to sign on behalf of the company.

(E) Beneficial Owner(s)

(i) Bearer Shares

Copy the following text below into the text area and fill out
for each Beneficial Owner.
-----------------------------------------------------
Name:
Number of shares:
Address:
Passport sent via email attachment : Yes or No
Tel.:
Certificate No.:
Fax:
Email Address:
-----------------------------------------------------  

OR

(ii)Registered Shares

Copy the following text below into the text area and fill out
for each Registered Shares.
-----------------------------------------------------
Name:
Number of shares:
Address:
Passport sent via email attachment : Yes or No
Tel.:
Certificate No.:
Fax:
Email Address:
-----------------------------------------------------  

(F) The Company is required to maintain accounting records for a minimum of five (5) years. Indicate the name and address of the place where the accounting records will be kept, whether within or outside of Belize. In the event of a change, you are required to notify us within 14 days of such change, in default your company may be struck from the register.

*Please include the following: Name/Company, Address, Tel.

(G) Mailing address (all documents will be sent to this address unless advised otherwise):

Please include the following:Name & Company Address, Tel., Fax, Email Address.

DUE DILIGENCE REQUIREMENTS

Provide a copy of EACH director, shareholder, beneficial owner, member, manager, settlor, trustee, protector, founder and all persons requesting the registration of the Corporation:
I. Notarized copy Passport with picture and signature data pages
II. In the alternative a notarized copy of any government/official issued form of identification with picture and signature
III. In the alternative if a Company will hold any of the above positions, then copy of the Corporate documents, a Certificate of Good Standing and Certificate of Incumbency detailing the directors/officers and shareholders/members of the Company
IV. Recent Utility bill within 3 months
V. Two Character references from an attorney or accountant or business associate which you have done business with for more than 2 years
VI. Bank reference- only if requesting a bank account

*I/We declare and confirm the above information is true and correct and that the company will not be used for money laundering, terrorist activities, or any other illegal activity or in a manner likely to damage the good name of Alpha Services Limited or the jurisdiction of incorporation. I/We acknowledge the requirements of your AML/CFT Compliance Policy and agree to comply therewith. I/We will take independent legal advice before proceeding and I am/We are aware, and intend, to honour my/our legal responsibilities in my/our jurisdiction.

I/We confirm and agree that should any changes occur in the information contained herein I/We will inform Alpha Services Limited.

Signature of Beneficial Owner

Dated this day of , 20


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Alpha Services Limited

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#84 Albert Street • P.O

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. Box 831

Belize City, Belize

Contacts:

Rodwell R.A. Williams – Executive Director/Attorney

Nigel Ebanks – Director/Attorney

Tania Moody – Director/Attorney

Cadine Rhamdas – Administrative Director

Tel # (501) 227-1847

Fax# (501) 227-5278

E-Mail: info@alphaservicesltd.com

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