Channel Partner KYC

Applicant Name *

Applicant Position *

Phone Number *

Email Address *

Nationality *

Passport Number *

Channel Partner Company Name *

Business License No. *

Business License Activity *

Place of Incorporation *

Date of Incorporation *

Expiry Date *

Type *

Company Address *

Company Website *

Managing Director Name * +

Please describe the service you are/will be providing to your clients *

What are the nationalities of your prospective clients? *

Which business sectors are your clients mostly engaged in? *

What is the expected volume of transactions/services you will be processing with Shams? *

What is the average amount and frequency of your client's payments? *

Through which mode of payment are funds transferred to you by your clients? *

Mention the primary payment method your company will use generally & when transacting with suppliers? Example, cash, Crypto currency, bank transfers etc. *

List all the countries where your targeted customers will be based (UAE Expatriates and international) *

Does any of the key connected persons reside outside of the UAE? *

Do you have any business dealings or presence in high-risk countries? *

Is there any business relationship and interest in sanctioned countries or entities that derive any of their profit from such countries or interest with a sanctioned designated entity? *

Do you have any relationship or interest in high-risk industries / businesses? *

Do you hold any other business license – or any other operations in the UAE or other country? *

If yes, please list the company name and which country it is based in. *

A Designated Non-Financial Business and Profession Declaration (DNFBP)

Does your company have Anti-Money Laundering Policies in place? *

Is your company registered in GoAML system or the equivalent reporting tool in the country your license is registered from? *

Do these policies cover relationships with Politically Exposed Persons (PEPs), their close associates and the control measures (EDD)? *

Do these policies document the processes in place to prevent, detect and report suspicious activity & Transactions? Internal/External? *

Does you entity have a designated compliance officers / Money Laundering Reporting Officer? *

Has you entity registered in the official government services to receive automated notification with update about UAE, UN consolidated and international sanction list? Ex - UAE The Executive Office for Control and Non-Proliferation (EOCN)? *

Clarify which country Law & Regulation *

Does your Entity have documents Policy & procedures related to Customer acceptance for On-boarding (KYC /CDD)? *

Does your Entity screen customers and transactions against sanctions lists, Politically Exposed Person, Adverse Media and financial crimes? *

Does your Entity undertake a risk-based assessment, classify its customer according to (Low, Medium, Medium High & High), and following the relevant risk factors? (Country risk, Customer risk, Product, service and transactions risk, and other risk factors.) *

Does your Entity apply Enhanced Due Diligence Procedures on clients classified as High Risk? *

Does your Entity provide AML training to Board members & relevant employees? *

Does your Entity keep record of all the above? *

If yes, for how many years? *

Does your company adhere to reporting obligation related to transaction threshold of AED 55K? *

Ultimate Beneficial Owner 1

Full Name in English *

Full Name in Arabic

Nationality *

Date of Birth *

Place of Birth *

Gender *

Mobile Number *

Email Address *

Passport Number *

Passport Issuance Date *

Passport Expiry Date *

Passport Issunace Country *

Are you a Resident in the UAE? *

ID Type *

ID Issuance Date *

ID Expiry Date *

ID Issunace Country *

UID Number

Work Entity Name *

Work Entity Address *

Work Phone Number *

Residential Address *

Share Ownership Percentage *

Number of Shares *

Value of Shares *

Date of Obtaining Shares *

Voting Rights *

Representative Name *

Representative Address *

Representative Capacity *

Is UBO Trustee? *

Do you have other entities? *

Does you company have a Nominee arrangement? *

Does the entity have any UBOs that are designated as Exempt Entities (listed under the Stock Market/Government Entity)? *

+ Add Beneficial Owner

Signature *

By submitting the information provided herein, I hereby covenant and agree that all information I have supplied to Sharjah Media City Free Zone (“Shams”) is true, accurate and valid. I further confirm that Shams shall assume no liability, whether in whole or in part, for any information that is determined to be untrue, inaccurate or invalid. In such an event, I confirm to assume full responsibility of any outcome, through the provision of such information.

Also by clicking submit, for the purpose of fulfilling the requirements of the Ultimate Beneficial Owner (“UBO”), pursuant to UAE Federal Decree by Law No. (20) of 2018, UAE Cabinet Resolution No. (10) of 2019, and UAE Cabinet Resolution No. (58) of 2020, we hereby declare and undertake the following:

1. The information contained therein, is true, accurate, valid, and up to date.
2. We assume full and total responsibility regarding the implementation of all relevant laws, regulations, policies, and procedures whilst maintaining compliance with the UBO information.
3. All UBO information submitted herein is not provided on behalf of any third parties (i.e., lawyers, agents, corporate service providers, or otherwise).

We further agree and acknowledge our continuing obligation to notify Sharjah Media City Free Zone of any amendments or modifications to our UBO information. A demonstrated or actual non-compliance shall result in us assuming liability for such violations.

Thank You

A Designated Non-Financial Business and Profession Declaration (DNFBP)

Ultimate Beneficial Owner 1