Account Opening

Company Information

Company Name (as shown on Trade License)

Country of Establishment

License No.

Year of Incoperation

Beneficial Owner/Authorizrd Signature 1

Address: Main office

City

Telephone

Email (official)

Section II: Personal Information

Checkbox List

Beneficial Owner

Authorized Signature

Both

Title
Mr. Mrs. Miss Ms

Surname (As shown in Passport)

First Name

Other Names

Gender
Male Female

Date of Birth

Country of Citizenship

Passport Number

Date of Issue

Date of Expiry

Current office Address

City

Phone

Mobile

Section III

Number of years of operating in business

Most of your work has been in?

Refinning

Bullion

Jewellery

Trading

Dore

Proposed Business Detail

Physical Business

Pure Gold Bar 99.95/99.99

Purchase

Sale

Export

Assay

Type of Delivery

Cargo

Hand

Both

Source of Gold/Funds

Are you a gold mining representative

Are you a gold jewellery manufacturer or wholesale

Bullion bar consolidator

Expected Frequency of Deliveries/pick ups

One

Two

Three

Attached Documents

Passport copies of company\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\'s representative

Trade Licence

Mining Licence Other

Due Diligence i the Mineral Supply Chain

Does your company have a strong management system?
Yes No

Do you have company policy?
Yes No

If yes does your policy comply with VECD guidlines for responsible supply chains of minerals from conflict affected and high-risk areas?
Yes No

Do you have contracts and agreements with other suppliers?
Yes No

Do you have a designed and implementation strategy to respond to identified risks
Yes No

If yes please provide details regarding your procedures Does your company carry out third-party audit of supply chain due diligence?
Yes No

Do you have the company policy on your website?
Yes No

If No please provide us with a copy of your company's policy
Yes No

Authorized Signature

Declaration Sources of Gold, and Funds

We/I the undersigned do hereby warrant under the penalty of perjury that the funds/Gold to be delivered to Stelna Solutions Limited-Ghana have been procured, sourced, secured through legal means and or investment channels. We/I further attest that such Gold/funds have been purchased or sourced from legitimate investment sources not involved or related to conflict funding, illicit gains from narcotic and or drug-related businesses, including human right violations neither from profits accrued in contravention of any laid down international laws including money laundering. We/I sate here to the best of my/our knowledge that the undersigned hereby guarantee that the source of funds have been properly sourced from legal and legitimate means to be used in the trading with Stelna Solutions Limited.

Authorized person (s) Name:

Authorized person (s) Signature

Place and Date

For Stelna Solutions Limited Use Only (Compliance Department)

Name

Have all requirements been fulfilled?
Yes No

If no kindly specify

Signature

Place, Date

Compliance Department

Name

Have all requirements been fulfilled?
Yes No

If no kindly specify

Signature

Place, Date

Account Opened By

Name

Signature

Place, Date

Client's Account Name

Client's Account No.

Some required Fields are empty
Please check the highlighted fields.

Share this:

Like this: