Company Information
Personal Information
Business Experience
Proposed Business Detail
Due Diligence i the Mineral Supply Chain
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
Title
Surname (As shown in Passport)
First Name
Other Names
Gender
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?
Proposed Business Detail
Physical Business
Type of Delivery
Source of Gold/Funds
Expected Frequency of Deliveries/pick ups
Attached Documents
Due Diligence i the Mineral Supply Chain
Does your company have a strong management system?
Do you have company policy?
If yes does your policy comply with VECD guidlines for responsible supply chains of minerals from conflict affected and high-risk areas?
Do you have contracts and agreements with other suppliers?
Do you have a designed and implementation strategy to respond to identified risks
If yes please provide details regarding your procedures Does your company carry out third-party audit of supply chain due diligence?
Do you have the company policy on your website?
If No please provide us with a copy of your company's policy
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.