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- Step 1 of 2

1.) COMPANY DETAILS

1.1 Company Name *

Company Address Layout 1

1.2 Registered Address *

Address Line 1

City

State / Province / Region

Postal Code

Country

1.3 Is Business Address same as Registered Address? *

Yes
No

Business Address *

Address Line 1

City

State / Province / Region

Postal Code

Country

Layout

1.4 Phone Number *

1.5 Email Address *

1.6 Date of Incorporation *

1.7 Country of Incorporation *

Layout

1.8 Trade License Number *

1.9 Trade License Issue Date *

1.10 TRN / GST / Excise / Service Tax Registration Number) *

Layout

1.11 If Listed, Indicate Name of Stock Exchange(s) and Ticker *

Write N/A if not listed anywhere

1.12 Website / URL *

Write N/A if no website

Layout

1.13 External Financial Auditors *

Write N/A if no answer

1.14 How many direct and indirect subsidiaries does the company have? *

**Please provide a Group Chart via Email

2.) BUSINESS ACTIVITY

2.1 Description of core business activity *

Layout

2.2 Does the company hold a license to conduct its business(es)? *

Yes
No

2.3 Please provide list of country(es) from where you purchase / sales your precious metals products. *

2.4 Main Products *

3. BENEFICIAL OWNERS

3.1 List of All Shareholders : (Please mention all the shareholders)

*** If more than 5 entries, please send the shareholding chart with KYC on email.

Layout Shareholder 1

Name *

Residential / Office Address

Date of Incorporation / Date of Birth *

Holding Percentage (%) *

Layout Shareholder 2

Name

Residential / Office Address

Date of Incorporation / Date of Birth

Holding Percentage (%)

Layout Shareholder 3

Name

Residential / Office Address

Date of Incorporation / Date of Birth

Holding Percentage (%)

Layout Shareholder 4

Name

Residential / Office Address

Date of Incorporation / Date of Birth

Holding Percentage (%)

Layout Shareholder 5

Name

Residential / Office Address

Date of Incorporation / Date of Birth

Holding Percentage (%)

3.2 List of All Ultimate Beneficial Owners : (Please mention all the UBO)

*** If more than 5 entries, please send the shareholding chart with KYC on email.

Layout Ultimate Beneficial Owners 1

Name

Residential Address

Date of Birth

Holding (%) in Shareholding Company

Layout Ultimate Beneficial Owners 2

Name

Residential Address

Date of Birth

Holding (%) in Shareholding Company

Layout Ultimate Beneficial Owners 3

Name

Residential Address

Date of Birth

Holding (%) in Shareholding Company

Layout Ultimate Beneficial Owners 4

Name

Residential Address

Date of Birth

Holding (%) in Shareholding Company

Layout Ultimate Beneficial Owners 5

Name

Residential Address

Date of Birth

Holding (%) in Shareholding Company

3.3 Does your Company or any of your Shareholders / UBOs / Directors falls under the category of PEP? *

Yes
No

4. MANAGEMENT STRUCTURE

4.1 Board of Directors :

Board of Directors Layout 1

Name *

Position *

Date of Birth *

Nationality(ies) *

Board of Directors Layout 2

Name

Position

Date of Birth

Nationality(ies)

Board of Directors Layout 3

Name

Position

Date of Birth

Nationality(ies)

4.2 Details of Authorized Signatory :

Authorized Signatory Layout 1

Name *

Position *

Contact Number *

Email Address *

Authorized Signatory Layout 2

Name

Position

Contact Number

Email Address

Authorized Signatory Layout 3

Name

Position

Contact Number

Email Address

4.3 Department Information :

Department Information Layout 1

Name *

Department Name *

Contact Number *

Email Address *

Department Information Layout 2

Name

Department Name

Contact Number

Email Address

Department Information Layout 3

Name

Department Name

Contact Number

Email Address

5. HUMAN RESOURCES

5.1 No. of Employees within the Company *

5.2 No. of Employees within the Group *

6. ORIGIN OF PHYSICAL PRECIOUS METALS

Section 6 Layout

6.1 Type of Entities of your precious metals suppliers *

Legal Entities (I.E., Companies, Banks or Financial Institutions)
Individuals

6.2 Country(ies) of origin of raw precious metals / refined precious metals delivered to us? OR Country(ies) of destination of raw precious metals / refined precious metals delivered by us? *

6.3 Is the Company legally required to have a licence to import / Export precious metals? (If Yes, Copy required) *

Yes
No

7. FACILITIES

Layout

7.1 Does the company have any melting or refining facilities? *

Yes
No

7.2 Does the Company have any manufacturing facilities? *

Yes
No

7.3 Does the Company produce its own jewellery? *

Yes
No

7.4 What are the types & forms of precious metals sourced by the Company? *

Recycled Precious Metals
LBMA GD Bullion
Rudimentary Bars
Jewellery
Broken Jewellery
Coins
Non LBMA Good Delivery Bullion (Au =>995 / AG =>9999)
Primary Material - Mined Precious Metals
None

7.5 What type of precious metals is the Company planning to send for refining? *

Gold
Silver
None

7.6 What is the form of precious metals planned to be sent for refining? *

Unprocessed Recycled Precious Metals
LBMA GD Bullion
Melted Recycled Precious Metals
Jewellery
Broken Jewellery
Coins
Non LBMA Good Delivery Bullion (Au =>995 / AG =>9999)
Primary Material – Mined Precious Metals
None

8. RESPONSIBLE PRECIOUS METAL SUPPLY CHAIN POLICY

8.1 Did your institution establish a responsible supply chain of gold from conflict-affected and high risk areas policy which is consistent with the standards set forth in the model supply chain policy in Annex II of the OECD Due Diligence Guidance for Responsible Supply Chains of Minerals from Conflict-Affected and High-Risk Areas? *

Yes
No

*If Yes, Copy of the policy Required

8.2 Does your institution comply or plan to comply with the OECD Due Diligence Guidance for Responsible Supply Chains of Minerals from Conflict-Affected and High-Risk Areas? *

Currently Complies
Plans to Comply
No

8.3 Is the company complying with any of the following industry initiatives? *

LBMA Responsible Gold Guidance
LBMA Responsible Silver Guidance
RJC Chain of Custody Standard
WGC Conflict Free Gold Standard
Conflict Free Smelter (CFS) Program
Others, please specify

Additional Comments (if any) :

8.4 What are the procedures in place to ensure that the precious metals purchased have not financed armed conflict? *

9. ANTI MONEY LAUNDERING (AML) & COMBATING FINANCIAL TERRORISM (CFT)

9.1 Is your institution subject to Anti-Money Laundering / Combating financial terrorism Law / Regulations? *

Yes
No

Layout

Name of the AML-CFT Law / Regulation *

Name of the Regulator *

10. BRIBERY POLICY

10.1 Does your Company have any bribery policy in place? *

Yes
No

10.2 Has the company or the Senior Management ever been charged anywhere in the world for violation of applicable anti-bribery laws or regulations? *

Yes
No

Please provide details (Anti-bribery Laws or Regulations) *

11. DATA PRIVACY PROTECTION

11.1 Does your company have Data Protection Policy? *

Yes
No

11.2 Does your company have a certified data storage system or an information system? *

Yes
No

12. PRECIOUS METALS SUPPLIERS DUE DILIGENCE QUESTIONAIRE

12.1 Does the Company have a person responsible (Compliance Officer) for all AML-CFT matters (Due Diligence, AML policies, internal training)? *

Yes
No

Section 13 Layout 1

Name of Compliance Officer *

Phone Number of Compliance Officer *

Email Address of Compliance Officer *

Section 13 Layout 2

12.2 Is the Company subject to an AML-CFT audit by an independent party or a governmental party? *

Yes
No

Date of your last AML-CFT compliance audit *

Section 13 Layout 3

12.3 Does the Company have an AML-CFT training for the employees? *

Yes
No

12.4 Does the Company delegate to third parties some of the compliance functions to be carried out? *

Yes
No

Please provide the details of those compliance functions: *

12.5 How long does the Company keep its due diligence files (records)? *

12.6 What type of information does the Company request from its precious metals suppliers?

Section 13 Layout 4

Companies / Banks / Any other Institutions *

Name
Address
Date of Incorporation
Country of Incorporation
Business Registry Extract or any equivalent document
Beneficial Owners
Origin of Precious Metals
Description of main activity and financial information

Individuals Suppliers / Shareholders / UBO's *

First Name and Last Name
Address
Date of Birth
Nationality
Copy of ID Card or Passport
Beneficial Owners
Origin of Precious Metals
Supplier Profile (Activity, Wealth etc.)

Layout

12.7 Does the Company have a risk-based assessment of its precious metals suppliers (e.g. low, medium or high risks)? *

Yes
No

12.8 Does the Company screen precious metals suppliers and transactions against sanctioned lists of persons, entities or countries issued by government / competent authorities? *

Yes
No

Layout

12.9 Does the Company perform enhanced due diligence for high risk precious metals suppliers? *

Yes
No

12.10 Does the Company assess its corporate precious metals suppliers’ AML-CFT and purchase procedures and practices? *

Yes
No

Layout

12.11 Does the Company perform a risk-based assessment to understand the normal and expected transactions of its suppliers (in order to identify the unusual transactions)? *

Yes
No

12.12 Does the Company have a monitoring program for unusual and potentially suspicious activity that covers funds transfers and monetary instruments (e.g. traveller’s cheques) or third party payments? *

Yes
No

Layout

12.13 Does the Company have to register all purchases and sales? *

Yes
No

12.14 By what mode does the company accept / make payment to its client? *

Bank Transfers
Cheque / Demand Drafts
Cash

Layout

12.15 Does the Company have a procedure in place to prevent, detect and report suspicious transactions from its suppliers to the relevant Authority? *

Yes
No

12.16 How many suspicious reports has the Company filed and handed over to the relevant Authority the last two years? *

12.17 Where cash transaction reporting is mandatory, does the Company have procedures to identify transactions structured to avoid such obligations? *

Yes
No

13. TRANSACTION MONITORING ON PURCHASE FROM INDIVIDUALS

13.1 Does the company deals with Individuals? *

Yes
No

13.2 Does the Company perform statistics on precious metals sold by person in order to identify unusual transactions? *

Yes
No

13.2.1 Please describe how? *

13.3 Does the Company have a specific procedure if a deal with an individual is significantly higher than the average deal? *

Yes
No

13.3.1 Please describe how? *

13.4 Is the Company able to verify that a person does not come several times to the counter / to the different counters to sell each time a small amount which leads to a considerable amount in total (smurfing)? *

Yes
No

13.4.1 Please describe how? *

14. INDUSTRIAL SOURCING (To Be Filled Only By Industrial Companies)

14.1 Does your company falls under the category of Industrial Company? *

Yes
No

14.2 What is the form of precious metals planned to be sent for refining? *

LBMA GD Bullion
Grains
Semi-finished products
Non LBMA Good Delivery Bullion (Au =>995 / AG =>9999)
Industrial Products (Please specify)

14.3 From which / to country(ies) do you purchase / sales your precious metals products?

14.4 From whom do you source your precious metal products? *

Refineries
Industrial
Banks
Others
Precious metals dealers

14.5 Have you identified the refinery, which produced the precious metals used in your supply chain? *

14.6 Have you assessed the refiner’s due diligence policies and practices? *

15. BANK DETAILS

Account Number 1 Layout

Bank Name *

Account Currency *

Account Number *

Account Number IBAN *

Account Number 1 Layout (copy)

Bank Name

Account Currency

Account Number

Account Number IBAN

16. SIGNATURES

Section 17 Layout 1

Name of Signatory *

Title / Position *

Section 17 Layout 2

Company Name *

Signature Date *

Place *

I hereby declare that the information given above is true and accurate as of the date of writing. *

I hereby declare that the information given above is true and accurate as of the date of writing.

I undertake to inform Zenith Metals DMCC of any material changes in the above details immediately. *

I undertake to inform Zenith Metals DMCC of any material changes in the above details immediately.

Save and Resume Later

SANCTIONED COUNTRIES DETAILS DOCUMENT

***Required Instructions

1.) View & Download your file from here : Sanctioned Countries - Undertaking Download

2.) Open the Editable PDF File

3.) Enter the required details in the editable mentioned places.

4.) Save this updated file, print on your letterhead with sign & stamp.

5.) Upload the updated file below.

Sanctioned Countries Details File *

Click or drag a file to this area to upload.

Allowed File Types: .PDF Only

AUTHORIZATION LETTER DETAILS DOCUMENT

***Required Instructions

1.) View & Download your file from here : Authorization Letter Download

2.) Open the Editable PDF File

3.) Enter the required details in the editable mentioned places.

4.) Save this updated file, print on your letterhead with sign & stamp.

5.) Upload the updated file below.

Authorization Letter File Upload *

Click or drag a file to this area to upload.

Allowed Files: .PDF only

POLITICALLY EXPOSED PERSON (PEP) DECLARATION DETAILS DOCUMENT

***Required Instructions

1.) View & Download your file from here : PEP Declaration Download

2.) Open the Editable PDF File

3.) Enter the required details in the editable mentioned places.

4.) Save this updated file, print on your letterhead with sign & stamp.

5.) Upload the updated file below.

PEP Declaration File Upload *

Click or drag a file to this area to upload.

Allowed Files: .PDF only

SOURCE OF FUNDS DETAILS

***Required Instructions

1.) View & Download your file from here : Souce of Funds Download

2.) Open the Editable PDF File

3.) Enter the required details in the editable mentioned places.

4.) Save this updated file, print on your letterhead with sign & stamp.

5.) Upload the updated file below.

Source of Funds File Upload *

Click or drag a file to this area to upload.

Allowed Files: .PDF only

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Get in Touch

Unit No B3-06-09 , Gold Tower , Jumeirah Lakes Tower , Dubai UAE
operations@zenithmetal.com
+971 4 564 5767

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ZENITH METALS DMCC strive towards becoming a leading player in the gold bullion trading sector with the help of our professional management team having a combined work experience of over 150 years in this industry.

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