Sun Island Transfers Ltd
OWNER/ OFFICER/ SIGNATORY/ SHAREHOLDER/ DIRECTOR INFORMATIONSelect applicable title for all owners, signatories, directors, officers and shareholders and complete theinformation below for each.
POSITION IN ORGANIZATION
POSITION IN ORGANIZATION
MAIDEN NAME (If Applicable)
LAST NAME
FIRST NAME
MIDDLE NAME(S)
PERMANENT HOME ADDRESS
TEL. (Mobile)
TEL. (Work)
TEL. (Home )
BUSINESS E-MAIL ADDRESS
PERSONAL E-MAIL ADDRESS
DATE OF BIRTH
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Month
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Day
Year
Date
COUNTRY OF BIRTH
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Month
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Day
Year
Date
COUNTRY OF RESIDENCE
NATIONALITY (List all of your nationalities/citizenships)
NIB Number
OTHER PROFESSION/JOB
OTHER SOURCE OF INCOME
Please indicate your PEP Status by checking a box below.
PEP - Politically Exposed Person A PEP is defined as a senior official in the executive, legislative,administrative, military or judicial branches of government and includes immediate family members, closeassociates etc).
Relative/Close Associate of a PEP
Customer Relationship to PEP
Self
Family member
Close associate
Partner
NAME of PEP
COUNTRY of PEP
Upload Passport ( Please include signature page of his passport )
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DECLARATION
I/We certify that the above information is true, correct and complete. I/We hereby give authority to SunIsland Transfers Ltd. to obtain independent verification of the above information and to examine suchdocuments or other evidence reasonably capable of providing such verification and agree that the abovegiven information may be used to offer the business any services from time to time as permitted by law,regulatory/statutory and/or governmental organization
Customer Name (Print):
Date
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Month
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Day
Year
Date
Signature
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