Client Information Form (Legal team)

Client Information Form

Dear Partner, we kindly request you to fill out this Client Information Form for contracting and compliance purposes. Thank you for your cooperation. If you encounter difficulties filling out this Form, please contact your TEQ Contact Person.
I. Your Data
Your Name

First NameLast Name
Your Email Address
example@example.com
II. Entity's Data (entity you represent)

Note: Data are compulsory for contract preparation purposes
Entity Category
Official Place of Residence (FULL address)
Country issuing photo ID
Nationality
Photo ID type
Photo ID number
Entity Name and Legal Form you represent/working for
(e.g. Football Ltd.)
Tax number / EU VAT number
If the Legal Person is from an EU member country, please enter its EU VAT number!
Official Seat
Tax number / EU VAT number
If you are from an EU member country, please enter your EU VAT number!
Company Registration number
Authorized signer's name (who is empowered to sign any official document, e.g. contract)
Authorized signer's official (company) email address (please note that signer's private e-mail address is not accepted in case it represents a legal entity)
(e.g. teqball@teqball.com, but iloveteqball@gmail.com is not deemed to be official)
Entrepreneur Number
The number on which you are registered as a sole trader.
Company excerpt which contains all the requested data AND a certificate that the given Authorized signer has the right to sign (if the excerpt doesn't contain this informaton)

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More files can be uploaded if it's needed. Cancelof
Photo ID card which contains all the requested data

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More files can be uploaded if it's needed. Cancelof
Sole Trader excerpt which contains all the requested data

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An official documentum that certify that you are a sole trader. / More files can be uploaded if it's needed. Cancelof
III. TEQ Contact Person Details
TEQ Contact Person's (your contact person's name at Teqball, not yours!)

First NameLast Name
Email address of such TEQ Contact Person
example@example.com
Please choose the TEQ entity you are in contact with
Name of other TEQ entity
IV. Business Relationship details
Contract type
Describe the type of contract
Short description of business
Other relevant information
IV. Due Diligence information
1) Does the Partner have anti-bribery program?
2) Does the Partner have data privacy policy and a data protection program in place?
3) Does the Partner have a compliance program?
4) Is the Partner under liquidation proceedings?
5) Has the Partner been subject to sanctions or have been convicted in the past 24 months?
In case you answered ’No’ to question Number 1, 2 or 3 please explain!
In case you answered ’Yes’ to question Number 4 or 5, please explain!
Comments, if any, regarding the above
Attachments, if any

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Please note, that in case of business partners within the EU, we can only accept invoices containing EU VAT number.
By filling out this form, you declare that the above information are accurate and true, for which you are responsible.
I confirm.
I expressly consent to the processing of my personal data submitted through this form. (for TEQBALL Group: https://cdn.buttercms.com/kOq0VN73Q3mVR3HR2n3j ); for FITEQ: (https://cdn.buttercms.com/VcJehJaSie58DYEsG8CM )
Should be Empty: