Express Gold Refining - Individual Account Application

Individual Account Application
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Client Information

Please provide all required details to register your business with us
Full Name*

First NameMiddle NameLast Name
Date of Birth*

MonthDayYear
Citizenship*
Contact Number*
Format: (000) 000-0000.
E-mail*
example@example.com
By opening an account with us, you consent to us contacting you about your transaction and to provide you with company news and promotions. For more information, please see our privacy policy.
Address*

Street Address

Country

CityState / Province

Postal / Zip CodeCountry
Additional Information
EmployedSelf-employedUnemployedRetiredStudent
Present/Previous Job Title (please be as specific as possible)*
SalarySavingsInheritance/GiftInvestmentsRetirement IncomeProperty SaleOther: _____________________________
Purchase of Precious MetalsSales of Precious MetalsRefining Services
Total volume anticipated to be purchased, refined, traded and/or stored annually (in CAD or KG)*
If no anticipated volume is indicated, our internal thresholds will be applied for the account risk rating analysis, and further information might be requested from the customer if necessary.
Are you conducting the transaction on behalf of a third party?
Yes No*
Are you or anyone of your immediate family a Politically Exposed Person?
Yes No*
A politically Exposed Person is an individual who holds or has ever held one of the following offices or positions in or on behalf of a country: head of state or government; a member of the executive council of government or member of a legislature; a deputy minister (or equivalent); an ambassador or an ambassador's attaché or counsellor; a military general (or higher rank); a president of a state-owned company or bank; a head of a government agency; a judge, or a leader or president of a political party in a legislature. Politically Exposed Person also includes the following family members of the individual described above: mother or father, child, spouse or common-law partner, spouse's or common-law partner's mother or father and brother, sister, half-brother or half-sister (that is, any other child of the individual's mother or father).
Additional Notes
Notice to Clients

To assist in preventing the financing of money laundering or terrorist activities, the Canadian government has passed the Proceeds of Crime (Money Laundering) and Terrorist Financing Act, which requires financial institutions, securities dealers, money service businesses and others to obtain, verify and record information that identifies persons or entities who engage in certain transactions with or through our company.

It means that for individuals, including individuals who purport to represent a corporate or not-for-profit client, Express Gold Refining Ltd. ("EGR") will verify, among other things, your name, residential or street address, date of birth and occupation. We may also ask to see a driver's license or other government-issued identifying documents from you and seek information about you from a credit-reporting agency.

For corporate or not-for-profit entities, this means that we will verify, among other things, beneficial ownership information and the purpose for which your account with us exists. EGR will also verify the identity of individuals authorized to provide instructions for the accounts of certain entities. We shall also require that certain information be kept up to date, including beneficial ownership information. We will also ask to see the constating documents for each corporate or not-for-profit entity.

By signing below, you authorize EGR to obtain personal information about you.
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Individual Account Application

Client Information

Additional Information