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  • GA Telesis, LLC

    1850 NW 49th Street Fort Lauderdale, FL 33309 United States of America, Tel: +1 (954) 676-3111 Email: tradecompliance@gatelesis.com Website: www.gatelesis.com
  • Know Your Customer (KYC) Form

  • □ This form must be completed, signed, and dated by the Compliance Officer or other duly authorized officer of the company named below (the “Company”).
    □ Please fill out the form in English and be sure to check all boxes, as appropriate. □ Incomplete forms will not be accepted and may result in unnecessary delay of orders.
    □ You must notify us promptly in writing of any changes in the information provided.

  • 1. BACKGROUND INFORMATION

  • 2. TYPE OF ENTITY (If sole proprietor or self-employed, skip to item 3)

  • Type of Entity
  • Is the Company government-owned?
  • If yes, please identify the government entity and % of Ownership.

  • Is the Company publicly traded?
  • If yes, please identify the market/exchange and trading symbol.

  • Know Your Customer Form
    F700-03 Rev 9 Date 03-JUN-2025

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  • GA Telesis, LLC

    1850 NW 49th Street Fort Lauderdale, FL 33309 United States of America, Tel: +1 (954) 676-3111 Email: tradecompliance@gatelesis.com Website: www.gatelesis.com
  • 3.Ultimate Beneficial Ownership Information (for entities that are not wholly governmentowned or publicly traded)

    Ultimate Beneficial Ownership information must include all individuals and/or entities holding any ownership interest in the Company. Attach additional sheets, if necessary, to provide the required information. The sum of all ownership percentages in the two tables below must equal 100%.

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  • Ultimate Beneficial Ownership Information for Owners of the Company that are Legal Entities. Please list all individuals or entities holding any beneficial ownership interest in each legal entity owner (if any) listed in the table above. Attach additional sheets, if necessary, to provide the required information. The sum of all beneficial ownership percentages for each legal entity listed in the table below must equal 100%.

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  • For entities located outside of the United States only, evidence must be provided of each individual owner’s legal name. The following unexpired government-issued identification or documents may be provided to satisfy this requirement:
    ◼     Passport
    ◼     National Identification Card
    ◼     Any other unexpired government-issued document bearing a photograph

    Evidence must be provided for each legal entity’s legal name, registered number, and registered office address. The following documents may be provided to satisfy this requirement:
    ◼     Articles of Incorporation or Articles of Organization
    ◼     Partnership or Operating Agreement
    ◼     Government-issued Business License
    ◼     Trust Instrument
    ◼     Certificate of Good Standing

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  • Know Your Customer Form
    F700-03 Rev 9 Date 03-JUN-2025

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  • GA Telesis, LLC

    1850 NW 49th Street Fort Lauderdale, FL 33309 United States of America, Tel: +1 (954) 676-3111 Email: tradecompliance@gatelesis.com Website: www.gatelesis.com
  • 4. Senior Management Information

    List each Director, Manager, and any Officer (e.g., President, Vice-President, CEO, and CFO) who effectively exercises control over the Company.

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  • 5. Trade Compliance Representations

  • a. Does your Company, or any affiliated individual or entity appear on any restricted party list maintained by the United States, United Kingdom, and/or the European Union? If yes, please attach a complete explanation.(1)*
  • NOTE: Only buyers of products need to complete items 5b-d below.

  • b. Will you be incorporating any product obtained from GA Telesis into any defense article that is subject to ITAR?*
  • c. With regard to products obtained from GA Telesis, is your Company an:*
  • (1) The latest Consolidated Screening List of Restricted Persons can be found at: https://2016.export.gov/ecr/eg_main_023148.asp
    (2) For purposes of this section, an “End-user” means a person, company or entity that receives and ultimately uses the exported or re-exported items for its own internal use, and not for distribution or resale. Forwarding agents or intermediaries like MROs that will eventually ship the parts to a third party are not End-users. A “Reseller” means a company or individual that purchases products with the intention of selling them rather than consuming or using them.

  • Know Your Customer Form
    F700-03 Rev 9 Date 03-JUN-2025

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  • GA Telesis, LLC

    1850 NW 49th Street Fort Lauderdale, FL 33309 United States of America, Tel: +1 (954) 676-3111 Email: tradecompliance@gatelesis.com Website: www.gatelesis.com
  • 6. Bank/Accounting Information

  • Format: (000) 000-0000.
  • 7. Declarations and Signature

    The undersigned agrees that:

    a. The Company will not ship to any Restricted Country or furnish to any Restricted Person (as such terms as defined below) any product obtained from GA Telesis in any manner, including through sale, lease, exchange, or part-out.

    "Restricted Country" means any country or nation which engages in armed conflict, declared or otherwise, with the armed forces of the United States and/or United Kingdom, and any other country or nation with which nationals (either individual or corporate) of the United States and/or United Kingdom are prohibited from doing business by law, regulation, order, resolution, or stated policy, including but not limited to Cuba, Iran, Syria, North Korea, or Crimea. General information on United States sanctions can be found at: https://home.treasury.gov/policy-issues/financial-sanctions/sanctions-programs-and-country-information.

    "Restricted Person" means (a) any person who is a citizen of, or entity that is organized under the laws of or whose principal place of business is located in, any Restricted Country; and (b) any person or entity with which nationals or residents (either individual or corporate) of the United States and/or United Kingdom are prohibited from doing business by law, regulation, order, resolution, or stated policy. The latest Consolidated Screening List of Restricted Persons can be found at: http://export.gov/ecr/eg_main_023148.asp.

    b.The Company will abide by all applicable United States, European Union, and United Kingdomexport control laws and regulations for any products, software or technology that require any licenses or prior approvals from the United States, European Union, or United Kingdom government prior to export or re-export.

    c. All Trade Compliance representations set forth in this KYC Form shall survive the completion, early termination, cancellation or expiration of any applicable purchase order, agreement or contract with GA Telesis, and the Company will cause its subsidiaries and affiliated companies to comply with these terms.

    The undersigned compliance officer or other duly empowered officer of the Company hereby certifies that the information furnished above is true and correct to the best of my knowledge and belief, and I agree to inform you immediately of any changes to such information.

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  • Date:*
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  • Know Your Customer Form
    F700-03 Rev 9 Date 03-JUN-2025

  • INSTRUCTIONS

    Follow the instructions for each section to expedite processing and to avoid unnecessary requests for additional information.

    1. Background Information.
    Legal Name of Company. Enter the legal name of the entity exactly as it appears in the corporate charter or other legal document creating the Company or the full name of an individual.
    Trading Name of Company. Enter the trade name of the Company if different from the legal name. The trade name is the “doing business as” (DBA) name. Other Company Names. Enter any other name by which the Company is known or under which it does business.
    Address. Provide the Company’s physical address. If the Company’s physical address is outside the United States, you must enter the city, province or state, postal code, and name of the country. Do not abbreviate the country name. Company Website. Enter the URL address for Company’s website.
    Telephone. Enter the Company’s telephone number including country code. Legal/Trade Compliance Officer’s name and address. Enter the contact information of the Legal or Compliance person that will be responsible to receive and sign this form in the future.

    2. Type of Entity.
    Type of Entity. Select the type of entity that best describes the Company, or if sole proprietor or self-employed, skip to item 3.
    Jurisdiction of Formation. Enter the state and/or country where the entity was formed.
    Is the Company Publicly Traded? Check “Yes” if the Company’s ownership is distributed amongst general public shareholders via the free trade of shares of stock on exchanges or over-the-counter markets. Check “No” if the Company is privately or state-owned. If “Yes” is checked, please enter the market or exchange on which the Company’s shares are traded and trading symbol.

    3. Ownership Information.
    For companies that are not government-owned or publicly traded, please list the names of all individuals or entities having any ownership interest in the Company. For individuals, evidence of the individual’s legal name is required. The following unexpired government-issued identification or documents may be provided: (i) passport, (ii) national identification card, or (iii) any other unexpired government-issued document bearing a photograph. For entities, evidence of the entity’s legal name, company or registration number, and registered office address is required. Copies of the following documents may be provided to satisfy this requirement: (i) the Articles of Incorporation or Articles of Organization of the entity; (ii) Partnership or Operating Agreement; (iii) Government-issued Business License; (iv) Trust Instrument; or (v) Certificate of Good Standing.

    4. Senior Management Information.
    Enter the full name of each director or manager as well as any officer, including, but not limited to: CEO, CFO, President, Senior Vice President, and other executives who effectively exercise control over the Company.

    5. Trade Compliance Representations.
    Read each inquiry carefully, check the appropriate box and fill out the applicable requested information.

    6. Bank/Accounting Information.
    Enter the requested bank information for screening purposes, and contact information.

    7. Declarations and Signature.
    Please review each declaration carefully. Please insert your company title in the Declaration paragraph and sign, print your name, and date in the signature section.

  • Know Your Customer Form
    F700-03 Rev 9 Date 03-JUN-2025

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