KYC Questionnaire & Checklist

KYC Questionnaire & Checklist

As Limited Fiscal Representative (LFR) in the Netherlands, Cargocoon Netherlands B.V. is legally required to perform due diligence checks on all represented companies. These checks ensure compliance with Dutch tax legislation, EU VAT rules, and customs regulations, and demonstrate to the Dutch Tax Authorities (Belastingdienst) that both Cargocoon and its clients act in good faith. Therefore, we kindly ask you to carefully fill in all parts (from A to F) of this questionnaire. If you have all company documents ready and at hand, completing this questionnaire will take maximum 20-30 mins. Please reach out to us if you have any questions: kyc@cargocoon.com
A. Company Details
1. Legal Company Name*
2. Registered Address*

Street Address

Street Address Extra Line

CityCountry

Postal / Zip Code
3. Country of Incorporation*
4. Date of Establishment*

MonthDayYear
5. VAT number(s)*
6. EORI number(s)*
Bank Details
7. Bank Name*
8. Account Name*
9. IBAN*
10. SWIFT / BIC *
bank identifier code
Contact Person for LFR Operations in your Company
11. First Contact*

First NameLast Name
Position / Function*
Email*
example@example.com
Phone Number*
Please enter a valid phone number
12. Back-up Contact*

First NameLast Name
Position / Function*
Email*
example@example.com
Phone Number*
Please enter a valid phone number

B. Company Structure
NoYes (please upload the extraction of Chamber of Commerce of your parent company)
Please upload Chamber of Commerce Extract of the parent company from your device by browsing or dragging and dropping in the below field:

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NoYes (please provide the names of your sister companies or subsidiaries)
List of Sister Companies or / and Subsidiaries
NoYes (please upload group chart / oraganogram)
Please upload a group chart or organogram from your device by browsing or dragging and dropping in the below field:

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4. How many people work in your company (the represented company not global)?*
Management
1. Please provide the names of your company's Directors / Legal Representatives (as in the Chamber of Commerce). *

First NameLast Name
Position *
First NameLast Name
Position
First NameLast Name
Position
First NameLast Name
Position
First NameLast Name
Position
Shareholders
2. Please give the names and percentages of shares of the shareholders (legal entity or natural person) of your company.*
Ultimate Beneficial Owner's (UBO's)
3. Please provide the names of any individual that holds more than 25% of shares or voting rights please also list the percentage of shares*

First NameLast Name
% of Shares*
First NameLast Name
% of Shares
First NameLast Name
% of Shares
First NameLast Name
% of Shares
First NameLast Name
% of Shares

E. Checklist Required Documents
Please provide below documents to complete the KYC (click here to open the list if the list does not open itself)*
Please upload all required documents from your device by browsing or dragging and dropping them in below field:*

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F. Declaration
We confirm that the information and documents provided are complete, true, and up to date. We undertake to inform immediately in case of any changes such as, but not limited to, bankruptcy, insolvency proceedings, mergers, acquisitions and joint ventures.

We declare that our company does not have a fixed establishment, office, branch, or employees in The Netherlands and therefore qualifies for Limited Fiscal Representation.

We further declare that our company, its directors, and its UBOs act in good faith, have no fraudulent intentions, and have no history of involvement in tax fraud, customs fraud, or financial crime. We also confirm that our company, directors, and UBOs are not subject to EU, UN, or international trade sanctions.

We understand that providing concerning, false or misleading information will result in immediate termination and/or refusal of Fiscal Representation and may be reported to the Dutch Tax Authorities.
Name of the Authorised Signatory*

First Name as in Chamber of CommerceLast Name as in Chamer of Commerce
Position*
Signature*

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Date Signed*

MonthDayYear
Date
Please verify that you are human*
Should be Empty:

A. Company Details