AgriBank PLC - SkyParks Business Centre, Malta Intenational Airport, Luqa, LQA 4000, MALTA
T: +356 2092 6000 F: +356 2092 6100 E: info@agribankplc.com
VAT NO:MT 2091 7025 Co Reg No: C57067

Customer Due Diligence Form for Legal Persons

Section 1 - Applicant for Business Identification

Section 2 - Contact Person

Section 3 - Business Activity

Section 4 - Transaction Information

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(Type N/A if you are not using any PSPs)
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(Type N/A if you are not using any PSPs)
(To select multiple values, kindly hold down the SHIFT or CMD/CTRL button when selecting)
(To select multiple values, kindly hold down the SHIFT or CMD/CTRL button when selecting)
(Type N/A if you are not using any PSPs)
(To select multiple values, kindly hold down the SHIFT or CMD/CTRL button when selecting)
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Section 5 - Beneficial owner information

Section 6 - Upload Section

Section 7 – PEP Declaration

Politically exposed persons (PEPs) are individuals who are or have been entrusted with prominent public functions, for example Heads of State or of Government, senior politicians, senior Government, judicial or military officials, senior executives of state owned corporations, and important political party officials. Family members and close associates of such persons are also considered as PEPs.
Are you and/or any other natural person detailed in this form a politically exposed person?
If yes, please specify