Company/Business Name: [Company Name]
Customer Name: [Customer Legal Name]
Customer ID / Account No.: [ID]
Date of Request/Change: [Date]
Effective Date (If Different): [Date]
Completed By: [Name, Title]
Reviewer/Approver: [Name, Title]
Customer Type: ☐ Individual ☐ Business/Entity
Reason for Update: ☐ Customer request ☐ Periodic review ☐ Document expiry ☐ Monitoring trigger ☐ Other: [__]
1. Summary of Changes
1.1 Brief summary: [1–3 sentences].
2. Updated Customer Details (Check All That Apply)
2.1 Legal name: ☐ No change ☐ Updated to: [**]
2.2 Trading name/DBA: ☐ No change ☐ Updated to: [**]
2.3 Registered address: ☐ No change ☐ Updated to: [**]
2.4 Operating address: ☐ No change ☐ Updated to: [**]
2.5 Phone/email: ☐ No change ☐ Updated to: [**]
2.6 Website: ☐ No change ☐ Updated to: [**]
2.7 Industry/business activity: ☐ No change ☐ Updated to: [**]
2.8 Expected activity/volume: ☐ No change ☐ Updated to: [**]
2.9 Authorized signers: ☐ No change ☐ Updated (list): [**]
2.10 Beneficial owners/controllers: ☐ No change ☐ Updated (details): [**]
2.11 Other: [__]
3. Verification and Re-Checks
3.1 Verification method used: ☐ documents ☐ database ☐ video ☐ other: [__]
3.2 Screening performed:
-
Sanctions: ☐ Clear ☐ Possible match ☐ Not performed (explain)
-
PEP: ☐ Clear ☐ Possible match ☐ Not performed (explain)
-
Adverse media (optional): ☐ Clear ☐ Concern ☐ Not performed (explain)
Sanctions: ☐ Clear ☐ Possible match ☐ Not performed (explain)
PEP: ☐ Clear ☐ Possible match ☐ Not performed (explain)
Adverse media (optional): ☐ Clear ☐ Concern ☐ Not performed (explain)
3.3 Notes: [Notes].
4. Updated Documents Collected
4.1 ☐ Updated ID(s)
4.2 ☐ Proof of address
4.3 ☐ Registry extract / certificate of good standing
4.4 ☐ Ownership chart/cap table
4.5 ☐ Board resolution/authority letter (optional)
4.6 ☐ Other: [List]
5. Risk Review (If Applicable)
5.1 Prior risk rating: ☐ Low ☐ Medium ☐ High
5.2 Updated risk rating: ☐ Low ☐ Medium ☐ High
5.3 Reasons for risk rating (brief): [**]
5.4 Enhanced due diligence required: ☐ No ☐ Yes (steps): [**]
6. Decision and Approval
6.1 Decision: ☐ Approved ☐ Approved with conditions ☐ Rejected ☐ Pending
6.2 Conditions/follow-ups: [__]
6.3 Approval date: [Date]
Signatures
Completed By: [Name, Title]
Date: [Date]
Signature: ___________________________
Reviewed/Approved By: [Name, Title]
Date: [Date]
Signature: ___________________________