KYC Update / Modification Form Template

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)

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: ___________________________