PRELIMINARY KYC / KNOW YOUR COUNTERPARTY FORM – BUYER / AGENT
to be filled for official use of Ametheus Holdings Pvt Ltd
(Please fill all applicable fields and reply to this message. This is a preliminary questionnaire to initiate business discussions.)
1. Company / Entity Details
• Full Legal Name:
• Trading Name / Brand:
• Type of Entity (Private Ltd / LLC / Partnership / Sole Prop / Other):
• Country of Incorporation / Registration:
• Date of Incorporation / Establishment:
• Registration Number (CIN / CRN / Equivalent):
• Company Website:
• Registered Address:
• Operational / Trading Address:
2. Main Contact Person
• Full Name:
• Designation:
• Mobile / WhatsApp Number:
• Email ID:
• Alternate Contact:
3. Core Business Activities
• Main Products / Services (e.g. Petroleum Products, Agri Commodities, Metals, etc.):
• Primary Countries of Operation / Trade:
• Annual Business Volume (approx):
• Years in Current Business:
4. Bank Account Details (for payments / LCs)
• Account Holder Name:
• Bank Name:
• Branch & Address:
• Account Number:
• Currency (INR / USD / Others):
• SWIFT Code / IBAN / Routing Number:
• Any other relevant banking information:
5. Sanctions & Compliance
• Do you or your company have any dealings with sanctioned countries, entities, or individuals? (Yes/No) If Yes, please provide details:
• Are you or any key persons Politically Exposed Persons (PEP)? (Yes/No) If Yes, please provide details:
• Do you have internal policies for AML, Anti-Bribery, and KYC? (Yes/No)
6. Intended Transaction / Relationship with Ametheus
• Product(s) Interested In (e.g. LPG, EN590 Diesel, Rice Protein, Copper Cathodes, etc.):
• Approximate Quantity / Volume: • Frequency (One-time / Monthly / Regular):
• Country of Delivery / Performance:
• Nature of Relationship (Buyer / Agent / Trader / End-User / Other):
7. Key Persons (Directors / Partners / Major Shareholders) (Especially those holding >25% ownership)
| Full Name | Designation | Citizenship | ID Number (DIN/Passport) |
|---|---|---|---|
| 1. | |||
| 2. |
Additional Documents Requested (Please attach or share later):
- Company Registration Certificate
- Latest Bank Letter / Account Proof
- Director / Owner ID Proofs (Passport / PAN etc.)
- Any other relevant compliance documents
Certification I/We hereby confirm that the information provided above is true, accurate, and complete to the best of my/our knowledge. I/We agree to provide additional documents or information as required for full due diligence.
Signed: Name:
Position:
Date:
Company Stamp / Name:
Note from Ametheus: This is a preliminary KYC form. On successful review, we will proceed with detailed discussions, offers, and full compliance checks.
