Preliminary KYC / Know Your Counterparty Form – Ametheus
This is a preliminary KYC form for traders, buyers, agents or end-users who wish to initiate business discussions with Ametheus. Please complete all applicable fields. This form helps us start discussions quickly while maintaining basic compliance standards.
Note: If you are a Charterer for vessel fixtures, please use the full form: KYC/CIS of Client (Charterer) – 03.
Header Information
| Field | Details |
|---|---|
| Date | |
| Completed by (Name / Company / Role) | |
| Contact (Email / Phone / WhatsApp) |
SECTION A – Company / Entity Details
| No. | Question | Answer |
|---|---|---|
| A1 | Full Legal Name | |
| A2 | Trading Name / Brand (if different) | |
| A3 | Type of Entity | ☐ Private Ltd ☐ LLC ☐ Partnership ☐ Sole Prop ☐ Other: |
| A4 | Country of Incorporation / Registration | |
| A5 | Date of Incorporation | |
| A6 | Registration Number (CIN / CRN / Equivalent) | |
| A7 | Company Website | |
| A8 | Registered Address | |
| A9 | Operational / Trading Address (if different) |
SECTION B – Main Contact Person
| No. | Question | Answer |
|---|---|---|
| B1 | Full Name | |
| B2 | Designation | |
| B3 | Mobile / WhatsApp Number | |
| B4 | Email ID | |
| B5 | Alternate Contact (if any) |
SECTION C – Core Business Activities
| No. | Question | Answer |
|---|---|---|
| C1 | Main Products / Services | |
| C2 | Primary Countries of Operation / Trade | |
| C3 | Approximate Annual Business Volume | |
| C4 | Years in Current Business |
SECTION D – Bank Account Details
(For payments, LCs or commissions)
| No. | Question | Answer |
|---|---|---|
| D1 | Account Holder Name | |
| D2 | Bank Name | |
| D3 | Branch & Address | |
| D4 | Account Number | |
| D5 | Currency | ☐ USD ☐ INR ☐ Other: |
| D6 | SWIFT Code / IBAN / Routing Number | |
| D7 | Any other banking information |
SECTION E – Sanctions & Compliance
| No. | Question | Answer |
|---|---|---|
| E1 | Do you or your company have any dealings with sanctioned countries, entities or individuals? | ☐ No ☐ Yes – Details: |
| E2 | Are you or any key persons Politically Exposed Persons (PEP)? | ☐ No ☐ Yes – Details: |
| E3 | Do you have internal policies for AML, Anti-Bribery and KYC? | ☐ Yes ☐ No |
SECTION F – Intended Transaction / Relationship with Ametheus
| No. | Question | Answer |
|---|---|---|
| F1 | Product(s) Interested In | |
| F2 | Approximate Quantity / Volume | |
| F3 | Frequency | ☐ One-time ☐ Monthly ☐ Regular ☐ Other: |
| F4 | Country of Delivery / Performance | |
| F5 | Nature of Relationship | ☐ Buyer ☐ Agent ☐ Trader ☐ End-User ☐ Other: |
SECTION G – Key Persons
(Directors / Partners / Major Shareholders – especially those holding >25% ownership)
| No. | Full Name | Designation | Citizenship | ID Number (Passport / DIN / Equivalent) |
|---|---|---|---|---|
| 1 | ||||
| 2 | ||||
| 3 |
Documents Requested
(Please attach or share later)
- Company Registration Certificate
- Latest Bank Letter / Account Confirmation
- Director / Owner ID Proofs (Passport / National ID)
- Any other relevant compliance documents (optional)
Self Declaration
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.
Name: _______________________________ Position: _______________________________ Date: _______________________________ Signature / Company Stamp: _______________________________
Submission Instructions Return the completed form (preferably as a single PDF with attachments) to: [email protected]
Subject Line format: Preliminary KYC – [Company Name] – [Date]
Note from Ametheus This is a preliminary KYC form only. After successful review and basic compliance checks, we will proceed with detailed discussions and offers. All information is treated as confidential.
