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PEP Customer Due Dilligence Form


To comply with the Criminal Justice (Money Laundering and Terrorist Financing) Acts 2010 to 2018, PTSB is required to identify customers who are a Politically Exposed Person (PEP) or a relative or close associate (RCA) of a Politically Exposed Person, and to obtain details from those customers in respect of their source of wealth and the source of funds to their account(s).

This application allows you to digitally complete and submit the PEP Customer Form online.

Estimated time to complete: 5 mins.

Unfortunately, at this time, once you start this form you will not be able to save and return at a later date. When completing this form you cannot move back to a previous section until all mandatory questions have been answered.

Please make sure you have the following information to hand in order to complete the form:

Your Personal Details

Your Income Details

Information regarding the source of funds you are depositing with the bank.

Details of how you have generated your total wealth.

Personal Details

Politically Exposed Person (PEP) - an individual who is or has at any time in the preceding 12 months been, entrusted with a prominent public function/role.

Relative Close Associate (RCA) - an immediate family member (spouse or equivalent to a spouse, child, spouse of a child or equivalent to a spouse of a child, parent, and any other family member) and/or any individual who has joint business interests with a PEP or who can conduct financial transactions on behalf of a PEP.

Income Details

Source of Wealth

 
Where applicable please provide the address of your properties

Source of Funds

Purpose of Account
Source of Funds
Purpose of Account
Source of Funds
Purpose of Account
Source of Funds
Purpose of Account
Source of Funds

Declaration

I certify the accuracy of all information contained in this form. I undertake to inform you without delay should any of the information change.

I agree to provide PTSB with such further information or documentary evidence in respect of the source of funds and source of wealth on request.

I understand that by providing this information it does not mean that PTSB will provide or continue to provide banking facilities.

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