CIP Form – Corporations – Obelisco Advisers

Client Information Profile - Corporations

Business name

Type of industry

Company’s Purpose/Objective

Type of clients the company will be working with

Name of the business owner

Title/Position of the business owner

Shares or Interest Owned

Allocation of Shares by Shareholder and Amount Owned

Total Number of Shares or percentage of Interest Owned in Company

Physical Address

Mailing Address

Business Website

Business phone number

Business Email address

Financials

Jurisdictions of clients

Jurisdictions of suppliers

Number of employees

Foreign Tax ID

Domestic Tax ID

Banking product needed

Initial deposit

Average monthly balances

Number of incoming wires per month

Number of Outgoing wires per month

Destination of the wires

Additional Information

Referred by