Model Compliance Programme for Accountants.doc

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…………….…….…. …………………………………………………………………………………………………………………………… …….…….…….…. …………………………………….…….… ……………………………………….. ……………….…………... Prepared by (optional) Designation (optional) Date The following section is for the use of the Compliance officer Action Taken …………………………………………………………………………………………………………………………. ………………..……. …………………………………………………………………………………………………………………………… ……….….….……. …………………………………………………………………………………………………………………………… ………..……….…. …………………………………………………………………………………………………………………………… …….………..……. ………………………………………… ………………………………………….… Compliance Officer - AML Date Appendix III - Source of Funds Declaration Form INFORMATION OF BENEFICIAL OWNER OF TRANSACTION Date: Name (First Name, Middle Name, Surname) Date of Birth National Identification No./DP No./Passport No. Address Country of Birth Business/Residence Phone No. Occupation/ Nature of Business Page | 32
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Source of Funds declared to be: Pursuant to Regulation 15 (h) of the Financial Obligations Regulations 2010, I/ Entity XX is required to obtain information on the source of funds for this transaction. Customer’s signature (optional) I/We have made inquiry and to the best of my/our knowledge and belief the funds were not derived from or are being employed in any illegal transaction by the person/company for whom/which I am acting. ________________________________________ Receiver Name, Address and ID No. Receiver Signature PERSON CONDUCTING THIS TRANSACTION IF DIFFERENT THAN ABOVE Name (First Name, Middle Name, Surname) Date of Birth National Identification No./DP No./Passport No. Address Country of Birth Business/Residence Phone No. Nature / Purpose of the transaction DESCRIPTION OF TRANSACTION DESCRIPTI DECLARATION FOR COMPANY USE ONLY Transaction taken by:______________________________ Approving Officer:___________________________ T ransaction Accepted Transaction Declined Customer refused to sign form Remarks (continue on a separate sheet, if necessary) Date: ________________Reviewed by Compliance Officer___________________ Page | 33 Non Cash: Currency: Amount: Currency: Amount: Cash:
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Appendix IV – Training Register Training held by XXXXX on DATE Topics covered: EMPLOYEE NAME DEPARTMENT POSITION SIGNATURE 1 2 3 4 5 6 7 8 9 10 11 12 Page | 34
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Appendix V – Terrorist Funds Report FIU TFR FORM Made in accordance with section 22 C of the Anti- Terrorism (Amendment )Act, 2010, Act No 2 of 2010 and section 22AB the Anti-Terrorism (Amendment )Act, 2011, Act No 16 of 2011 Ref. No.
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