Government / Organisation Representative Information

Buyer Information
Are you authorized to make purchases by your agency / organization ? *
What type of entity will be paying for purchases on this platform? *

Government Institutions Customer Profile

BIOGRAPHICAL INFORMATION:


CONTACT INFORMATION:


BANK DECLARATION: (Please provide details below as applicable):


SUPPORTING DOCUMENTS – GOVERNMENT INSTITUTIONS

Establishing Law/Presidential Decree/ Certificate of Registration / Certificate of Incorporation (As Applicable)
Maximum upload size: 16.78MB
Certificate of Change of Name (If applicable)
Maximum upload size: 16.78MB
Memorandum & Article of Association/Company Statutes/ Company Regulations (If Applicable)
Maximum upload size: 16.78MB
Identification Documents (National ID or Passport) for individuals with controlling authority or those that will be signing on the account with Afreximbank (e.g. CEO or Deputy CEO) *
Maximum upload size: 16.78MB
Annual Report and Financial Statements for the past 3 years *
Maximum upload size: 16.78MB
Profiles of Board of Directors (CV) *
Maximum upload size: 16.78MB
Profiles of Executive Management (CV) *
Maximum upload size: 16.78MB
Environmental and Social Impact Assessment Report (for customers involved in project-related transactions)
Maximum upload size: 16.78MB
Relevant Environmental Approvals and Certifications (for customers involved in project-related transactions)
Maximum upload size: 16.78MB

COMPLIANCE DECLARATIONS:

Non-Profit Institution Customer Profile


BIOGRAPHICAL INFORMATION

Type and Nature of Institution’s Activities (Please check as appropriate and provide details) *

CONTACT INFORMATION


COMPLIANCE DECLARATIONS:

Are there Donors, Directors or Executive Management who hold positions in the public sector/government ? (Please check as appropriate) *
Is the Institution, or other related parties under any sanctions or restrictions by the registering body or any sanctioning body? (Please check as appropriate)
The institution is compliant with Registration Requirements in all the countries it operates. (Please check as appropriate) *
The Institution is compliant with Anti-Bribery and Anti-Corruption Laws in all the countries it operates. (Please check as appropriate) *
ANTI-MONEY LAUNDERING, COUNTER TERRORISM FINANCING AND TAX COMPLIANCE DECLARATION *

SUPPORTING DOCUMENTS – NON-PROFIT INSTITUTIONS:

Certificate of Registration / License/Permit (As Applicable)
Maximum upload size: 16.78MB
Constitution/By-Laws (As Applicable)
Maximum upload size: 16.78MB
Latest Annual Activity Report or Financial Statements (If applicable) *
Maximum upload size: 16.78MB
Profiles of Board of Directors (CV) *
Maximum upload size: 16.78MB
Copies of Identification Documents (National ID or Passport) for Board Members *
Maximum upload size: 16.78MB
Profiles of Executive Management (CV) *
Maximum upload size: 16.78MB
Profiles of Authorised Signatories (CV) *
Maximum upload size: 16.78MB
Copies of Identification Documents (National ID or Passport) for Authorised Signatories *
Maximum upload size: 16.78MB

Corporate Customer Profile


FORM FOR CUSTOMER DUE DILIGENCE

Sanctions: Is the company, company’s shareholders/ Members of the board of directors under any sanctions or restrictions.

CERTIFICATION

I/We on behalf of the company do hereby declare that:
The business that the Company is involved in does not include any proceeds of crime/money laundering. *
The Company is not involved in Financing of Terrorism or other financial crimes. *
The company is not a shell company (i.e has a physical presence in the country(ies) of operation) *
The companies performs due diligence on all counterparties i.e. customers, contractors, employees, and other parties *
The Company conducts background checks on counterparties and does not deal with parties involved in money laundering, financing of terrorism and other financial crimes *
Is compliant with anti-bribery laws and regulations of the operating country(ies). *
No legal action been brought against the company before the regulatory organ regarding violations of anti-money laundering and/or terrorist financing laws and regulations. (If there is any. Please provide details of name of case and court references and summary of the outcome of court proceedings) *
All information provided above is true and represents the company *

SUPPORTING DOCUMENTS – CORPORATES

Memorandum & Articles of Association (certified copy) *
Maximum upload size: 16.78MB
Certificate of Incorporation (certified copy) *
Maximum upload size: 16.78MB
Certificate of Change of Name (if applicable)
Maximum upload size: 16.78MB
Confirmation of Changes in ownership structure/shareholders in the past 5 years.
Maximum upload size: 16.78MB
Company’s Annual Report and Financial Statements for the past 3 years; *
Maximum upload size: 16.78MB
Board of Directors Resolutions/Mandate *
Maximum upload size: 16.78MB
Board of Directors individual profile (CVs) *
Maximum upload size: 16.78MB
Information on company’s profile including registered jurisdictions, physical addresses (P.O.Box is not acceptable), Directors including Independent Directors, company’s external auditors, type of business, etc. *
Maximum upload size: 16.78MB
Ownership structure (including key promoter(s), comprehensive list of shareholders, respective percentages of their stakes in company, biographies (CVs) of individual promoters/owners of company with relevant certified passport pages or national identity card. *
Maximum upload size: 16.78MB
Declaration of initial sources of funding by key promoters and their notarized statements of net-worth which includes other business interests (shareholding) in other companies *
Maximum upload size: 16.78MB
Name of Parent/Holding Company (if applicable); statutory information to include; Certificate of Incorporation; Memorandum & Articles of Association, others *
Maximum upload size: 16.78MB
Detailed individual and/or parent company profile and shareholding structure; Board of Directors; key management team; subsidiaries; nominees; trustees; etc. *
Maximum upload size: 16.78MB
Biographies (CVs) of key management team of company *
Maximum upload size: 16.78MB
Confirmation of compliance with workplace safety, Environmental Risk and Social Management Regulations (To attach evidence e.g. appropriate Certification/ Environmental Impact Assessment Report) *
Maximum upload size: 16.78MB
Declaration *