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AMLC Verification Assistance Request Form

The document is a Request for Verification Assistance Form from the Anti-Money Laundering Council in the Philippines. It outlines the obligations of individuals and entities regarding dealing with designated individuals or entities and the reporting of frozen assets. The form is to be used for seeking verification of identity when there is uncertainty about a possible match with designated individuals or entities.

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Ash Xïng
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20 views3 pages

AMLC Verification Assistance Request Form

The document is a Request for Verification Assistance Form from the Anti-Money Laundering Council in the Philippines. It outlines the obligations of individuals and entities regarding dealing with designated individuals or entities and the reporting of frozen assets. The form is to be used for seeking verification of identity when there is uncertainty about a possible match with designated individuals or entities.

Uploaded by

Ash Xïng
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

ANTI-MONEY LAUNDERING COUNCIL

[FORM 1]
REQUEST FOR VERIFICATION ASSISTANCE FORM

Individuals and entities located within Philippines, and Filipino individuals or entities located outside
Philippines, must not deal with assets owned or controlled by designated individuals or entities or those acting
on their behalf or at their direction. It is also prohibited to provide financial services or make assets available
to designated individuals or entities, or individuals or entities owned or controlled by them or acting on their
behalf or at their direction.

All individuals and entities must report actions taken with respect to frozen assets described above. The
obligation to report includes reporting any attempted transactions.

If you are uncertain whether an individual or entities is a correct match with a designated individual or entity,
you can use this form to seek verification of identity.

Assets suspected of being subject to targeted financial sanctions obligations must be frozen while seeking
verification and no assets or financial services are to be provided.

Completed forms should be sent to [email protected]

DETAILS OF INDIVIDUAL REQUESTING VERIFICATION ASSISTANCE

Name of individual/business making the request:

Postal address:

Street address (if different):

Contact individual:

Telephone number:

Email address:

DETAILS OF POSSIBLE MATCH

Bank customer Payment search

Non-bank customer Database search


Customer full name:

Customer address:

Customer date of birth:

Linked accounts:

Details of all assets held in relation to possible match:

Identification document details:

Copy of identification documents attached: Yes No

REFERENCES:

Philippines List reference number/s:

United Nations Security Council Consolidated List reference:

Names of individuals or entities:

PAYMENT DETAILS (IF APPLICABLE)

Sender’s name:

Sender’s postal address:

Sender’s street address:

Other details of sender:

Source of funds:

Recipient’s name:

Recipient’s postal address:

Recipient’s physical address:


Other details of recipient (e.g. Bank account details):

Date and location of transaction:

Purpose of transaction:

HAS A SUSPICIOUS TRANSACTION REPORT BEEN FILED: Yes No

If yes, date lodged:

Reference number:

OTHER COMMENTS

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