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CUSTOMER DUE DILIGENCE (CDD) FORM - INDIVIDUAL - RETAIL BANKING

Date of visit D
1 D
6 M
0 M
2 Y
2 Y
0 Y
2 Y
4 Time of visit
Location CDD completion date D D M M Y Y Y Y

1. Personal Details: New customer ✔ Existing customer CIF number (for existing customers)

Full name of the person (as per passport) Aidana Umirzhanova

Multiple passport holder Yes ✔ No If yes, kindly list the nationalities below:

S.No Nationality

Does the Customer hold valid UAE residence visa or is a GCC National? ✔ Yes No
if yes residence in UAE since 2014
Is the Client Yes ✔ No
a) a national from sanction country and he is self employed OR
Yes ✔ No
b) a private banking customer with portfolio account OR

c) a non-resident customer.*? Yes ✔ No

Country of normal residence

Will the customer transaction include those with sanction countries? Yes ✔ No

2. Purpose and intended use of the account:

✔ Personal (salary /expenses/ savings) Investment

3. Will the account be used for business activities Yes ✔ No

4. PEP Identification (Politically Exposed Persons): If yes please complete PEP assessment form.
Is customer a PEP? Yes* ✔ No * In case of PEP, update the PEP assessment form.

5. Employment and Income Details

✔ Employed Self employed Not employed

ME hotel by melia
Company name

The Opus by Omniyat - Burj Khalifa Blvd - Business Bay - District - Duba
Address

Position / Title Sales Coordinator Years in Employment / Business 2023

Employed

Monthly salary (AED) 6000 Additional monthly income (AED)

Estimated total annual income(AED) 72000 Salary transferred to Emirates NBD Yes No

Self employed

Monthly Business income (AED) Additional monthly income (AED)

Estimated total annual income % of

Type of Entity
(AED) Ownership

Nature of Business/Occupation (Including countries in which it operates, no. of employees, no. of offices etc.type of business transactions )

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 Not employed (Please update the source of income in section 7)

Additional monthly income from

Monthly income (AED)
property/investments (AED)

Estimated total annual income

Any other monthly income (AED)
(AED)

Estimated total Net Worth (AED)

6. Products
Wealth Management (Portfolio/
✔ Basic Banking (CASA / deposit ) Safe Deposit Lockers*
Investments)
What banking products / Cards(Charge, Credit, Corporate, Execution only Stock Broker
(ENBD Securities) Hold Mail
services are expected to Prepaid, Branded, Affinity)
be availed / availed by the
customer ? Loans Private Equity

Others (Please specify)

*Holds Safe deposit lockers / rent boxes measuring more than 70cm x 70 cm x Yes No If yes, Number of boxes
70 cm with Emirates NBD UAE only?

7. Source of Wealth: Please update the respective source of income that has generated Customer’s wealth

✔ Salary Earnings Business Earnings Investment Income Sale of Company/Business

Sale of Property Gift/ Inheritance Others (please specify)

Please provide a detailed explanation on customers’ source of wealth.

8. Source of Initial deposit/funds

Amount (AED) Cash Cheque* Remittance*

*Please provide the name

of the Bank and Country

Source of funds / initial

deposit

9. Monthly anticipated transaction pattern (in AED):

Frequency/number of Frequency/number of
Transactions Type Value Credit Value Debit
transactions transactions

Cash

Internal Transfers

Cheque

Bank name and country Bank name and country

Bank name and country Bank name and country

Remittance
Bank name and country Bank name and country

Bank name and country Bank name and country

Bank name and country Bank name and country
Total (total value of all types of transactions
mentioned in above table)
Expected eventual size of relationship /
Expected balance in the account (AED)

NE06FRM0152 (Page 2 of 4) INDIVIDUAL CUSTOMER DUE- DILIGENCE FORM 04.18 Ver 2

 10.Does the customer hold any relationship with Group (ENBD,EI, KSA, Yes* ✔ No *If yes, fill in below table
UK,INDIA,Egypt&Singapore ) in individual capacity or as related party to any entity.

Account Name CIF Number Business unit, Location and Relationship

11. Does the customer have any existing relationships with other Banks? Yes* ✔ No *If yes, fill in below table

Bank name and Account Name Estimated relationship value (in AED) Banking since (MM-YY)

12. Business Recommendation / Summary / Additional information

Please provide additional information about the customer (customer/business profile, rationale of opening account for non-resident, details of
any third party transactions. Provide relevant information which would significantly contribute towards the analysis of the risk profile of the
customer.

13. (To be signed and confirmed by staff only in case of sanction indicia)

✔ I confirm that all pages of passport are checked and customer is not frequent traveler to the sanctioned country & not a normal resident
of sanctioned country

The above information is a true reflection of my knowledge about the relationship. I recommend that the relationship to be established/
continued with the bank.
Recommended by:

Name

Staff ID

Designation

Signature

Date D D M M Y Y Y Y

Approved by:

Name

Staff ID

Designation

Signature

Date D D M M Y Y Y Y

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 15. Compliance comments: (for group compliance use only if applicable)

Name Signature

Staff ID Date

Notes:
• All fields are mandatory, in case any field is not applicable; kindly mention ‘Not applicable’. No fields to be left blank.
• For ongoing reviews CDD update: Section 8 is not applicable.
• For Joint account holders separate CDD form should be completed for each account holder.
• In case of lack of space, please attach separate report to include additional information.
• For guidelines on documentation please refer to Manual for Identification and Verification of Customers.

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