Company Details Form - C - BMI

BMI Bank B.S.C.(c.), Bahrain World Trade Center,
P.O. Box 350, Manama, Kingdom of Bahrain
T +973 17 508080
F +973 17 226641
Politically Exposed Persons (PEP) Details Form
For Retail customer
PEP: ’Politically exposed persons’ means individuals who are, or have been, entrusted with prominent public functions in Bahrain - or a foreign country, such as
Heads of State or government, senior politicians, senior government, judicial or military officials, senior executives of state owned corporations or important
political party officials. Bahraini PEPs would include all ministers, all MPs, and all ministry officials with the rank of Undersecretary or above.
1. Is the customer a politically exposed person
Yes
No
Position title/Description
2. Is the customer related to a PEP
Yes
No
Any person who is a member of the immediate family of a PEP (e.g. parent, brother, sister, son, daughter, father-in-law, mother-in-law;
or a senior advisor or other person known to be closely associated with a PEP)
Position title/Description of PEP
For Corporate customer
1. Is anyone of the directors, shareholders (holding more than 20% stake individually), proprietor or partners a politically exposed person
Yes
No
Other Details
Directorship
Shareholdings
Business ownerships
Other sources of income
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Declaration
Customer service agent
Date
X
Signature
Head of business name
Date
X
Signature
Copy of a PEP customer’s completed application form should be sent to the compliance department.