Revised Central Bank-AMLA Guidelines - Anti-Money Laundering ...

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AML/CFT GUIDELINEISSUED BY THECENTRAL BANK OF BARBADOSIN CONJUNCTION WITH THE ANTI-MONEY LAUNDERING AUTHORITYMAY 2011PART B Name of account holder(To be completed only if transaction was conducted onbehalf of another person other than those mentioned inpart A)8.:……..…………………..……………………………(Given names and surname)PART C Transaction details15…………………………………….………………Type of transaction (e.g. deposit, purchase travellers’ chq)9.:…………………….………………………………………………………….…………………………………(Address)10.:………………………………………………..……(Nationality – if not Barbadian)11.:………………………………………………..……(Occupation)12.:………………………………………………..……(Date of birth)16. ………………….……………………………….(Date of transaction)17. …………………………….……………………..(Amount of transaction ($BC)18. ……………………………………….………….(If foreign currency involved, name)19……………………………………………………(Cheque / transfer /money order / etc)………………………………………………………13.: Type and number of affected accounts (Name of drawer / Ordering customer)………………………………………………………………………………………………………………………………………………………………………………(Name of payee / beneficiary)14.: Particulars of ID, e.g. National ID no., 20. Other bank involved (if applicable)–name/branch/countrybank account no.…………………………………………………………………………………………………………………………………………………………………….………………………………………………………………..Anti-Money Laundering/Combating Terrorist Financing Guideline May 2011 52Bank Supervision DepartmentCENTRAL BANK OF BARBADOS
AML/CFT GUIDELINEISSUED BY THECENTRAL BANK OF BARBADOSIN CONJUNCTION WITH THE ANTI-MONEY LAUNDERING AUTHORITYMAY 2011PART D Grounds for suspicion (and description if appropriate)21. Give details of the nature of and circumstances surrounding the transaction and the reason for suspicion(PLEASE WRITE IN BLOCK LETTERS)……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………….…………………………………………..…………………………………(If insufficient space, attach a separate statement)22. If additional information is attached, tick this boxFIU USE ONLY23. If identity of the customer has not been established in PART A, and they are not known to the officer, give adescription (e.g. sex, approximate age, height, build, complexion, etc.)………………………………………………………………………………………………………………….…………………………………………………………………………………………………………………………………………….…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………PART E Details of financial institution/place of transaction24. Type of cash dealer: BANK Cr. Union 28. Signatory……………………….….………….Other (describe)…………………………………………..…………29. Title/Position…….……………………..…..…25. Organisation…………………………….….. 30. Dealers Internalreference number…………………………….26. Branch……………………………………….27. Address of Branch ……………………………………………………………………………….Anti-Money Laundering/Combating Terrorist Financing Guideline May 2011 53Bank Supervision DepartmentCENTRAL BANK OF BARBADOS
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Revised Central Bank-AMLA Guidelines - Anti-Money Laundering ...

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