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CUSTOMER INFORMATION FORM PRIVATE PERSONS
Before subscription, please read key investor information (KIID) and fund regulations at
www.fondita.com
Name of customer:
*
required
Personal identity code:
*
required
Home address:
*
required
Postal code and city:
*
required
E-mail address:
*
required
Phone number:
E-mail may be used for reporting
*
required
Yes
No
Language
*
required
English
Finnish
Swedish
Bank account number (IBAN):
*
required
BIC / SWIFT:
Does any other person have ownership or user rights to the bank account?
*
required
Yes
No
Name of the person
*
required
Citizenship(s)
*
required
Countries of taxation:
*
required
If you answered other than Finland on the previous question, please provide us your Taxpayer Identification Number in the country concerned.
TIN code:
Possible additional entity or person for reporting purposes:
The customer may approve sharing of information to another person or entity. It is not to be considered as proxy for dealing instructions.
The questions below are based on
the Act on Detecting and Preventing Money Laundering and Terrorist Financing.
We are obligated to collect the following information to fulfil our legal obligations.
Estimated earned / capital income per year:
*
required
< 30 000
30 000 - 60 000
60 000 - 100 000
over 100 000 euro
Estimated net worth (assets - liabilities) in euro:
*
required
Origin of assets used for subscription:
*
Salary
Capital income
Inheritance / Gift
Other
What?
*
Politically exposed person means a natural person who is or who has been entrusted during the last 12 months with prominent public functions including one the following:
heads of State, heads of government, ministers and deputy or assistant ministers
members of parliament
members of the governing bodies of political parties
members of supreme courts, of constitutional courts or of other high-level judicial bodies, the decisions of which are not subject to further appeal, except in exceptional circumstances
members of courts of auditors or members of organ that inspects financial administration of state corresponding to State Auditor's Office
members of the boards of central banks
ambassadors or chargés d'affaires
high-ranking officers in the armed forces
members of the adminitrative, management or supervisory bodies of State-owned enterprises
directors, deputy directors and members of the board or equivalent function of an international organisation
Politically exposed person’s family members include the following:
the spouse, or a person considered to be equivalent to a spouse under the legislation of the country in question, of a politically exposed person
the children and their spouses, or persons considered to be equivalent to a spouse, of a politically exposed person
the parents of the politically exposed person
The investor is or has been a politically exposed person (
PEP
) during the last 12 months or a family member or a close business partner to one?
*
required
Yes
No
Additional information if the answer is yes:
*
The investor has any of the following connections to the United States: 1) tax liability, 2) birthplace, 3) citizenship
*
required
Yes
No
Please provide your US TIN or Social Security number:
*
The objective of the subscription?
*
required
General investment activity / return on investment
Other
Other, what?
*
required
I agree to inform the Fund Management Company about changes in the client details.
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