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@extends('frontend.layouts.master')

@section('title', 'KYC Form')

@section('content')

<div class="header__banner__main header__banner__inner">
    @include('frontend.common.bannerImage')
    
    <div class="banner__content">
        <div class="banner__container__inner">
            <h1><span>KYC</span> Form</h1>
        </div>
    </div>
</div>

<div class="body__content__main body__containt__main__inner">
    <div class="common__wrapp">
        <div class="container">
            <div class="contact__wrapp">
              <form action="{{ route('kycFormSubmit') }}" method="POST" enctype="multipart/form-data">
                @csrf
                 <h2 class="text-center pb-4"><b>KYC APPLICATION:</b></h2>
                 <div class="row m-0">
                    <label class="col-md-4 control-label" >Purpose of this Account:</label>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <label class="checkbox-inline" >
                          <input type="radio" name="purpose_of_account" id="account-0" value="Mining Co" required>
                          Mining Co
                          </label>
                          &nbsp; &nbsp;
                          <label class="checkbox-inline" >
                          <input type="radio" name="purpose_of_account" id="account-1" value="Trading">
                          Trading
                          </label>
                           &nbsp; &nbsp;
                          <label class="checkbox-inline" >
                          <input type="radio" name="purpose_of_account" id="account-2" value="Broker">
                          Broker
                          </label>
                           &nbsp; &nbsp;
                          <label class="checkbox-inline">
                          <input type="radio" name="purpose_of_account" id="account-3" value="Refinery">
                          Refinery
                          </label>
                       </div>
                    </div>
                    <div class="col-md-12">
                       <div class="form-group form__group">
                          <label for="" class="form-label">Corporate Name:</label>
                          <input type="text" class="form-control form__control " name="corporate_name" value="" required="">
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <label for="" class="form-label">Business Type:</label>
                          <input type="text" class="form-control form__control " name="business_type" value="" required="">
                       </div>
                       <div class="form-group form__group">
                          <label for="" class="form-label">Address:</label>
                          <textarea class="form-control form__control " name="business_address" id="" cols="30" rows="3" required></textarea>
                       </div>
                       <div class="form-group form__group">
                          <label for="" class="form-label">Post Box No.:</label>
                          <input type="text" class="form-control form__control " name="business_post_box_no" value="" required="">
                       </div>
                       <div class="form-group form__group">
                          <label for="" class="form-label">E-mail Address:</label>
                          <input type="email" class="form-control form__control " name="business_email" value="" required="">
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <label for="" class="form-label">Regulated by:</label>
                          <input type="text" class="form-control form__control " name="business_regulated_by" value="" required="">
                       </div>
                       <div class="form-group form__group">
                          <label for="" class="form-label"> Tel:</label>
                          <input type="text" class="form-control form__control " name="business_tel" value="" required="">
                       </div>
                       <div class="form-group form__group">
                          <label for="" class="form-label"> Mob:</label>
                          <input type="text" class="form-control form__control " name="business_mob" value="" required="">
                       </div>
                       <div class="form-group form__group">
                          <label for="" class="form-label"> Fax:</label>
                          <input type="text" class="form-control form__control " name="business_fax" value="" required="">
                       </div>
                       <div class="form-group form__group">
                          <label for="" class="form-label"> License No.:</label>
                          <input type="text" class="form-control form__control " name="business_license_no" value="" required="">
                       </div>
                    </div>
                    <div class="col-md-12">
                       <div class="form-group form__group">
                          <label for="" class="form-label">Owners Name(s):</label>
                          <input type="text" class="form-control form__control " name="business_owners_name" value="" required="">
                       </div>
                    </div>
                    <b>Minerals Mining Operator:</b>
                    <div class="col-md-8">
                       <div class="form-group form__group">
                          <label for="" class="form-label">1. Name</label>
                          <input type="text" class="form-control form__control " name="mining_operator_name" value="" required="">
                       </div>
                    </div>
                    <div class="col-md-4">
                       <div class="form-group form__group">
                          <label for="" class="form-label">Passport No.</label>
                          <input type="text" class="form-control form__control " name="mining_passport_no" value="" required="">
                       </div>
                    </div>
                    <div class="col-md-4">
                       <div class="form-group form__group">
                          <label for="" class="form-label">Position</label>
                          <input type="text" class="form-control form__control " name="mining_position" value="" required="">
                       </div>
                    </div>
                    <div class="col-md-4">
                       <div class="form-group form__group">
                          <label for="" class="form-label">Email</label>
                          <input type="email" class="form-control form__control " name="mining_email" value="" required="">
                       </div>
                    </div>
                    <div class="col-md-4">
                       <div class="form-group form__group">
                          <label for="" class="form-label">Tel:</label>
                          <input type="text" class="form-control form__control " name="mining_tel" value="" required="">
                       </div>
                    </div>
                    <b>Minerals refinery:</b>
                    <div class="col-md-8">
                       <div class="form-group form__group">
                          <label for="" class="form-label">2. Name</label>
                          <input type="text" class="form-control form__control " name="refinery_name" value="" required="">
                       </div>
                    </div>
                    <div class="col-md-4">
                       <div class="form-group form__group">
                          <label for="" class="form-label">Passport No.</label>
                          <input type="text" class="form-control form__control " name="refinery_passport_no" value="" required="">
                       </div>
                    </div>
                    <div class="col-md-4">
                       <div class="form-group form__group">
                          <label for="" class="form-label">Position</label>
                          <input type="text" class="form-control form__control " name="refinery_position" value="" required="">
                       </div>
                    </div>
                    <div class="col-md-4">
                       <div class="form-group form__group">
                          <label for="" class="form-label">Email</label>
                          <input type="text" class="form-control form__control " name="refinery_email" value="" required="">
                       </div>
                    </div>
                    <div class="col-md-4">
                       <div class="form-group form__group">
                          <label for="" class="form-label">Tel:</label>
                          <input type="text" class="form-control form__control " name="refinery_tel" value="" required="">
                       </div>
                    </div>
                    <b>Minerals Seller/Broker:</b>
                    <div class="col-md-8">
                       <div class="form-group form__group">
                          <label for="" class="form-label">3. Name</label>
                          <input type="text" class="form-control form__control " name="seller_name" value="" required="">
                       </div>
                    </div>
                    <div class="col-md-4">
                       <div class="form-group form__group">
                          <label for="" class="form-label">Passport No.</label>
                          <input type="text" class="form-control form__control " name="seller_passport_no" value="" required="">
                       </div>
                    </div>
                    <div class="col-md-4">
                       <div class="form-group form__group">
                          <label for="" class="form-label">Position</label>
                          <input type="text" class="form-control form__control " name="seller_position" value="" required="">
                       </div>
                    </div>
                    <div class="col-md-4">
                       <div class="form-group form__group">
                          <label for="" class="form-label">Email</label>
                          <input type="text" class="form-control form__control " name="seller_email" value="" required="">
                       </div>
                    </div>
                    <div class="col-md-4">
                       <div class="form-group form__group">
                          <label for="" class="form-label">Tel:</label>
                          <input type="text" class="form-control form__control " name="seller_tel" value="" required="">
                       </div>
                    </div>
                 </div>
                 <h2 class="text-center pb-4"><b>KNOW YOUR CUSTOMER (KYC) FORM STRICTLY CONFIDENTIAL</b></h2>
                 <div class="row m-0">
                    <div class="col-md-6">
                       <b>S.N. Particulars</b>
                       <div class="form-group form__group">
                          <label for="" class="form-label">1. Full Name of the Customer:</label>
                       </div>
                    </div>
                    <div class="col-md-6">
                       <b>Details</b>
                       <div class="form-group form__group">
                          <input type="text" class="form-control form__control " name="customer_fullname" value="" required="">
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <label for="" class="form-label">2. Legal Status</label>
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <label class="checkbox-inline">
                              <input type="radio" name="customer_legal_status" id="legal_status_0" value="Individual" required="">
                              Individual
                          </label>
                          <label class="checkbox-inline">
                              <input type="radio" name="customer_legal_status" id="legal_status_1" value="Company">
                              Company
                          </label>
                          <label class="checkbox-inline">
                              <input type="radio" name="customer_legal_status" id="legal_status_2" value="Partnership">
                              Partnership
                          </label>
                       </div>
                       <div class="form-group form__group">
                          <label for="" class="form-label">Others:</label>
                          <input type="text" class="form-control form__control " name="customer_others" value="">
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <label for="" class="form-label">3. Permanent Address</label>
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <textarea class="form-control form__control " name="costomer_permanent_address" id="" cols="30" rows="3" required></textarea>
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <label for="" class="form-label">4. Business/Trading Address</label>
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <textarea class="form-control form__control " name="costomer_business_address" id="" cols="30" rows="3" required></textarea>
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <label for="" class="form-label">5. ID No./CR No./Registration No.</label>
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <input type="text" class="form-control form__control " name="costomer_reg_no" value="" required="">
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <label for="" class="form-label">6. Purpose and Nature of Transaction to be undertaken</label>
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <input type="text" class="form-control form__control " name="costomer_undertaken" value="" required="">
                       </div>
                    </div>
                    <b>7. In case of Individual</b>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <label for="" class="form-label">(i) Nationality</label>
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <input type="text" class="form-control form__control " name="costomer_nationality" value="" required="">
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <label for="" class="form-label">(ii) Occupation or Profession</label>
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <input type="text" class="form-control form__control " name="costomer_profession" value="" required="">
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <label for="" class="form-label">(iii) Name of Establishment or Employer</label>
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <input type="text" class="form-control form__control " name="name_of_establishment_or_employer" value="" required="">
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <label for="" class="form-label">(iv) Location of activity</label>
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <input type="text" class="form-control form__control " name="location_of_activity" value="" required="">
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <label for="" class="form-label">(v) Is the Individual a Politically Important Person (PEP)?</label>
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <label class="checkbox-inline" >
                          <input type="radio" name="politically_important_person" id="person_Yes" value="Yes" required="">
                          Yes
                          </label>
                          &nbsp; &nbsp;
                          <label class="checkbox-inline" >
                          <input type="radio" name="politically_important_person" id="person_No" value="No">
                          No
                          </label>
                       </div>
                    </div>
                    <b>8. In case of Others</b>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <label for="" class="form-label">(i) City & Country of Incorporation</label>
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <input type="text" class="form-control form__control " name="city_&_country_of_incorporation" value="" required="">
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <label for="" class="form-label">9. Date of Birth / Incorporation</label>
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <input type="date" class="form-control form__control " name="date_of_birth" value="" required="">
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <label for="" class="form-label">10. What is the principal business/activity of the Customer?</label>
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <input type="text" class="form-control form__control " name="activity_of_the_customer" value="" required="">
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <label for="" class="form-label"><b>11. Is the Customer acting on behalf of another Person? If Yes,</b></label>
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <label class="checkbox-inline">
                          <input type="radio" name="customer_behalf_another_person" id="another_person_Yes" value="Yes" required="">
                          Yes
                          </label>
                          &nbsp; &nbsp;
                          <label class="checkbox-inline">
                          <input type="radio" name="customer_behalf_another_person" id="another_person_No" value="No">
                          No
                          </label>
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <label for="" class="form-label">(i) Name of Beneficial Owner</label>
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <input type="text" class="form-control form__control " name="name_of_beneficial_owner" value="" required="">
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <label for="" class="form-label">(ii) ID No./CR No./Registration No.</label>
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <input type="text" class="form-control form__control " name="another_person_reg_no" value="" required="">
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <label for="" class="form-label">(iii) Domicile Country</label>
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <input type="text" class="form-control form__control " name="another_person_domicile_country" value="" required="">
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <label for="" class="form-label">(iv) If Beneficial Owner is an Individual, then</label>
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <input type="text" class="form-control form__control " name="another_person_owner_is_an_individual" value="" required="">
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <label for="" class="form-label">a) Nationality</label>
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <input type="text" class="form-control form__control " name="nother_person_nationality" value="" required="">
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <label for="" class="form-label">b) Is the Individual a Politically Important Person (PEP)?</label>
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <label class="checkbox-inline" >
                          <input type="radio" name="is_the_individual_another_person" id="individual-Yes" value="Yes" required="">
                          Yes
                          </label>
                          &nbsp; &nbsp;
                          <label class="checkbox-inline" >
                          <input type="radio" name="is_the_individual_another_person" id="individual-No" value="No">
                          No
                          </label>
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <label for="" class="form-label">12. Regulatory Status</label>
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <label class="checkbox-inline" >
                          <input type="radio" name="regulatory_status" id="regulatory_status-Independent" value="Independent" required>
                          Independent
                          </label>
                          &nbsp; &nbsp;
                          <label class="checkbox-inline" >
                          <input type="radio" name="regulatory_status" id="regulatory_status-Non-Independent" value="Non-Independent Regulator">
                          Non-Independent Regulator
                          </label>
                          &nbsp; &nbsp;
                          <label class="checkbox-inline" >
                          <input type="radio" name="regulatory_status" id="regulatory_status-Unregulated" value="Unregulated">
                          Unregulated
                          </label>
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <label for="" class="form-label">13. Name of Regulator (if any)</label>
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <input type="text" class="form-control form__control " name="name_of_regulator" value="" required="">
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <label for="" class="form-label">14. Name of Stock Exchange (if Listed)</label>
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <input type="text" class="form-control form__control " name="name_of_stock_exchange" value="" required="">
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <label for="" class="form-label">15. If a Holding company, name of any other subsidiaries/branches/associated companies
                          </label>
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <input type="text" class="form-control form__control " name="name_of_any_other_subsidiaries" value="" required="">
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <label for="" class="form-label">16. If not, Group Company (if any)</label>
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <input type="text" class="form-control form__control " name="group_company" value="" required="">
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <label for="" class="form-label">17. If business activities are conducted in more than one country, please indicate names of all countries</label>
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <input type="text" class="form-control form__control " name="name_of_all_countries" value="" required="">
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <label for="" class="form-label">18. Bank Details</label>
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <input type="text" class="form-control form__control " name="bank_details" value="" required="">
                       </div>
                    </div>
                    <b>19. Contact Details of Customer</b>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <label for="" class="form-label">(i) Contact Person</label>
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <input type="text" class="form-control form__control " name="contact_person" value="" required="">
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <label for="" class="form-label">(ii) Tel & Fax</label>
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <input type="text" class="form-control form__control " name="tel_&_fax" value="" required="">
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <label for="" class="form-label">(iii) E-mail/website</label>
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <input type="text" class="form-control form__control " name="email_website" value="" required="">
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <label for="" class="form-label">(iv) Contact details of Compliance Officer (if any)</label>
                       </div>
                    </div>
                    <div class="col-md-6">
                       <div class="form-group form__group">
                          <input type="text" class="form-control form__control " name="contact_details_compliance_officer" value="" required="">
                       </div>
                    </div>

</div>

<div class="mt-5">
                        <table cellspacing="0" cellpadding="0"
                                style="border:1px solid #000; width:100%; padding:10px; margin:0px auto;">
                            <thead>
                                <tr>
                                    <th colspan="4"
                                        style="font-size:15px; font-weight:700; font-family:Arial, Helvetica, sans-serif; text-align:left; border:1px solid #000; border-bottom:0px;">
                                        <h1 style="padding:10px; line-height:normal; margin:0px;">20. Copies* of Customer Identification
                                        Documents
                                        </h1>
                                    </th>
                                </tr>
                                <tr>
                                    <th colspan="4"
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; font-style:italic; padding:10px; border:1px solid #000; border-bottom:0px;">
                                        <p>Please submit the documents and tick (x) against the documents attached</p>
                                    </th>
                                </tr>
                            </thead>
                            <tbody>
                                <tr>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000; border-bottom:0px; border-right:0px; text-align:center;">
                                        <p>(i)</p>
                                    </td>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000;border-bottom:0px; border-right:0px">
                                        <p>Individual</p>
                                    </td>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000; border-bottom:0px; border-right:0px">
                                        <p>ID Card/Passport/Driving License (DL)</p>
                                    </td>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000; border-bottom:0px;">
                                        <p>Proof of Domicile Country**</p>
                                    </td>
                                </tr>
                                <tr>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000; border-bottom:0px; border-right:0px; text-align:center;">
                                        <p>(ii)</p>
                                    </td>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000;border-bottom:0px; border-right:0px">
                                        <p>Company</p>
                                    </td>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000;border-bottom:0px; border-right:0px">
                                        <p>Company Registration</p>
                                    </td>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000; border-bottom:0px;">
                                        <p>List & Passport copies of Authorised Signatories</p>
                                    </td>
                                </tr>
                                <tr>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000; border-bottom:0px; border-right:0px; text-align:center;">
                                    </td>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000;border-bottom:0px; border-right:0px">
                                    </td>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000;border-bottom:0px; border-right:0px">
                                        <p>Major Shareholders:</p>
                                    </td>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000; border-bottom:0px;">
                                        <p>List of Major Shareholders</p>
                                    </td>
                                </tr>
                                <tr>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000; border-bottom:0px; border-right:0px; text-align:center;">
                                    </td>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000;border-bottom:0px; border-right:0px">
                                    </td>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000;border-bottom:0px; border-right:0px">
                                        <p>Shareholders who, directly or indirectly</p>
                                    </td>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000; border-bottom:0px;">
                                        <p>List & Proof of Domicile Country** of Directors</p>
                                    </td>
                                </tr>
                                <tr>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000; border-bottom:0px; border-right:0px; text-align:center;">
                                    </td>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000;border-bottom:0px; border-right:0px">
                                    </td>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000;border-bottom:0px; border-right:0px">
                                        <p>owns or controls more than5% of the shares or voting rights</p>
                                    </td>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000; border-bottom:0px;">
                                    </td>
                                </tr>
                                <tr>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000; border-bottom:0px; border-right:0px; text-align:center;">
                                        <p>(iii)</p>
                                    </td>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000;border-bottom:0px; border-right:0px">
                                        <p>Partnership</p>
                                    </td>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000;border-bottom:0px; border-right:0px">
                                        <p>Certificate of Registration</p>
                                    </td>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000; border-bottom:0px;">
                                        <p>Partnership Deed</p>
                                    </td>
                                </tr>
                                <tr>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000; border-bottom:0px; border-right:0px; text-align:center;">
                                    </td>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000;border-bottom:0px; border-right:0px">
                                    </td>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000;border-bottom:0px; border-right:0px">
                                        <p>List & Passport copies of Authorised Signatories</p>
                                    </td>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000; border-bottom:0px;">
                                        <p>List & Proof of Domicile Country** of Partners</p>
                                    </td>
                                </tr>
                                <tr>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000; border-bottom:0px; border-right:0px; text-align:center;">
                                        <p>(iv)</p>
                                    </td>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000;border-bottom:0px; border-right:0px">
                                        <p>Trust</p>
                                    </td>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000;border-bottom:0px; border-right:0px">
                                        <p>Certificate of Registration</p>
                                    </td>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000; border-bottom:0px;">
                                        <p>Trust Deed</p>
                                    </td>
                                </tr>
                                <tr>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000; border-bottom:0px; border-right:0px; text-align:center;">
                                    </td>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000;border-bottom:0px; border-right:0px">
                                    </td>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000;border-bottom:0px; border-right:0px">
                                        <p>List & Passport copies of Settlor, Trustees, Protector</p>
                                    </td>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000; border-bottom:0px;">
                                        <p>List & Passport copies of Authorised Signatories</p>
                                    </td>
                                </tr>
                                <tr>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000; border-bottom:0px; border-right:0px; text-align:center;">
                                    </td>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000;border-bottom:0px; border-right:0px">
                                    </td>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000;border-bottom:0px; border-right:0px">
                                    </td>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000; border-bottom:0px;">
                                        <p>List of Major Beneficiaries</p>
                                    </td>
                                </tr>
                                <tr>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000; border-bottom:0px; border-right:0px; text-align:center;">
                                    </td>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000;border-bottom:0px; border-right:0px">
                                    </td>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000;border-bottom:0px; border-right:0px">
                                        <p>Major Beneficiaries:</p>
                                    </td>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000; border-bottom:0px;">
                                        <p>Beneficiary who is to receive at least 25% of the funds of the Trust</p>
                                    </td>
                                </tr>
                                <tr>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000; border-bottom:0px; border-right:0px; text-align:center;">
                                        <p>(v)</p>
                                    </td>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000;border-bottom:0px; border-right:0px">
                                        <p>Any other Legal Person</p>
                                    </td>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000; border-bottom:0px; border-right:0px">
                                        <p>Registration Document</p>
                                    </td>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000; border-bottom:0px;">
                                        <p>List & Passport copies of Authorised Signatories</p>
                                    </td>
                                </tr>
                                <tr>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000; border-right:0px;border-bottom:0px; text-align:center;">
                                    </td>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000; border-right:0px;  border-bottom:0px; text-align:center;">
                                    </td>
                                    <td colspan="2"
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000; border-bottom:0px;">
                                        <p>List of the Individuals/Entities who ultimately owns, or exercises effective control over such person
                                        </p>
                                    </td>
                                </tr>
                                <tr>
                                    <td colspan="2"
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000; border-right:0px;">
                                        <p><strong>Declaration</strong></p>
                                    </td>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000; border-right:0px; text-align:center;">
                                    </td>
                                    <td
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000; text-align:center;">
                                    </td>
                                </tr>
                                <tr>
                                    <td colspan="4"
                                        style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000; border-top:0px; border-bottom:0px;">
                                        <p>I/We hereby confirm that the above information provided to you is true and correct to the best of our
                                            knowledge.
                                        </p>
                                        <p>I/We acknowledge that if the information provided is found to be false or misleading then the
                                            business relationship may be annulled anytime at your discretion. I/We hereby agree to provide any
                                            additional information/documentation that may be required.
                                        </p>
                                    </td>
                                    <tr>
                                        <td width="50%" height="150" colspan="2"
                                            style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000; border-right:0px;  border-bottom:0px;">
                                            <p>Date</p>
                                            <div class="form-group form__group">
                                              <input type="date" class="form-control form__control " name="declaration_date" value="" required="">
                                            </div>
                                        </td>
                                        <td colspan="2"
                                            style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000; border-bottom:0px;">
                                            <p>Signature of Authorised Signatory</p>

<div class="form-group form__group">
                              <input type="file" class="form-control form__control " name="declaration_signature" value="" required="">
                           </div>
                                        </td>
                                    </tr>
                                    <tr>
                                        <td colspan="4"
                                            style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000; border-bottom:0px;">
                                            <p>*Certified copies of documents clearly signed, stamped and dated by any of the following: -</p>
                                        </td>
                                    </tr>
                                    <tr>
                                        <td colspan="4"
                                            style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000; border-bottom:0px;">
                                            <p>(1) A representative of an embassy, consulate, or high commission of the country; or</p>
                                            <p>(2) A lawyer or attorney; or</p>
                                            <p>(3) A notary public or commissioner of oaths; or</p>
                                            <p>(4) A chartered or certified accountant.</p>

<div class="form-group form__group">
                              <input type="file" class="form-control form__control " name="declaration_documents" value="" required="">
                           </div>
                                        </td>
                                    </tr>
                                    <tr>
                                        <td colspan="4"
                                            style="font-size:12px; font-weight:400; font-family:Arial, Helvetica, sans-serif; text-align:left; padding:10px; border:1px solid #000;">
                                            <p>The date of signatory should not be older than 3 months.</p>
                                            <p>Copies of certified copies is not acceptable.</p>
                                            <p>**Any document to show the residential address like utility bill, tenancy agreement</p>
                                        </td>
                                    </tr>
                                </tbody>
                        </table>
                    </div>

<div class="row mt-5">
                        
                       <div class="col-md-12">
                          <div class="form-group form__group">
                             <label for="" class="form-label">Any of the above information that does not fit into the allocated column should be presented below or other information you may wish to disclose:</label>
                          </div>
                       </div>
                       <div class="col-md-12">
                          <div class="form-group form__group">
                             <textarea name="declaration_text" class="form-control" cols="30" rows="15"></textarea>
                          </div>
                       </div>
                    </div>
                    <div class="">
                        <button type="submit" class="btn btn-primary">Submit</button>
                    </div>
                 </div>
              </form>

</div>
        </div>
    </div>
  </div>

@endsection

[+] event
[-] faq.blade.php [edit]
[+] ..
[-] dynamicPage.blade.php [edit]
[-] contact.blade.php [edit]
[-] requestADemo.blade.php [edit]
[-] team.blade.php [edit]
[+] career
[-] kycForm.blade.php [edit]