FORM A2 – Customer Particulars

(For Entity / Legal Arrangement)

RES / CEA Details

RES Name

CEA Reg. No.:

Date of Form Completion

RES is representing

1. Information on Entity / Legal Arrangement

Is the representative authorised to act on behalf of the entity/legal arrangement?

If Yes, keep a copy of the Letter of Authorisation.

Full name of entity/legal arrangement (as per ACRA records)

Keep a copy of ACRA Certificate of Incorporation (if applicable).

Registered office address

Principal address of business (if different)

Telephone no.

Email address

UEN / Incorporation / Registration no.

Date of incorporation / registration

Country / territory of incorporation / registration

Main business activity

Type of entity / legal arrangement

2. Particulars of Senior Management Personnel

Are the senior management personnel the beneficial owners of the entity/legal arrangement?

Senior Management Personnel – Person 1

Designation

Full name

Type of Identification Document

Identity Card No.

Nationality

Senior Management Personnel – Person 2

Designation

Full name

Type of Identification Document

Identity Card No.

Nationality

3. Beneficial Owner(s)

Identify and verify beneficial owners. If unavailable, obtain details of the senior management personnel.

Beneficial Owner – 1

Full name

Type of Identification Document

Identity Card No.

Date of birth

Nationality

Occupation

Residential address

Beneficial Owner – 2

Full name

Type of Identification Document

Identity Card No.

Date of birth

Nationality

Occupation

Residential address

Client’s Acknowledgement & Signature

I acknowledge that all the information I have provided in this form is true, accurate and complete to the best of my knowledge.
I understand that the estate agent (EA) or real estate salesperson (RES) to whom I am providing the information as set out in this form is required to obtain such information from me and obtain my acknowledgement on the information provided in their conduct of customer due diligence (CDD) measures under the Estate Agents (Prevention of Money Laundering, Proliferation Financing and Terrorism Financing) Regulations 2021. The EA or RES may also request for additional information or documents from me to fulfil their CDD duty.

Name

Date

-

Signature

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