Questionnaire for new contractors

Dear contractors!

We are very grateful for your time to fill out this questionnaire. We are confident that mutual understanding, reliability and openness between us will be the key to long-term and stable cooperation.

To complete the internal approval process and agree to work with your company, we need the information below.

When completing this Know Your Counterparty Form (“KYC”), please follow the instructions and provide all the relevant information most applicable to you. Please ensure you provide all relevant information in a complete and orderly manner, as missing or incomplete information will delay the approvals and check process and cause delays in the commencement of a commercial relationship between KATMA GROUP LLC and you. If you have any questions, please contact us at: info@katma.com.ua.

Submission of the above information does not guarantee registration with KATMA GROUP LLC. KATMA GROUP LLC reserves the right to reject any application without assigning any reason(s) whatsoever.

Following receipt of the above information, KATMA GROUP LLC shall evaluate and assess your application for registration, which may require the submission of additional information or documentation on a case-by-case basis. At the time of first receipt of any confidential information from you, KATMA GROUP LLC is deemed to have signed the attached Non-Disclosure Agreement and shall bound by its terms. Following completion of the evaluation process, KATMA GROUP LLC shall notify you as to whether your application for registration has been successful or not.

Please confirm that:

We hereby declare that the information provided by us in: (i) this KYC form; and (ii) any additional supporting documentation we have provided to KATMA GROUP LLC in connection with this KYC form (collectively the “Information”), is true and correct and we undertake to inform KATMA GROUP LLC promptly of any changes to the Information. Should any of the information provided appear to be false, incorrect or misleading we will hold KATMA GROUP LLC harmless for any negative results that KATMA GROUP LLC may suffer as a result thereof.

YES

We hereby acknowledge that we understand and have no objection to the fact that the information we provide in this KYC form will be analyzed and verified by programs such as Worldcheck, Ethixbase, Credicheck and others.

YES

We hereby acknowledge receipt of and confirm having read and understood the terms and conditions set forth in a Confidentiality Agreement received from KATMA GROUP LLC and agree to be bound by the confidentiality and other obligations set forth therein.

YES

We further acknowledge and warrant that any and all personal data which is disclosed or transferred to KATMA GROUP LLC will be shared to KATMA GROUP LLC in compliance with applicable data privacy & protection laws and in accordance with the terms of the Confidentiality Agreement attached to this KYC form and we acknowledge that such personal data will be used by KATMA GROUP LLC for its business purposes, to comply with applicable legal requirements.

YES

CONFIDENTIALITY AGREEMENT

1. Company name

2. Full address

3. Website

4. Tax number

5. Certificate number of VAT payer, date of registration

6. Size of business according to the laws of the country of incorporation (small, medium, large, other option)

7. Number of employees

8. Amount of paid authorized capital ($)

9. How long has your company been trading in petroleum products/services in the industry?

10. Is trade in petroleum products/services in this area the only activity of your company?

11. Product origin (if applicable)

12. How long has your company been working with the supplier of the Goods you plan to supply to our company? (if applicable)

13. Director's full name, country of residence

14. List of beneficiaries, country of residence

15. Presence of politically exposed person status of owners/director/board

16. Presence of owners/directors/board members on sanctions lists

17. Average monthly turnover of the company ($)

18. The company's turnover for the last year ($)

19. How many shipments of petroleum products/services does your company make per month?

20. The company's Ebitda (if not calculated, then net profit) for the past year ($)

21. Value of company's fixed assets ($)

22. Real estate, total value ($)

23. Payables of the company at the time of completing this form ($)

24. Number of legal proceedings in which the company is a defendant, as of the moment of completing this form, total amount of disputable funds

25. The number of enforcement proceedings in which the company is a debtor, as of the moment of completing this form, the total amount of funds to be recovered

26. Taxes owed over the last three reporting periods, total amount ($)

27. Please attach statutory documents

28. Please attach latest financial report

29. Please attach last auditor's report

30. Please attach company ownership structure

31. Bank details:

Name of account holder (name of counterparty)

IBAN number, (or account number if the country does not use an IBAN)

Account currency

32. Information of the employee who filled in the form:

a) - NAME

b) - E-mail

c) - phone

Captcha