Capital Markets Authority Know Your Customer (KYC) Form Decision

Decision Number 17
Know your Customer (KYC) Form
The CMA Chairman/Governor of the Central Bank of Lebanon, Pursuant to Law 161 of August 17, 2011 on Capital Markets, whereby the CMA is vested with all the powers pertaining to financial instruments, And pursuant to the Decision of the Capital Markets Authority Board taken at its meeting of March 2, 2015, Declares the following,
Article One: The provisions of this decision shall apply to financial intermediation
institutions, financial institutions, and banks dealing in securities in Lebanon.
Article Two: Following the issuance of this decision, any of the aforementioned institutions
that wish to open accounts, to deal in/trade in securities as agent should:

• Adopt KYC form that contains at least the information in the attached
  form.
• Provide CMA with a copy of the said form.
  The aforementioned institutions that deal in/trade in securities as agent in accounts opened before the date of publication of this decision will be granted till 1/1/2016 to apply the provisions of this decision.
  Article Three: This Decision shall come into force upon its publication in the Official
  Gazette.
  Beirut, on February 10, 2014.
  Chairman of CMA / Governor of the Central Bank Riad Toufic Salameh (Signature)

Know Your Customer (K Y C)
If the Client is an Individual
Full Name:
Date of Birth:
ID Number:
Family Status:
Number of Family Members:
Nationality:
Other Nationality:
Address of the Correspondence:
Email Address:
Telephone Number:
Mobile Number:
Approximate Annual Income in USD?
25,000 or less
25,001 – 50,000
50,001 – 100,000
100,001 - 250,000
250,001 – 500,000
500,001 – 1,000,000
More than 1,000,000
Approximate Investible Assets in USD?
25,000 or less
25,001 – 100,000
100,001 - 500,000
500,001 – 1,000,000
1,000,001 – 5,000,000
More than 5,000,000
Is the Client a Member of Board of Directors or Manager in a Listed Company or Issuer? Yes/No Is the Client having access, by law, to special information not made public in a

Listed Company or Issuer? Yes/No
Is the Client in a personal close relation with a person having access by law, to special information not made public in a Listed Company or Issuer? Yes/No Any other Financial Info? If the Client is an Entity Company’s Legal Name:
Registered Address:
Country of Registration:
Date of Establishment or Activity
Starting:
Telephone Number:
Fax Number:
Number of Employees:
Paid Capital:
Annual Business Turnover:
Contact Person:
Representative Name and Authority:
Address of the Correspondence:
Company’s Telephone Number:
Company’s Fax Number:
Company’s Mobile Number:
Email Address:
Any other Financial Info?

Information about Investment
 Evaluate the Client's knowledge and investment experience and specify which of the Financial Products as follows:
1- Weak
2- Good
3- Excellent
 Stocks
 Bonds
 Forex
 Deposits
 Trade Finance
 Investment Funds
 Structured Financial Products
 Derivatives
 Future Contracts
 Real Estate
Client’s Capacity to Bear Risks:

• Low □Medium □High
  Please Clarify the Answer Above:
  Client's Purpose behind Investment?
   Hedging
   Income
   Balance
   Capital Growth