CLIENT INFORMATION FORM

INDIVIDUAL
FORM #CUF-032024
Thank you for your interest in joining the JMMB Group. Certain information will need to be provided. Please see the Client Requirements Checklist for requirements for each territory.
Kindly select territory where application is being completed Universal Client Number
☐ Jamaica (JA) ☐ Trinidad & Tobago (TT) ☐ Dominican Republic (DR)
PERSONAL INFORMATION
Title (Mr. Ms. Mrs. Other) First Name Middle Name(s) Last Name

Alias (If applicable) Mother’s Maiden Name: Gender: ☐ Male ☐ Female

Marital Status ☐Single ☐ Married ☐ Separated ☐ Common Law ☐ Divorced ☐ Widowed
Date of Birth (dd/mm/yyyy) Country of Birth (Nationality) Country of Citizenship Country where tax is paid (tax residence)

Are you a National of any other Are you a citizen/permanent resident of any other Is Tax paid in any other country? ☐ Yes ☐ No
Country? ☐ No ☐ Yes country? ☐ No ☐ Yes If Yes state:
If Yes state: If Yes state country:
State TIN: State TIN:
POLITICALLY EXPOSED PERSONS (PEP)
Are you or any of your immediate family members (spouse*, child, step & adopted child, parents, siblings, child’s spouse*) or their close business
associates, a current or former Head of State, Head of Government, member of any House of Parliament, Minister of Government, member of the
judiciary, military official above the rank of Captain, member of police above the rank of Assistant Commissioner, Permanent Secretary or Chief
Technical Director in charge of a Government department/ministry/executive agency/ statutory body, official of any political party &/or director
or CEO of any company owned by your country of residence or a foreign government?
☐ No ☐Yes If Yes in what capacity?
* including common-law

Are you acting as a trustee for another in relation to the business relationship or one-off transaction concerned? ☐ No ☐Yes
CONTACT INFORMATION
Residential/Permanent Address (Proof of address required – no older than 3 months)

Parish/City: State: Zip Code/Sector: Country:

How long have you been living at this address? If less than 10 years please indicate previous address below.
☐ More than 10 years ☐ Less than 10 years
Previous address:

Parish/City: State: Zip Code/Sector: Country:

Mailing address if different from residential address:

Parish/City: State: Zip Code/Sector: Country:

Telephone Numbers: Home: Work: Mobile (1): Mobile (2):

Email address (1) Email address (2)

Preferred Method of Contact: Call: ☐ Home ☐ Work ☐ Mobile ☐ Email ☐ WhatsApp ☐ SMS
EMPLOYMENT INFORMATION
Primary Employment Status ☐Full Time ☐Part Time ☐Retired ☐Self Employed ☐Student ☐Unemployed ☐Minor
Industry/Sector: Occupation/Profession: Start Date:

Employer’s Name
(Business name if self-employed):
Employer’s Address:
Parish/City: State: Zip Code/Sector: Country:
CONTACT PERSON INFORMATION
Name Address

Relationship Contact Numbers Email address

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INCOME DETAILS & PROJECTED LEVEL OF ACTIVITY
Income Range gross per annum (e.g. between $100,000 - What is the maximum projected level of activity within a year? (E.g. between $100,000 - $200,000)
$200,000)

Expected transaction amounts and frequency (e.g. $10,000 Main source(s) of Funds/Income Source(s) of Wealth
per month) (How will you fund your account?) (How have you accumulated your wealth?)
Currency: Amount: ☐ Salary ☐ Investment ☐ Gift/Inheritance ☐ Salary ☐ Investment ☐ Gift/Inheritance
Frequency: ☐ Pension ☐ Other: ☐ Pension ☐ Other:
Principal Bankers Branch/Address of Principal Bankers

ELECTRONIC INDEMNITY
TO: JMMB GROUP LIMITED and its subsidiaries and affiliated companies GIFI - 012022
(including: Jamaica Money Market Brokers Ltd. (JMMB Investments); JMMB Bank (Jamaica) Limited; JMMB Investments (Trinidad & Tobago Ltd.); JMMB Bank
(T&T) Ltd.); Banco de Ahorro y Credito JMMB Bank S.A.; JMMB Puesto de Bolsa S.A.)
Authority and Indemnity re Electronic Mail and Verbal Instructions for Individual Clients
The term “JMMB Group” when used in this document means, collectively, JMMB Group Limited and all of its worldwide subsidiaries and affiliated companies, whether
such subsidiaries and affiliated companies are now in existence or are subsequently formed or become affiliated with JMMB Group Limited.
I (your client) hereby authorize JMMB Group to act on instructions for the operation of my account(s) with JMMB Group (each, an “Account”) which it receives by any
of the methods approved by me below (hereinafter referred to as “the Instructions”). I understand and agree that there is an increased level of risk and
vulnerability involved in JMMB Group acting on the Instructions received by oral communications or e-mail, and notwithstanding, desire that JMMB Group
acts on the Instructions. In consideration of JMMB Group, any of its officers or agents or otherwise accepting the Instructions, whether such Accounts are individual
or joint, or they currently exist or are subsequently opened or operated in my name, I agree:
1. that JMMB Group may accept and act on the Instructions sent by me from time to time and I voluntarily and with full knowledge take and assume any and all
risks associated with the Instructions. As such, I understand and agree that I, solely, will bear any financial (or other) loss that I may suffer as a result
of JMMB Group acting on the Instructions, even where those Instructions may have been improperly or fraudulently sent or were forged,
wrongfully altered or otherwise misused;
2. that whenever the Instructions are received by JMMB Group and purportedly sent by me (subject to specific signing instructions on the account, e.g. “any
one to sign” or “all to sign”), JMMB Group shall have no obligation to check or verify the authenticity or accuracy of the Instructions or the identity of the
sender or confirmer of the Instructions and may act on the Instructions as if they had been duly provided in writing under my signature or given by me in
person at one of your offices. I understand and agree that I, solely, will bear responsibility if the Instructions are sent from an email that is breached
or are improperly sent by someone who has access to the email from which the Instructions may be sent;
3. to irrevocably authorize JMMB Group to execute the Instructions immediately upon first receipt by any of the methods approved by me below or from time to
time (e.g. email), and to debit my/our Account(s) with all sums of money whatsoever, interest on money, costs, charges and expenses which JMMB Group
may incur or charge as a result of its complying with the Instructions. Where the Instructions are later duplicated or contradicted by instructions bearing
signatures or given by me in person at one of JMMB Group’s offices, JMMB Group may act on those instructions as well as the previous Instructions sent in
accordance with this authorization. If this should occur I acknowledge that JMMB Group shall not bear any loss or damage resulting from acting on both sets
of Instructions and I hereby agree to indemnify JMMB Group against all losses, liabilities, claims or damages which may arise. JMMB Group in line with good
customer service may endeavor to assist me to rectify, however JMMB Group is not obligated to do so. Transactions involving a third party are at the sole
discretion of that party to assist in rectifying;
4. that in acting on the Instructions, JMMB Group will at all times be deemed to have acted properly in executing the Instructions and to have completely
performed all obligations owed to me, notwithstanding that the Instructions received by JMMB Group purportedly from me may have been initiated or
communicated in error or fraudulently, or without or in excess of any required authority and notwithstanding any error or misunderstanding or lack of clarity
in the terms of such Instructions. I agree that JMMB Group may execute any Instructions by reference to the account number only, even if the name on the
account is also provided (including where there may be a discrepancy between the two). I shall at all times be bound by the Instructions received by JMMB
Group and purportedly sent by me from time to time on which JMMB Group may act. JMMB Group will be deemed to have properly received the
Instructions even if sent by someone who was not authorized to do so or are sent as a result of miscommunication or technological error;
5. that JMMB Group reserves the right, in its absolute discretion, not to act on the Instructions received in whole or in part. Without limiting that absolute power,
JMMB Group may refuse to act on the Instructions if JMMB Group believes that the Instructions were fraudulently provided. In its sole and absolute discretion,
JMMB Group may put the Instructions on hold pending further enquiry or further confirmation (whether written or otherwise) by me or another holder on the
Account. JMMB Group shall in no event or circumstances be held liable in any respect for any costs or losses suffered from declining to accept or act on the
Instructions or putting the Instructions on hold;
6. that notwithstanding the above, JMMB Group is not obligated to carry out such further enquiry or seek or obtain further confirmation (nor shall past acts of
further enquiry or confirmation be deemed to impose an obligation at any time), and it may proceed to act in accordance with the Instructions and shall in no
event or circumstances be held liable in any respect for any costs or losses suffered from so proceeding;
7. JMMB Group may from time to time change its policies in relation this authorization without notice to me. These policy changes include the types of
instructions to which this authorization may or may not apply. Unless otherwise changed by JMMB Group, the policy is that this authorization will not apply
to:
(i) changing signing instructions on accounts;
(ii) adding persons to existing accounts;
(iii) applications for cards (including debit and credit cards);
(iv) requests for, and legal documents effecting, hypothecations and guarantees;

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(v) legal documents effecting JMMB Bank loan contracts; and
(vi) Jamaica Central Securities Depository (JCSD) Pledge Forms;
8. to indemnify JMMB Group, its officers, agents and assigns and to keep each of them free and harmless from and against all actions, proceedings, liabilities,
claims, damages, diminution in value of property, costs, losses and expenses of any nature whatsoever and howsoever arising out of or in connection with
JMMB Group acting on the Instructions in whole or in part sent or having exercised (or failed to exercise) the discretion conferred upon JMMB Group in
paragraph 5 above. I irrevocably agree to pay such amounts to JMMB Group that arise pursuant to this paragraph on demand. This paragraph shall survive
the termination or invalidity of this authorization or any portion of it;
9. to be jointly and individually liable under this authority and indemnity in respect of any and all joint Accounts;
10. that JMMB Group is providing me with an additional contractual service via this authorization, and will hold and enforce its terms on me and any Account
holder(s) that are currently on or that may be added to my Account for which this service will apply. I agree that notice of the terms of this authorization to
one joint Account holder is deemed to be notice to any/all other joint Account holder(s), and all joint Account holders will be bound by the terms herein. I
undertake to inform all joint Account holder(s) of the execution of this authorization and its terms;
11. that I acknowledge that providing the Instructions is for my convenience and in my interest only and at my sole discretion and is not a feature of my Account(s)
with JMMB Group;
12. that this authorization will operate to terminate and supersede all previous authorities that I gave to JMMB Group to accept instructions on an account by
way of fax or e-mail or by oral communications;
13. that this authorization may be terminated by me or by JMMB Group upon ten (10) days’ prior written notice to the other, provided, however, that this
authorization may be terminated by JMMB Group immediately without notice in the event JMMB Group deems the security of the procedures hereby
established to have been, or potentially have been, materially compromised or breached; and provided further that termination by JMMB Group or me shall
not affect JMMB Group’s rights or release me from my obligations, including without limitation, to indemnify JMMB Group with respect to any Instructions
received by JMMB Group prior to termination;
14. JMMB Group may from time to time in writing vary, add to or replace the terms and conditions in this indemnity and unless I terminate this authorization, I
will be deemed to consent and agree to each such variation, addition and replacement which shall be binding on me;
15. that this authorization in all respects shall be construed in accordance with and governed by the laws of the country where the member company of the
JMMB Group is located.

Please indicate the method(s) for the transmission of Instructions to JMMB Group which are approved or not approved by you by checking the appropriate box. For
each method of transmission, you must indicate either Yes or No.
Method of Transmission of Instruction Yes No

1. Electronic mail (by the means of transmitting information electronically between computers
via the worldwide web hereinafter referred to as “E-mail”) at the e-mail addresses indicated
below:

Email Address: ________________________________________________

Email Address: ________________________________________________

2. Verbally (oral communication by telephone or other means) It being acknowledged and

understood by me that verbal instructions may only be provided to the Call Centre Unit,
unless otherwise permitted by JMMB Group.

DECLARATION & CONSENT

Your financial information is used to help us manage reputational, regulatory, financial and operational risks and to better serve you. Your information
may also be used to satisfy valid information requests from regulators and other service providers or individuals, wherever located, who are legally
entitled to obtain as well as maintain the confidentiality of this information. In addition, the information provided may also be shared with other
companies within JMMB Group, which term shall mean JMMB and its subsidiaries, affiliates and associated companies wherever located in the world
and whether such subsidiaries, affiliates and associated companies are now in existence or are subsequently formed or become affiliated with JMMB,
who will be entitled to retain copies of any information disclosed. The JMMB Group will ensure that the necessary technical and organizational
measures are in place to safeguard against any security breach before transferring any personal data.

It is hereby agreed and accepted that the JMMB Group reserves the right to collect, process and share as data for marketing and research efforts
any information that is provided herein. You may opt out of direct marketing of products and services by contacting the JMMB Group. Your choice to
limit marketing offers will apply until you notify us to modify your preference.

My Consent Yes No
I hereby accept and agree that JMMB Group can use my information for marketing and research purposes and
send me marketing information.

I confirm that by signing this form, I declare and acknowledge that the information given by me is correct and can be relied upon by the JMMB Group;
also that I am authorizing JMMB Group to take such steps as it may deem necessary to verify any of the information provided by me.
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I have read this form before signing and am aware of the obligations contained herein.

For further information on how JMMB Group processes your personal information, visit our website at https://jm.jmmb.com/privacy-policy to view our
privacy statement.

Client’s Signature Date (dd/mm/yyyy) ___________________

If documents were signed outside of JMMB’s Office, this section is to be completed by any of the following,
Justice of the Peace, Notary Public, Bank Manager or Attorney-at-Law.
I hereby certify that the signature(s) appearing on this form was/were affixed in my presence by the said person who Place
presented satisfactory identification. stamp/seal
here
Name Signature Date dd/mm/yyyy

FATCA CERTIFICATION
Please indicate your status by signing at A or B below
A. FATCA certification for Non-US Persons

Under penalties of perjury, I declare that I have examined the information on this form and to the best of my knowledge and belief it is true, correct, and complete. I
further certify under penalties of perjury that:
§ I am the individual that is the beneficial owner (or am authorized to sign for the individual that is the beneficial owner) of all the income to which this form relates
or am using this form to document myself as an individual that is an owner or account holder at a foreign financial institution,
§ The person named under the section entitled ‘Personal Information’ on this form is not a U.S. person,
§ The income to which this form relates is:
a) not effectively connected with the conduct of a trade or business in the United States,
b) effectively connected but is not subject to tax under an applicable income tax treaty, or
c) the partner’s share of a partnership's effectively connected income,
§ The person named under the section entitled ‘Personal Information’ on this form is a resident of the treaty country where they indicated tax is paid (if any) within
the meaning of the income tax treaty between the United States and that country, and
§ For broker transactions or barter exchanges, the beneficial owner is an exempt foreign person as defined in the instructions.
Furthermore, I authorize this form to be provided to any withholding agent that has control, receipt, or custody of the income of which I am the beneficial owner or any
withholding agent that can disburse or make payments of the income of which I am the beneficial owner.

I agree that I will advise the JMMB Group immediately if any certification made on this form is no longer valid.

Signature of beneficial owner (or individual authorized to sign for beneficial owner) Date DD/MM/YYYY

B. FATCA Certification for US Persons

Under penalties of perjury, I certify that:

1. The Taxpayer Identification Number (TIN) provided is correct (or I am waiting for a number to be issued to me), and
2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS)
that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to
backup withholding, and
3. I am a U.S. citizen, or other U.S. person (Including Green Card Holders or Persons with Substantial Us Presence e.g. Students)

Certification instructions - You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you
have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or
abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and
dividends, you are not required to sign the certification, but you must provide your correct TIN.

Signature of US Person Social Security Number (SSN) Date DD/MM/YYYY

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FOR INTERNAL USE ONLY

Subsidiary/Branch/Department: _______________________________________________________________________________________

Documents Received from Client (kindly attach to this form)

c Driver’s Licence c Passport c National ID + Birth/Adoption Certificate c Marriage Certificate
c Resident/ Citizenship Card c Birth/Adoption Certificate c Court Order c Voluntary Declaration
c Proof of Residential Address c Tax ID (or foreign equivalent)*c Notarized Picture + Birth Certificate (Minors only) c Decree Absolute
c Certificate of Loss of Nationality of the United States c Missing Certificate of Loss of Nationality of the United States Form
*Provide all Tax IDs
Receiving Agent: Signature: Date (dd/mm/yy):

Input Agent: Signature: Date (dd/mm/yy):

FOR BRANCH
USE ONLY Relationship Officer:

Risk Status: Connected Party:

Low Medium High Yes No
If High Risk Approved by: Signature: Date (dd/mm/yy):
FOR BRANCH/
COMPLIANCE Compliance Notes:

Input Officer: Signature: Date (dd/mm/yy):

FOR
CENTRALISED
Approving Officer: Signature: Date (dd/mm/yy):
BUSINESS
SUPPORT
SERVICES Scanning Officer: Signature: Date (dd/mm/yy):