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KYC - PL - Individual - W.E.F 08-01-2024

This document is a Know Your Customer (KYC) profile form for an individual customer of Prime Lands (Pvt) Ltd. It collects personal details such as name, date of birth, citizenship, contact information, occupation, sources of finance, purpose of purchase, family details, and a declaration signed and dated by the customer.

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f.kahapola
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45 views

KYC - PL - Individual - W.E.F 08-01-2024

This document is a Know Your Customer (KYC) profile form for an individual customer of Prime Lands (Pvt) Ltd. It collects personal details such as name, date of birth, citizenship, contact information, occupation, sources of finance, purpose of purchase, family details, and a declaration signed and dated by the customer.

Uploaded by

f.kahapola
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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PRIME LANDS (PVT) LTD - PV 7088

No 75, D.S. Senanayake Mawatha, Colombo - 08.


t +94 112 699 822 f +94 114 209691
e [email protected]
www.primelands.lk

Know Your Customer (KYC) Profile Form (Individual)

FOR OFFICIAL USE ONLY


Date
Customer Code
Project Code
Project Name
Unit No/Lot No
Sales person name

(To be filled only in English)


PERSONAL INFORMATION

Name with initial


[Prof /Dr /Mr /Ms]

Full Name

Date of birth / /

Citizenship Sri Lankan


Dual Citizen – Specify the other county
Foreign National– Specify the country

NIC No/ Passport No (Please attach a copy of NIC or Passport)

Taxpayer Identification Number (TIN)

ADDRESS

Permanent Address

Residential Address

If the residential address differs from the NIC, it should be verified and supported by one of the following accepted documents

Valid Driving License Utility Bill not over three months’ old Income Tax Receipt/
Tenancy Agreement (Electricity/Water/Fixed Phone) Assessment Notice
Employment Contract Letter from a public Authority Others (Specify)

OCCUPATION

Professional Administration/Executive Self Employed


Others (Please specify)

Name & Address


of the employer

Position/Designation
MEMBER OF PRIME GROUP
SOURCES OF FINANCE

Sales & business income Occupation income Commission & brokerage


Export proceeds Sale of Assets Bank Loans
Family remittances Lease or Rent income Others(Specify)
Investment Income Gifts

PURPOSE OF PURCHASING

Residential - Immediate living Residential - Future living Investment Rent/Lease

CONTACT REFERENCES

Home Office
Land Phone No
Mobile Phone No
Email address

FAMILY DETAILS

Civil Status Married Unmarried

Spouse Name

Occupation Contact No

HOW DID YOU FIND OUR PROJECT?

Banner News Paper Ads/ Lahipita Ads Ikman/Lanka Property Web


Hoardings Facebook/ Instagram TikTok /YouTube
Leaflet/ Promotions Website SMS/ WhatsApp/ Email
Radio/ TV Referral Others (Please specify)
(By another customer/ By sales person)

(Please cross off the inappropriate when there are multiple options available.)

OTHERS

* Are you or your close relative a Politically Exposed Person (PEP)? Yes No

“Politically exposed person” means an individual who is entrusted with prominent public functions either domestically or by a foreign country,
or in an international organization and includes a head of a State or a Government, a politician, a senior government officer, judicial officer or
military officer, a senior executive of a State owned Corporation, Government or Autonomous body but does not include middle rank or junior
rank individuals;

* Are you a repeat customer? Yes No

DECLARATION

I declare that the information given in this application is true and correct.

Date Signature

MEMBER OF PRIME GROUP

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