Henderson Rowe Entities Question Title 1. Henderson Rowe Client Account Number- HRXXXXX Question Title 2. Entity Name ( Legal Name ) Question Title 3. Entity Type ( Company, Trust, Charity ) Question Title 4. Entity Registered Number Question Title 5. Nature of Entity ( description of entity purpose or nature of business) Question Title 6. Registered Address House No House / Building Name Address Line (1) Address Line (2) Town County Country Postcode Question Title 7. Country of Incorporation Question Title 8. Country of Taxation Question Title 9. FATCA AEOI Entity Status ( Active NFE, Passive NFE, FFI, NFFE, etc) Question Title 10. GIIN ( Global Intermediary Identification Number) Question Title 11. Contact Details Telephone Number Mobile Number Email Address Question Title 12. Controlling Party 1 Details Controlling Party Name Address 1 Address 2 Address 3 Postal Code Email Address Nationality Dual Nationality (if applicable) NINO/ TIN * Country of TIN Date of Birth Place of Birth Country of Residence Country of Taxation Question Title 13. Nature of Control Shareholder Director Trustee Power of Attorney Executor Beneficiary Other (please specify), if multiple please specify Question Title 14. Controlling Party 2 Details Controlling Party Name Address 1 Address 2 Address 3 Postal Code Email Address Nationality Dual Nationality (if applicable) NINO/ TIN * Country of TIN Date of Birth Place of Birth Country of Residence Country of Taxation Question Title 15. Nature of Control Shareholder Director Trustee Power of Attorney Executor Beneficiary Other (please specify), if multiple please specify Question Title 16. Controlling Party 3 Details Controlling Party Name Address 1 Address 2 Address 3 Postal Code Email Address Nationality Dual Nationality (if applicable) NINO/ TIN * Country of TIN Date of Birth Place of Birth Country of Residence Country of Taxation Question Title 17. Nature of Control Shareholder Director Trustee Power of Attorney Executor Beneficiary Other (please specify), if multiple please specify Question Title 18. Additional Information ( Controlling Parties, Nature of Entity, etc) Done
