KYC — Individual AML Form — Crown Payroll Services

This form is for individual clients — directors, UBOs, partners, and sole traders. A separate KYB form is also required for all business clients.

Fields marked * are required. Additional sections will appear automatically if Enhanced Due Diligence is required based on your answers.

Personal Details

Title

Full legal name Required

Any previous names

Preferred name (if different)

Nationality Required

Date of birth Required

Country of birth

National Insurance number

Contact email address Required

Mobile / contact phone number Required

Residential Address

Are you a UK resident?

Yes No

Please select an option

Country of residence Required

Full residential address (including post code) Required

Date moved into current address Required

Previous residential address

Required as you have lived at your current address for less than 3 years — include full address, postcode and dates

Required

Tax Residency

Are you UK tax-resident?

Yes No

Please select an option

Identity & Address Verification

Please upload a government-issued photo ID and proof of address below. All documents must be uploaded directly to this form — we do not accept documents by email for AML compliance purposes.

ID document type Required

Photo ID

Passport or driving licence — clear scan or photo of the full document

Please upload a photo ID document

ID document number Required

ID document expiry date Required

Proof of address

Utility bill, council tax bill, or bank statement dated within the last 3 months

Please upload a proof of address document

Engagement Capacity & Employment

In what capacity are you engaging Crown Payroll Services?

Select the option that best describes your role in this engagement

Please select an option

Company name Required

Company registration number

As shown on Companies House — usually 8 digits

Required

Companies House ID Check Code

Required for directors and shareholders of limited companies — leave blank if you do not have one

Trading name (if different to your legal name)

Charity name Required

Charity registration number

As shown on the Charity Commission register

Required

Please describe your capacity

Are you completing this form in your personal capacity, or as a representative on behalf of another person?

Required under Reg. 28(10) of the Money Laundering Regulations 2017

In my personal capacity (as a director/officer/employee/individual) As a representative on behalf of another person (EDD required)

Please select an option

Full name of the person you are acting for

Your relationship to that person

Address of the person you are acting for

Politically Exposed Person (PEP)

Please note: If you answer Yes to either question below, additional questions will appear in this form as required under the Money Laundering Regulations 2017. Crown Payroll Services will also carry out enhanced checks and further evidence or documentation may be requested. This does not automatically prevent you from becoming a client.

A PEP is someone entrusted with prominent public functions — heads of state, government ministers, senior judges, ambassadors, senior military, or senior executives of state-owned enterprises. This includes family members and known close associates.

Are you a Politically Exposed Person (PEP)?

Yes No

Please select an option

Are any family members or close associates a PEP?

Yes No

Please select an option

Please provide full details

Full name, their role or public function, and the country in which they are or were a PEP

Sanctions & Geographic Risk

Are you, or have you been, subject to any UK, UN, EU or US sanctions, asset freezes, or other restrictive measures?

Yes No

Please select an option

Please provide full details

Do you have personal, residential, family, or business connections to any country subject to sanctions or considered high-risk by the FATF?

High-risk countries include those on the FATF grey or black list. If unsure, answer Yes and provide details — Crown Payroll Services will assess.

Yes No

Please select an option

Please specify the country and nature of connection

Source of Wealth EDD Required

Source of wealth means how you have accumulated your overall assets over time — distinct from the source of funds used to pay fees.

Source of wealth (overall accumulation of your assets)

e.g. long-term employment income, business ownership, investment returns, property portfolio, inheritance, gifts — please be as detailed as possible

Required

Estimated total net worth (approximate range) Required

Do you consider yourself a High-Net-Worth Individual (HNWI)?

At least £1 million in liquid or investable assets, excluding primary residence

Yes No

Please select an option

Compliance Declarations EDD Required

All questions in this section are required for Enhanced Due Diligence. Please answer accurately and in full.

Have you ever been convicted of financial crime?

Yes No

Please select an option

Have you ever been subject to external investigation, or are you currently under investigation?

Yes No

Please select an option

Have you ever been involved in regulatory action?

Yes No

Please select an option

Have you ever been declared bankrupt or subject to an IVA / DRO?

Yes No

Please select an option

If you answered Yes to any of the above, please provide full details

Include dates, outcomes, and any relevant context

Declaration

I confirm that the information provided in this form is true, accurate, and complete to the best of my knowledge. I agree to provide supporting documentation where required and understand that Crown Payroll Services may carry out identity verification, sanctions, PEP and adverse media checks in accordance with UK Money Laundering Regulations and CCAB AML Guidance for the Accountancy Sector. I consent to my personal data being shared with Veriphy or another third-party electronic identity verification provider for the purpose of completing AML checks. I understand that Crown Payroll Services may request updated information from me periodically as part of ongoing monitoring of the business relationship. I consent to my personal data being processed for these purposes in line with Crown Payroll Services' Privacy Notice and UK GDPR.

I confirm and agree to the declaration above

Print full nameRequired

Date signedRequired

Electronic Signature

Draw your signature below to confirm your submission

Your signature confirms that you have completed this form truthfully and accurately. The submission will be timestamped and recorded for audit purposes.

Crown Payroll Services Ltd | AML Policy May 2026 | IAB Supervised | MLRO: Dean Ainslie
MLR 2017 (as amended) | Regulation 40 — retain for 5 years from end of business relationship

Form Submitted

Enhanced Due Diligence Required