Create account — Alimentum Exchange

Part 1 — General Information

Full legal name *

Legal form (e.g. limited company, partnership, joint stock company)

Registered office address

Company / business registration no.

Tax ID

Country of tax residence

Principal business address (if different to registered)

Mailing address

Other locations of business

Is your company publicly traded? Yes No

Primary exchange (if traded)

Symbol / ticker

Other exchanges (if applicable)

Is your company regulated? Yes No

Name of primary regulator

Jurisdiction of primary regulator

Firm reference no. (if applicable)

Company website

Nature of your company's business

When trading on Alimentum, will you act on a proprietary/principal basis or on an agency basis for underlying customers?

Net assets (with as-of date)

Turnover (with as-of date)

Audited accounts available to provide? Yes No

Part 2 — Ownership & Control

Is your company wholly or partly state-owned? Yes No

Does any other state-owned entity, public body or government official have any role in management? Yes No

Beneficial owners with ≥25% direct/indirect interest (one per line: Full name | Nationality | DOB | Country | % and level)

Directors, senior management & authorised signatories (one per line: Full name | Role | DOB | Nationality)

Are any owners, directors, officers, managers, shareholders or relevant employees Politically Exposed Persons (PEPs)? Yes No

Part 3 — AML / CTF Questionnaire

1. Required by law to have an AML/CTF compliance program? Yes No

2. Does your company have an AML/CTF compliance program? Yes No

3. Anti-corruption compliance program? Yes No

4. Policies regarding relationships with PEPs? Yes No

5. Policies/procedures to ensure compliance with market-abuse laws? Yes No

6. Policies/procedures to prevent use of funds/material from illegal activities? Yes No

7. Regular sanctions screening against a Sanction Authority? Yes No

8. Policies/procedures/systems sufficient to prevent your relationship with Alimentum being used for sanctioned transactions? Yes No

9. Policies/procedures for environmental protection & sustainable development? Yes No

10. Policies/procedures to comply with safety & health laws? Yes No

11. Compliance with Modern Slavery Act / Human Rights Act or equivalent (no child/forced labour, no trafficking)? Yes No

12. Does your compliance program require due diligence on customers & suppliers? Yes No

13. Compliance training covering AML/CTF, anti-corruption, sanctions, ESG, market abuse? Yes No

14. Do you have a Compliance Officer overseeing compliance programmes? Yes No

If yes to Q14, Compliance Officer name & contact

15. If "No" to any of Q2–Q14, please explain

16. In the last 5 years, transactions with any Designated Parties List counterparty, sanctioned state entity, or sanctioned-country goods? Yes No

17. In the last 5 years, any investigation/charge/conviction for money laundering, terrorist financing, bribery, corruption, fraud, theft, tax evasion, market abuse (Misconduct)? Yes No

18. Company/affiliates/shareholders suspended or debarred from business in any country for Misconduct? Yes No

19. Any conflict of interest a relationship with Alimentum would give rise to? Yes No

20. Any incentive, finder's fee, commission or gratuity paid/received in connection with your relationship with Alimentum? Yes No

21. Could any Public Official personally benefit if Alimentum establishes a relationship or trades with your company? Yes No

Part 4 — Documentation

Company type (determines required documents)

Documents (certificate of incorporation, constitutional documents, register extract / director IDs, ownership chart, audited accounts, standard settlement instruction) are uploaded to the secure repository after submission.

Declaration

Name of signatory (a director of the company) *

Position / title *

I/We confirm the information provided is true and accurate and all documents provided are up to date.