FORM B - Langstaffs

Statutory Anti-Money Laundering Questionnaire (Form B) - Business/Organisation

7. Full Name of person completing this questionnaire*

8. Name of business or organisation*

9. Registered address of business or organisation*

10. In which geographic areas does this business or organisation have dealings? Please tick all areas where the business recieves more than 5% of sales revenue, or spends more than 5% of total purchases.

UK
Europe
North America
Central and South America
Africa
Middle East
Asia
Australasia

11. Does this business or organisation take cash?

No/Not really (0-5% of total revenue)
Yes (6-25% of total revenue)
Yes (26-100% of total revenue)

12. Please briefly describe the nature of the trade and the products or services in which this business or organisation deals.*

For example: self-employed advertising consultant covering UK clients; newsagent in Donacaster; property developer in Cornwall; B&B owner in Portsmouth; gardener for domestic clients in Tetbury etc

13. Please provide details of all transactions in the last 12 months over £10,000 in value (or "None")