Reason of the consultation
Way of contact
Countries / geographic areas of the professional activity
Other relevant information
Information regarding the beneficial owner
Are you a politically exposed person (PEP)?
Date and signature of the client/representative
I declare that this form has been completed by me or in my presence and that the information provided therein is true, therefore I accept that any omission or falsity of the information contained in this form would cause the cancellation of this application and of the mediation contract.
I also undertake to keep the information up to date and to inform AUGÉ HOLDING GRUP of any changes that may be made to this information in the future.
I authorize you to verify all information contained in this form, at the discretion of the institution.
I declare that income and assets have been acquired through lawful and legitimate activities, in the same way, that I have never been involved in the crime of money-laundering or other activities considered or that could be considered criminal or that contravene national regulations and International in terms of money-laundering or criminal activity of any kind.
Finally, I attest to having been warned about the scope of Law 14/2017 article 3, number 6 of said regulatory body and the concept of Politically Exposed Person.