[Your Company Name] Due Diligence Questionnaire
1 Personal Details
Title: _______________ Surname: _______________
First Name: _______________ Middle Name(s): _______________
Previous Name(s) or Aliases: ______________________________
Address: _____________________________________________
Time at Address: ________ If at current address less than 3 years, provide previous address
Previous Address: _____________________________________________
Gender: M__ F__ Date of Birth: _______________
Home Phone: _______________ Work Place: _______________
Mobile: _______________ Email: _______________
NI No: _______________ Martial Status: _______________
2 Verification Evidence
a. Obtain 2 forms of identity verification from the below list*: –
- UK Passport
- UK/EU Photo Driving Licence
- National Identity Card
- State Pension/Benefits Book
- Armed Forced ID Card
- [Add/Delete as applicable]
b. Obtain 2 forms of address verification from the below list* (dated within last 3 months): –
- Council Tax Statement
- UK/EU Photo Driving Licence (if not already used for identity)
- Bank/Building Society Statement (excluding online statements)
- Mortgage/Rent Statement
- HMRC Tax Notification
- Utilities Bill – gas, electric, water etc (excluding mobile phone)
NOTE: *If the employee is involved in a high-risk role (i.e. in relation to your money laundering obligations), carry out Enhanced Due Diligence (EDD), obtain 3 separate pieces evidence to validate both the customers identity and address.
3 Previous/Current Employment Details (New Employees Only)
Company: _______________ Point of Contact: _______________
Address: _____________________________________________
Telephone: _______________ Time with Employer: _______________
Position: _______________ Employee No: _______________
NOTE: *You should obtain a written reference for any exiting previous employer and also obtain evidence of any relevant qualifications, skills or experience as noted on the CV or application form.
**Reasons for leaving employment and details such as skills and qualifications should be noted on the relevant HR forms and not this due diligence questionnaire.
4 Background Searches & Checks
Background checks and searches should be completed (except where simplified due diligence is valid) to verify the customers identity, employment and address. Searches should also be made where the service, product or transaction require verification of a customer’s financial, criminal and/or historical status.
a. Has the employee’s address been verified via an electoral register search?
YES/NO
b. Have you validated the employee’s financial status (including any insolvencies, bankruptcies or relevant defaults/CCJ’s)?
YES/NO
c. Have you completed a CRB check?
YES/NO
d. Have you obtained a written reference from the employee’s previous employer?
YES/NO
e. Have you obtained copies of any relevant qualifications, certificates, skills, courses etc?
YES/NO
f. Ensure that copies of all searches are saved/printed and retained with the completed due diligence form and note any relevant search information below: –
Detail any relevant findings from conducting background searches and checks:
____________________________________________
____________________________________________
*For EDD, ensure that you carry out searches via 2 different credit providers (i.e. Experian and Equifax or use Check My File for listings of all four credit bureaus), to ensure a thorough background check and status is obtained.
Date Completed: _______________
Next Review Date: _______________
Completed By: _______________
Position: _______________
Signed: _______________