UNIQUE LINKAGE FORMAT FOR SUPPLIERS, CUSTOMERS AND USERS

    Completion date:

    REGISTRATIONUPGRADE

    Indicate with an X the modality in which you are enrolling.

    CUSTOMERSUPPLIEROTHER

    Indicate with an X your activity according to the following classification:

    CustomerProvisions and SuppliesTransportOthers

    IDENTIFICATION

    Indicate with an X your activity according to the following classification:

    Natural personLegal personPublic entity

    Bussines/ Company name

    Economic activity

    BASC certificate

    NoYes

    ISO / BASC certificate

    NoYes

    version

    Identity Document: TIN (Tax Identification Number), ID, foreigner ID, Passport, etc., according to what you have

    Type of document:

    IDCEForeigner IDPassportOTHER

    Document number:

    Place of Issue

    Main Adress

    Country / City

    Telephone number

    Zip code

    Email

    Fax

    Tax responsabilities

    ISIC code: (if applicable):

    ICA rate ( if applicable )

    Tributary quality

    Régimen ComúnSimplified regime

    Major taxpayer

    NOYes

    Number of resolution

    Date of resolution

    Self- withholding

    NOYes

    Number of resolution

    Date of resolution

    Rent-free

    NOYes

    Number of resolution

    Date of resolution

    Social information

    Partners and shareholders

    Name and last name

    ID

    % of participation

    Name and last name

    ID

    % of participation

    Name and last name

    ID

    % of participation

    Legal representatives

    Name and last name

    ID

    % of participation

    Name and last name

    ID

    % of participation

    Name and last name

    ID

    Telephone number

    BOARD OF DIRECTORS

    Name and last name

    ID

    Telephone number

    Name and last name

    ID

    Telephone number

    Name and last name

    ID

    Telephone number

    INFORMATION OF THE PEOPLE WHO WILL DO THE OPERATION

    Name and last name

    ID

    Telephone number

    Name and last name

    ID

    Telephone number

    Name and last name

    ID

    Telephone number

    References

    Bank references

    Bank

    Account number

    Type

    Branch office

    Telephone number

    Contact

    Bank

    Account number

    Type

    Branch office

    Telephone number

    Contact

    Commercial references

    Name or company name

    Contact

    Telephone number

    Name or company name

    Contact

    Telephone number

    DECLARATION OF FUND’S ORIGIN

    I testify that our company and its employees know the rules of prevention of money laundering and terrorism financing. We have the best commitment to avoid that our company turns into an instrument of violation of the rules that govern this regime. I testify that I have not belonged to any type of illegal outlaw groups and I have not helped them in the development of their illicit activities. Furthermore, I have not developed money laundering activities in Colombia or outside the country. I testify that all the goods that are part of my patrimony have been acquired by legal actions through the development of my profession and main economic activity.

    Main economic activity

    In the same way, I testify I do not have any links with people who are or have been included in public lists as suspect of money laundering, terrorism financing or companies in which they are shareholders. I testify I do not have links with people who have developed, helped or financed any activities described in the previous paragraph.

    I testify that:
    All the given information and the attached documents are true. All the information that I attach is truthful and verifiable, and I authorize its verification for any natural or legal person, private or public, without any limitation. I authorize this from now on and while there is a commercial relationship with any entity which belongs to Sociedad Portuaria Terminal de Contenedores de Buenaventura S.A- TC BUEN S.A or who represents its rights. I promise to update the information and documents at least once a year or any time, if necessary. In the same way, I authorize Sociedad Portuaria Terminal de Contenedores de Buenaventura S.A -TC BUEN S.A. or who represents its rights, in permanent and irreversible way, to search, inform, report, procced or divulge any information related to my behavior as a customer to data base entities or credit bureaus, if it is for statistic, financial or commercial purposes.

    Name of the legal representative

    Requested by

    Date

    Attach files

    Please check the documents you sent.

    Single Tax Registration certificateChamber of commerce (less than 2 months)Financial statements of the last fiscal adjustmentLast year income tax declaration photocopy1 bank certificateLegal representative ID photocopyLast 3 months bank statements2 commercial certificatesDIAN resolution for activities to performISO / BASC certificate photocopyShareholding structure certificate ( optional)