Corporate or Entity Account Form

1

General Information

Legal Name of the Entity *

Operating / Trade Name (If different)

Date of Incorporation (YYYY-MM-DD) *

Jurisdiction of Incorporation *

Business Registration Number *

Tax ID / Business Number *

Nature of Principal Business *

Business Structure (Supporting documents required) *

Corporation Partnership Sole Proprietorship Trust Publicly Traded Trust Financial Entity Securities Dealer Not for Profit Others

Expected Activity with DPMS (Dealer in Precious Metals and Stones) *

Buying Selling Refining Others

Yearly Turnover (Input latest year as Year 1) *

Year 1 (Latest)

Year 2

Year 3

2

Contact Details

Registered Business Address

Holding No / Suite / Unit

Street Address *

City *

Province / State *

Country *

Postal Code *

Mailing Address

Same as Registered Address

Holding No / Suite / Unit

Street Address

City

Province / State

Country

Postal Code

Phone Number *

Email Address *

Fax Number

Website

3

Authorized Signing Officer(s)

Please list all individuals authorized to transact with Bullion Mart Limited on behalf of the entity.

Full Name *	Position / Title *	Email *	Phone *	Action

4

Profile of Business Activity

What is your intended purpose of the Business Relationship? *

Trading Refining Investment Re-sale Jewelry Others

Source of Funds *

Operating Revenue Shareholder contribution Bank loan / Line of credit Others

Frequency *

Monthly Quarterly Half-yearly Yearly

No. of Transactions *

1 - 2 3 - 5 6 - 10 More than 10

Total amount estimated on a yearly basis (in CAD $) *

5

Shareholding, Management & Control

Regulatory Requirements:

Corporations: Directors and all individuals directly or indirectly owning or controlling 25% or more.
Trusts: All trustees, known beneficiaries, and settlors.
Other Entities: All individuals owning or controlling 25% or more.

* Copy of Government-issued photo ID required for each beneficial owner listed.

Full Name *	Role *	% Ownership	Address *	DOB	Nationality	Action

Controlling Party Information

Required if no individual meets criteria of 25%+ beneficial ownership (e.g. CEO, CFO, Managing Member, President).

Full Name	Date of Birth	Title / Role	Contact Info (Email & Phone)	Action

6

Acknowledgement & Signature

I am duly authorized to submit this application and to make this declaration on behalf of the applicant entity. The information provided in this application and in all supporting documentation is true, accurate and complete to the best of my knowledge and belief. I understand that providing false or misleading information may result in denial, suspension, or revocation of registration or may trigger legal or regulatory consequences under applicable Canadian Laws, including the Proceeds of Crime (Money Laundering) and Terrorist Financing Act (PCMLTFA).

Authorized Signatory Details

Full Name *

Title / Position *

Date *

Digital Signature (Draw below) *

Corporate / Entity Account Form