SCOPE / OBJECTIVE

The ques(onnaire will be asked to the User/Client that completed the KYC Verifica(on, whereby the User
will have to disclose their source of funds along with appropriate documenta(on required.

S.No. Proof of Funds ques9ons to be asked to our User / Client

1. EMPLOYMENT STATUS
1.1. Kindly state your employment status. *

Employed Self-Employed/Entrepreneur Student Re(red

Unemployed

1.2. If Self - Employed/Entrepreneur, what is the Nature of your Business*

Please specify:

1.3. If Employed, what is your Current Job Role?*

- Assistant Manager, Picturebook Guesthouse
Please specify:
- My current job is located in Mae Sot, Thailand, which is a Hotel
called Picturebook Guesthouserun by non- profit Origanizatioin.
I am working as an assistant manager operating front desk, providing
services to the guests.

2. NET WORTH / FINANCIAL STATUS

2.1 What is your total es(mated net worth?*

Less than USD 20,000 If Other, please specify:

2.2. If Employed or Self Employed/Entrepreneur, what is your Total Annual Income?*

-120,000 baht
Please specify:
- As the monthly income from my current job is 10,000 Baht (Thai currency.

2.3. Kindly chose the Proof of Income from the below check box op(on*

Bank Statement for the Last 6 months Employer Pay Statement

Tax Payment Form Crypto Wallet Statement Online Trading Wallet

Statement
Other
If Other, please specify:

- I received my income by cash because the working standard is not on

professional level in Thailand.

Please a\ach the selected Proof of Income (Uploading Op-on)

 2.4. If Unemployed / Re(red / Student, what is your Total Annual Income?*

Please specify:

2.5. Kindly chose the Proof of Income from the below check box op(on*

Bank Statement for the Last 6 months Tax Payment Form

Crypto Wallet Statement Online Trading Wallet Statement

Other
If Other, please specify Cash (informal payment)
Please a\ach the selected Proof of Income (Kindly upload this file)

2.6 Any other Source of Fund you wish to declare.

Sale of Property Inheritance of Wealth or Funds

Other
If Other, please specify:

* Required to fill
Addi9onal Ques9ons on the basis of the withdrawal amount:-

● On the basis of the Total Annual Income and the type of Category the Users fall into they
will have to fill up the addi(onal documents.
● The below informa(on is what the Users will receive:-

For Broker Group Ltd to comply with the global AML (An( Money Laundering) Regula(ons and
Legisla(ons, it is mandatory for the Applicants to provide us with the below details which will assist us in
understanding how you have acquired your funds or wealth.

S.No. Addi9onal Proof of Funds Ques9ons

1. If Employed / Self-Employed

1.1. In the descrip(on box kindly provide the origin and source of your wealth.*
- A Hotel Staff
(Text Box)

- I have my permenant job and i am working now as a staff at Hotel

called Picturebook Gueshouse in Mae sot, Tak, Thailand.

1.2. Do you receive any bonuses?*

Yes No.
 On the basis of the above selected op(on please a\ach the suppor(ng document
(Uploading Op-on)
● Self Employed/ Entrepreneurs - Copy of recent financial statement / tax statement
/ crypto statement.
● Employee - Copy of the Bonus Pay Slip in the company le\er head and the company
stamp.
● For all - Bank statement displaying the most recent income earned.
1.3. Sale of any asset or property?*

Yes No.
If yes, please provide the suppor(ng document. (Kindly upload this file)

1.4. Ownership of any valuable property or asset (Shares, bonds, etc.)?*

Yes No.
If yes, please provide the suppor(ng document. (Kindly upload this file)

(Text Box)

1.5. If you have other source of income please specify:-*

 (Text Box)

I have only one job, and I am depending on my current job

as a staff of a Hotel.

1.6. Kindly provide a brief descrip(on about the ac(vity or services provided by your company.*

(Text Box)

- My company is providing services for the customers such as

selling room rentals to guests.

1.7. If your business is related to any one of the following business ac(vi(es, as per the AML
(An( Money Laundering) Regula(ons and Legisla(on, we will require addi(onal
documenta(on.
1. Law Firm or Legal Consultancies
2. Accoun(ng or Audi(ng Firm
3. Dealers of precious stones and metals
4. Corporate Service Providers
5. Real Estate Dealers
6. Casino, gambling or befng industry
7. Money Exchange House
Please provide the below addi(onal company documenta(on:-*
Trade License of the Company Ar(cle / Memorandum of Associa(on

Directory Register Bank Statement of the Company

Ul(mate Beneficial Owner Cer(ficate / Declara(on
* Required to fill
S.No. Addi9onal Proof of Funds Ques9ons
1. If Unemployed / Re9red / Student

1.1. In the descrip(on box kindly provide the origin and source of your wealth. *

Text Box:

1.2. If Re(red, do you receive a monthly pension or re(rement income? *

Yes No.
If yes, please provide the suppor(ng document. (Kindly upload this file)
1.3. If Unemployed/ Student, did you receive any inheritance money?*

Yes No.
If yes, please provide the suppor(ng document. (Kindly upload this file)

1.4. Sale of any asset or property?*

Yes No.
If yes, please provide the suppor(ng document. (Kindly upload this file)

1.5. Ownership of any valuable asset or property?*

Yes No.
If yes, please provide the suppor(ng document. (Kindly upload this file)

1.6. Have you made any prior investment(s) in company(ies)/ funds?*

Yes No.
If yes, please provide the suppor(ng document. (Kindly upload this file)

1.7. If you have other source of income please specify:-*

Text Box:
 1.8. If your investment in a company(ies) is related to any one of the following business
ac(vi(es, as per the AML (An( Money Laundering) Regula(ons and Legisla(on, we will
require addi(onal documenta(on.
8. Law Firm or Legal Consultancies
9. Accoun(ng or Audi(ng Firm
10. Dealers of precious stones and metals
11. Corporate Service Providers
12. Real Estate Dealers
13. Casino, gambling or befng industry
14. Money Exchange House
Please provide the below addi(onal company documenta(on:-*
Trade License of the Company Ar(cle / Memorandum of Associa(on

Directory Register Bank Statement of the Company

Ul(mate Beneficial Owner Cer(ficate / Declara(on
* Required to fill