Anti-bribery and corruption—due diligence questionnaire for agent/intermediary
Anti-bribery and corruption—due diligence questionnaire for agent/intermediary

The following Practice Compliance precedent provides comprehensive and up to date legal information covering:

  • Anti-bribery and corruption—due diligence questionnaire for agent/intermediary

To be completed by the agent/intermediary.

Please complete, sign and return to [insert name].

    1. 1

      General

      Company or individual name[Insert company/individual name]
      Address[Insert address]
      Principal country of business[Insert country]
      Other countries of business[Insert country]
      Individual or corporate entity?☐ Individual
      ☐ Corporate entity
      Individuals, please go to section 3.
      Primary Contact
      (name, title and contact details)
      [Insert primary contact]
    1. 2

      Ownership and management

      For corporate entities only.

      1. 2.1

        Owners of interests greater than [5%]

        NamePercentage ownership
        (%)
        [Insert name][Insert percentage]
        [Insert name][Insert percentage]
        [Insert name][Insert percentage]
        [Insert name][Insert percentage]
      1. 2.2

        Directors/officers/partners

        NameTitle
        [Insert name][Insert title]
        [Insert name][Insert title]
        [Insert name][Insert title]
        [Insert name][Insert title]
      1. 2.3

        During the last [five years] have any of your owners, directors, partners etc been government employees or officials, officials of a political party, candidates for public office or officials of a public international organisation (collectively ‘government officials’)?

        ☐ Yes

        ☐ No

        If yes, attach a separate sheet identifying names, dates, titles and details.

      1. 2.4

        To your knowledge, during the last [five years] have any of your owners, directors, partners etc been closely connected (ie having family, personal or business ties) to a government official?

        ☐ Yes

        ☐ No

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