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SELF-DECLARATION FORM
Skrill, as an authorised Electronic Money Issuer in the United Kingdom, is obligated to verify
those clients who are classified as Politically Exposed Person (PEP). In that regard please mind
that the information you provide must be as complete and accurate as possible. Any information
you provide us will only be used in accordance to the applicable data protection regulation.
We designate any person who meets any of the following criteria as a PEP:
An individual who holds, or has held within the preceding 18 months, a political function on
a national level or on a supranational or international level.
An immediate family member of someone meeting the criteria above.
A known close associate of someone meeting the criteria above.
Examples of prominent public functions, which we would always consider to be PEPs, include but
are not limited to the following:
Spouse
Partner, including a person considered by national law applicable to the PEP to be
equivalent to a spouse
Children, including stepson and stepdaughter (including sons- and daughters-in-law)
Spouses or partners of children
Parents
We define associates, we would always consider to be PEPs:
Any individual known to have joint beneficial ownership of a legal entity or legal
arrangement, or any other close business relations, with a PEP.
Any individual who has sole beneficial ownership of a legal entity or legal arrangement
which is known to have been set up for the benefit of a PEP
Please complete the following information, and select the relevant boxes:
I, ______________________________________________, ____________________________
NAME OCCUPATION
of__________________________________________________________________________
RESIDENTIAL ADDRESS
I confirm that the information in the present Declaration is true and accurate ☐
_________________________________ ____________________________
DATE E-SIGNATURE
Please be advised if you prefer to print, sign and scan the document this is acceptable.