Business Activity Questionnaire
Company name : __________________________________________________
TOTAL OILFIELD & INDUSTRIAL SUPPLIES LLC
Type : ✔ Existing New
Stakeholder name : __________________________________________________
SECTION A: BUSINESS EXPERIENCE
(repeat “Section A” if you list more relevant business experience)
How many years of relevant business experience do you have?
2 YEARS
1. Business experience: From _______________
NOV, 2021 To _______________
DEC, 2023
Company Name: SOLUTIONSTECH AND E-COMMERCE BUSINESS
Address: SOLUTIONS HOUSE, JAMAL GARDEN, SHEIKHUPURA, PUNJAB, PAKISTAN
Country: PAKISTAN Telephone: +923214439625
Email: SUPPORT@[Link] Website: www. [Link]
Business Role: ✔ Employee Business Owner
Nature of Business: ✔ Trading Manufacturing ✔ Service Other_______________________
2. Business experience: From _______________ To _______________
Company Name:
Address:
Country: Telephone:
Email: Website: www.
Business Role: Employee Business Owner
Nature of Business: Trading Manufacturing Service Other_______________________
SECTION B: SUMMARISED BUSINESS PLAN
Detailed description of your intended business:
Mention the intended type of products OR services you plan
CONSULTATION SERVICES, INDUSTRIAL AUTOMATION PRODUCTS
to offer:
List all the countries where your targeted customers will be
USA, UK, AUSTRALIA, CHINA, FINLAND
based in:
✔ Cheque
✔ Cash
Mention the payment methods you will be accepting from ✔ Bank Transfer
customers? United Payment Interface (Paymnet link, Credit/ Debit card)
Others “virtual currency…”
(If cash selected, please note that you will be required to provide with the average cash amount).
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Mention the primary payment method your company will use
Bank Transfers
generally & when transacting with suppliers? (Examples:
cheque, cash, bank transfers etc.)
List your key competitors:
Radwell International, United Kingdom
Who are the top 5 buyers that you will be dealing with, and
country of location for each:
LUOYONG, CHINA
Who are the top 5 suppliers that you will be dealing with, and XIBXIANG APDA FILTER CO., LTD, CHINA
country of location for each: DO Supply Inc, USA
OEM Source, Inc., USA
What is the anticipated / estimated annual turnover? 200,000
Does any of the key connected persons reside outside of the
YES
UAE?
Do you have any business dealings or presence in high-risk
No
countries?
Do you have any relationship with or interest in high-risk
No
industries / businesses?
Is there any business relationship and interest in sanctioned
countries or entities that derive any of their profit from such
countries or interest with a sanctioned designated entity?
(These sanctions include all operations, transactions and dealing directly or
Yes ✔ No
indirectly with countries, individuals, groups or entities under designated UN, UAE
& International Sanctions as well as FATF High Risk Jurisdictions Iran, North Korea,
Myanmar)
If yes, please list the company name and which country it is
based in.
Do you hold any other business license – or any other
Yes ✔ No
operations in the UAE or other country?
If yes, please list the company name and which country it is
based in.
Authorized Signatory Name : ______________________________________
Signature : ______________________________________
Date : ______________________________________
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SECTION C: SOURCE OF WEALTH DECLARATION
Name of Key Individual (UBO, shareholder) AHTESHAM ARSHAD
I/ We hereby confirm that investments made into the above-named company registered/to be registered in Sharjah Media City Free Zone Shams:
• Are not made on behalf of a third party;
• The funds invested are derived from legitimate sources and are not linked and/or derived from criminal origin, of
whatsoever nature, and in particular do not constitute the proceeds of money laundering or terrorist financing; and
• My/our overall wealth originate from the following source:
(Multiple selections are possible)
☐ Capital of company/dividends or income from business.
(If selected, please note that you might be required to provide the details, including company name and amount and submit to Shams along with this
form the most recent financial statements and A letter from a regulated accountant giving details of company profits over the last 2 years)
____________________________________________________________________________________________________
☐ Professional salary:
(If selected, please note that you might be required to provide: the name and address of Employer, details of business if self-employed, occupation,
Number of years in employment, Number of years in employment, gross annual income, last 3 months’ pay slips and bank statements that clearly
show receipt of the most recent 3 months)
____________________________________________________________________________________________________
☐ Profit from sold or maturing investments:
(If selected, please note that you might be required to provide: amount received, seller name, date received, for how long it was held and a
letter/contract note from previous investment company giving notification of proceeds of maturing investment/claim)
____________________________________________________________________________________________________
☐ Profits from property sale or lease:
(If selected, please note that you might be required to provide: sale value of property sold, full address of property sold, date of sale, broker
name/Auction if any and for how long the property was held)
____________________________________________________________________________________________________
☐ Profits from sale of business:
(If selected, please note that you might be required to provide: name & address of company, total sale price, applicant’s share, nature of business, date
of sale, signed letters from solicitor & accountant, copy of contract of sale and sight of investment monies on bank statement)
____________________________________________________________________________________________________
☐ Profits from share sale:
(If selected, please note that you might be required to provide: sale value of shares sold, description of shares/ funds, stockbroker or bank name used,
date of sale, for how long each investment was held and the legal sale document.)
____________________________________________________________________________________________________
☐ Inheritance:
(If selected, please note that you might be required to provide: total amount received, name of benefactor, relationship to benefactor, date received
and Solicitor’s letter)
____________________________________________________________________________________________________
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☐ Gift:
(If selected, please note that you might be required to provide: details of benefactor, reason for gift, relationship to benefactor, source of donated funds
and a letter from donor confirming details of gift and acknowledging the source of the donated funds)
____________________________________________________________________________________________________
☐ Matured life insurance policy:
(If selected, please note that you might be required to provide the insurance policy copy, details and total amount)
____________________________________________________________________________________________________
☐ Loan:
(If selected, please note that you might be required to provide: amount of loan, purpose for obtaining a loan, Name & address of loan provider date of
loan, loan agreement and recent loan statements)
____________________________________________________________________________________________________
☐ Company profit:
(If selected, please note that you might be required to provide: copy of latest accounts and a letter from a regulated accountant giving details of
company profits over the last 2 years)
____________________________________________________________________________________________________
☐ Other:
Please specify: _________________________________________________________________________________________
(If selected, please note that you might be required to provide: nature of income, amount, date received, received from whom, signed letter detailing
funds from a regulated accountant)
I declare that the information provided in this form is true and complete.
Signature : _____________________________
Date : _____________________________
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