Compliance (Regulatory Compliance) | Financial Monitoring

Step 2 of 4

Fill in the following data

Last name First name Patronymic (middle) name

Phone E-mail

Category to which you belong:

Position Unit

TIN

Entity name TIN

Entity name USREOU

Entity name

Entity name TIN

Entity name USREOU

Entity name

Provide details

I give my consent to personal data processing pursuant to the Law of Ukraine “On Personal Data Protection” for the purpose of processing my appeal by the JSC CB “PrivatBank” and the data disclosure if sent as appropriate.

Step 3 of 4

Type of the report you wish to submit:

On the violation in the field of AML/FT related to financial transaction;

On the violation in the field of AML/FT not related to financial transaction;

On the violation of other legislation (not in the field of AML/FT) and/or of Code of Conduct (Ethics) of the JSC CB “PrivatBank”

Step 4 of 4

Information on the violation in the field of AML/FT related to financial transaction:

Date/period of financial transactions

initial date

end-date

Amount and currency of each financial transaction

Amount

Currency

DELETE

Currency name

Participants of financial transactions and their role

Participant Role DELETE

Actual beneficiaries (if the information is available)

Beneficiary DELETE

Content of financial transactions

Available AML/FT signs

Under what circumstances (conditions) the financial transactions have been detected

Third parties, including outside the bank that could be involved in the above-stated transactions

Third party DELETE

Step 4 of 4

Information on the violation in the field of AML/FT not related to financial transaction

Step 4 of 4

Information on the violation of other legislation (not in the field of AML/FT) and/or of the Code of Conduct (Ethics) of the JSC CB “PrivatBank”

Detailed description of the violation

Date of detection

Link to the web-resource (if any) DELETE

Violation type of the legislation / banking procedures

Violation of the procedure for disclosure of bank secrecy

Failure to adhere to sanctions regulations

Performance of a prohibited transaction (e.g. spending transactions from arrested accounts)

Breach of limits in the event of making money transfers and other bank transactions

Violation of identification procedure

Violation of the legislation / banking procedures

Violation of customer rights at the time of a financial service provision (loan, deposit issuance, etc)

Other

Describe the violation

Regards,

Your appeal has been registered and is currently processed.

The Bank is taking all required measures to verify the information which you have provided in the appeal.

Please note, supporting your appeal with the evidence or actual information about the incident is crucial.

If you have such information available, please send it via the same channel as the appeal.

Thank you for your trust! Your appeal is important and truly appreciated.

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