Customer Information Update Form

Personal Details

Title *

Dr / Mr / Mrs / Ms / Miss

Name *

First

Middle

Last

Former Last Name

If applicable

Gender *

Date of Birth *

Marital Status *

Single
Married
Divorced
Widowed

Home Owner *

Nationality *

Please detail any Dual Nationality

Town of Birth *

Passport Number *

Telephone Contact

Home *

Work *

Secondary contact number

Mobile

Communications Preference *

Please select your preferred form of contact from the Bank

Primary Address *

Address Line 1

City

State / Province / Region

Postal Code

Details of previous address within the last 3 years

Address Line 1

City

State / Province / Region

Postal Code

If you have had more than one address within the last 3 years, please include the most recent address within that period.

St Helena / Ascension Address (if different from the above)

Address Line 1

City

State / Province / Region

Postal Code

For customers emigrating to St Helena or Ascension for employment.

Employment Status and Income Details

Employer Name

Employer’s Industry Type

Address

Address Line 1

City

State / Province / Region

Postal Code

Job Title

If Contracted, please detail length of Contract and end date

Estimated monthly salary

Please state any other source of income payments

Estimated total income value per month

Source of Income/Name of Provider (e.g, pension fund, government agency, personal guarantor, trust)

Address of Provider (If applicable)

Taxation Details

Country for Tax Reporting *

Bank of St Helena Ltd is legally required to collect Tax Identification Numbers (TIN) of all account holders, including those residing abroad. For individuals residing in the United Kingdom your Tax ID/TIN is typically your National Insurance number or Unique Taxpayer Reference (UTR). Your country for tax reporting is your primary country of residence, where you legally owe taxes on employment, retirement, or any other sort of income - typically the country where you permanently live or work. This tax residency is determined by the specific duration of time physically spent in a country and whether income is generated within that jurisdiction.

Tax ID Number *

US Tax Reporting

Are you a US Resident or Citizen? *

If you are a US Resident or Citizen, we will contact you to complete Form W-9 - Request for Taxpayer Identification Number and Certification.

Are you classified as a Politically Exposed Person? *

*A Politically Exposed Person (PEP) is someone who has been entrusted with a prominent function to a high-profile position either in a full-time role (e.g. Chief Secretary) or in a part-time capacity (e.g. Board Director). Bank of St Helena keeps a record of PEP’s who have accounts with the Bank to ensure compliance with Anti-Money Laundering and PEP Policy.

Associated Relationships

Bank of St Helena Account Name

(Please List Other Accounts (if any now or previously held) with the Bank of St Helena Ltd, held individually, jointly or for a Minor.

Account Number

Card Account

Bank of St Helena Account Name

Account Number

Card Account

Bank of St Helena Account Name

Account Number

Card Account

How many Accounts do you hold with other Banks? *

Why do we need your international account information? Bank of St Helena is required by law to maintain up-to-date records of our customers' global financial footprints. To ensure compliance with international tax and anti-money laundering regulations applicable to St Helena, you must disclose all foreign financial holdings. Please list all international bank accounts you hold outside of St Helena or Ascension Island. This includes foreign savings accounts, international investment accounts, and offshore funds. Our regulatory framework requires full disclosure of these assets, regardless of the country or financial institution where the accounts are held.

Supporting Documentation

Individuals holding St Helenian Status are required to provide a valid Passport* or a copy of their birth certificate and verification of current and past postal address (if applicable). Individuals without St Helenian Status will be required to provide a current Passport* for photo identification, verification of current and past postal address (if applicable) and proof of long term stay on either St Helena or Ascension Island e.g. Letter of Employment, Contract, etc. Please note where an applicant’s name differs to that shown on a Birth Certificate or Valid Passport, proof of name change must be provided. E.g. Marriage Certificate or Gazette Publication (please indicate below which documentation has been provided).

Proof of Identity (applicable for all Applicants) *

Passport
Birth Certificate (for St Helena residents only)

A certified passport copy is needed in cases where the customer is not physically present for identification purposes. Passport copies may be certified by member of the judiciary, an officer of an embassy, consulate or high commission of the country or territory of issue, a Justice of the Peace, or professional person such as a lawyer, notary public, certified public accountant or professional company secretary. The certifier will be required to date, print their name, and capacity clearly on the certified copy.

Confirmation of address, validate within the last 6 months (applicable for all applicants) *

Upload proof of Identity document, confirmation of address document and proof of long stay document (if applicable) *

Drag & Drop Files, Choose Files to Upload You can upload up to 5 files.

Declaration

It is hereby confirmed that:

The above details are correct and complete; *

I have read and accepted all applicable Terms & Conditions. *

I will promptly notify the Bank of any changes in the above details. *

I am not operating this account on behalf of someone else. *

Confirm

Name *

First

Middle

Last

Signature

Clear Signature

If you feel you signature is not legible, please upload a Jpeg or PDF copy below. This application will not be accepted without a signature

Signature Upload (if required)

Drag & Drop Files, Choose Files to Upload

Please upload a Jpeg or PDF copy of your signature if you prefer. This application will not be accepted without a signature

Date *

Captcha *

(Completely Automated Public Turing Test To Tell Computers and Humans Apart)

Website Legal Information

Customer Data Security

Privacy Policy

Personal Details

Telephone Contact

Employment Status and Income Details

Taxation Details

US Tax Reporting

Associated Relationships

Bank of St Helena Account Activity

Supporting Documentation

Declaration