BLENHEIM FIDUCIARY GROUP LIMITED

(BFGL)
CORPORATE DUE DILIGENCE DECLARATION
Please complete this form to the fullest extent possible. Guidance notes on how to complete the sections are
attached for your reference.

PART I GENERAL INFORMATION

1.

Full Registered Name:

Gulfstream Asia Pacific Incorporated

2.

Trading and /Former Name(s) or any alias:

N/A

3.

Full Registered Address including postal code:

Please do not use PO Box Address
Unit B, 15th Floor, ACT Tower, H.V. de la Costa Street, Salcedo Village, Makati City 1209

4.

Full Principal Business / Trading Address (if different from 3 above):

Click here to enter text.

5.

Telephone number(s): 632-8932344

6.

Website and / or email address: insights@compass.com.ph

7.

Date of Incorporation (DD/MM/YYYY):

8.

Place of Incorporation: Philippines

9.

Registered Number: CS201409459

10.

Business Activities:
buying and holding shares of other companies as a holding company

PART II PRINCIPALS AND MANAGEMENT

11.

Names of all current Directors and Officers:

Please state position held

1. Teresa Tam-Yap
3.Terese Melissa Yap
5. Artemia Tolabing Sibala

2.Terese Samantha Yap

4.Eliza Iso Martinez
6. Click here to enter text.

12.
Names of all shareholders holding 25% or more of the issued share capital of
the Company
Please state percentage holding

1. Teresa Tam-Yap 99.995%

text.
3.

2. Click here to enter

4.

Blenheim Fiduciary Group Limited is licensed as a fiduciary by the Guernsey Financial Services Commission
Page 1 of 8

BLENHEIM FIDUCIARY GROUP LIMITED

(BFGL)
CORPORATE DUE DILIGENCE DECLARATION
13.
Regarding shares held by nominees, companies, in trust, or in bearer form
please name each ultimate beneficial owner and percentage ownership: 1. Artemia Tolabing Sibala for Teresa Tam-Yap 99.995%
2. Eliza Iso Martinez for Teresa Tam-Yap 99.995%
3.
4. Click here to enter text.
14.

Is the Company capable of issuing bearer shares (please tick):

Yes
No

15.

Please name all individuals who have the authority to operate an account or
give instructions concerning the use or transfer of assets (if not already named in
the sections above):

1. Teresa Tam-Yap

2.Terese Samantha Yap

3. Click here to enter text.

4. Click here to enter text.

PART III TAX RESIDENCY

16.

Country of Tax Residence:

Philippines

17.

Organisations Taxpayer Identification Number (TIN) or Tax Reference

Number:
008-778-034

18.

If the organisation is not a US Specified Person please tick this box:

Please refer to guidance notes attached

PART IV REFERENCES
19.

Please complete the attached template letters.

PART IV SUPPORTING DOCUMENTATION

Please enclose the following documentation with this form: Document
Attached (tick)
1. Certificate of Incorporation or Good Standing
2. Latest annual accounts
3. Register of shareholders
4. Proof of ID and address in respect of all current
directors, officers and authorised signatories of the company
5. Proof of ID and address in respect of all shareholders
owning more than 25% of the issued share capital of the company
6. Completed W8-BENE form (entities not resident for tax purposes
in the United States only)
7. Bearer shares declaration (companies capable of issuing bearer shares)
Blenheim Fiduciary Group Limited is licensed as a fiduciary by the Guernsey Financial Services Commission
Page 2 of 8

BLENHEIM FIDUCIARY GROUP LIMITED

(BFGL)
CORPORATE DUE DILIGENCE DECLARATION
PART V - DECLARATIONS
I/We hereby declare that the information
provided herein and herewith may be held,
processed and retained by BFGL and its
associated, parent and subsidiary companies,
and their assigns (collectively or severally
Blenheim) for the purposes of complying with
anti-money laundering laws and regulations.
I/We
further
declare
that
the
information/documentation may be disclosed or
provided to financial institutions, banks,
investment houses and others for the purposes
of satisfying their verification and due diligence
requirements.
I/We hereby declare that the source of funds
and other assets placed in any entity serviced,
administered or managed by Blenheim results
from the activities listed under Part I(10) above
and that the transferors have full and
unencumbered legal right and title to those
funds and assets immediately prior to their
transfer to any such entity.
I/We hereby declare that the Company is not
involved in and has not been involved in, nor do
any of its assets, net worth, income nor
activities relate to, any criminal act, activity or
event including (but not limited to) armaments,
illegal
drugs
or
controlled
substances,
prostitution, bribery, corruption or money
laundering.
I/We hereby declare that the Company
continues to be validly incorporated and is not
insolvent.
I/We hereby declare that neither the Company
nor its directors have been nor are presently the
subject of any court action, legal proceedings or
dispute of any nature whatsoever, whether civil
or criminal, which has been taken, is being
taken or (to the best of my knowledge) is about
to be taken against us.

I/We hereby declare that the Company will not:

a) hinder, delay or defraud any creditors; b)
engage in any illegal or criminal conduct; nor c)
supply, trade in or move goods or services in
contravention of international sanctions or
import/export controls in Guernsey or in other
applicable countries. Furthermore, I/We declare
that neither Blenheim nor any entities serviced,
administered and/or managed by Blenheim will
be sought or retained to assist, facilitate or
engage in any illegal or criminal act, activities,
trade or conduct nor will they be sought or
retained to undertake licensed, regulated or
restricted activities without proper authority or
valid licence.
I/We hereby declare that the Company, its
directors and officers comply with applicable
anti-bribery and corruption legislation including
(but not limited to) the Prevention of Corruption
(Bailiwick of Guernsey) Law, 2003, as amended,
the UK Bribery Act, 2010, as amended and The
Foreign Corrupt Practices Act, 1977, as
amended. By accepting or benefiting from
Blenheims services, I/We undertake not to
render, procure or benefit from any improper
advantage whatsoever.
I/We hereby declare and undertake to advise
Blenheim within 30 days of any changes to the
information contained herein and agree to
provide such further documentation as may be
required by Blenheim as a result of said
change(s).
I/We hereby agree expressly, specifically and
without qualification to hold harmless and
indemnify
Blenheim,
their
officers
and
employees, and all other entities and individuals
that engage in any transaction in reliance on
any fact or statement contained in this
Declaration from any liability of any kind with
respect to any fact or statement contained in
this declaration which is false, untrue or
inaccurate in any manner.

Blenheim Fiduciary Group Limited is licensed as a fiduciary by the Guernsey Financial Services Commission
Page 3 of 8

For and on behalf of:

Entity Name:
________________________________________
______________________________________
Print Name:
Duly Authorised Officer:

Date:

To expedite matters, in the first instance, you may wish to e-mail or fax this form and its
attachments to us, but in any event, we will require that the hard copy originals be sent to us
either by courier or normal post to:
Second Floor, St. Peters House, Le Bordage, St. Peter Port, Guernsey, GY1 1BR
E-mail: info@blenheimgroup.com
Fax +44 (0)1481 724 116

Date:
Bank Name:
Address:

Fax Number:
For the attention of:

Dear Sirs,
Account Number:
I hereby authorise you to provide Blenheim Trust Company Limited, Blenheim
Management Services Limited or Barrington Trust Company Limited with a
reference regarding the following:

address,

Confirming the Companys name and

Confirming that the Company holds an

account with yourselves and the length of time that we have done so,

trustworthiness, and

Attesting

to

our

character

Attesting that to the best of your belief we have not been, nor are we
presently the subject of any court action or legal proceedings.
Yours faithfully,
For and on behalf of

Signed __________________________

(Company)

and

Print Name:
Duly Authorised Officer

Date:
Accountant/Lawyer Name:

Name of Firm/Practice

Address:

Fax Number
For the attention of:

Dear Sirs,
I hereby authorise you to provide Blenheim Trust Company Limited, Blenheim
Management Services Limited or Barrington Trust Company Limited with a
reference regarding the following:

address,

Confirming the Companys name and

have known the Company,

Confirming the length of time that you

trustworthiness, and

Attesting

to

our

character

and

Attesting that to the best of your belief

we have not been, nor are we presently the subject of any court action or legal
proceedings.
Yours faithfully,
For and on behalf of

Signed __________________________

Print Name:
Duly Authorised Officer

(Company)