Proceeds of Crime (Money Laundering) and Terrorist Financing Regulations (SOR/2002-184)
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Regulations are current to 2024-08-18 and last amended on 2024-07-01. Previous Versions
SCHEDULE 4(Paragraph 7(1)(d), sections 19 and 26, paragraphs 30(1)(f) and 33(1)(f), sections 40, 49, 55, 61 and 67, paragraph 70(1)(d), section 79, subsection 131(3) and section 152)Report with Respect to Receipt of Virtual Currency
PART C
Account and Reference Number Information
- 1*Every account number and other equivalent reference number connected to receipt of virtual currency or remittance
- 2*Type of account
- 3*Branch number, institution number and similar numbers connected to account or reference number
- 4*Name of each account holder
- 5*User name of each account holder
- 6*Type of fiat currency or virtual currency of account
- 7Date account opened
PART D
Information with Respect to Person Who Conducts Transaction and Who Is Client of Reporting Entity
- 1*Person’s name
- 2Person’s alias
- 3*Person’s date of birth
- 4*Person’s address
- 5Person’s country of residence
- 6Person’s email address
- 7Person’s telephone number
- 8*Nature of person’s principal business or their occupation
- 9*Identification number assigned to person by reporting person or entity
- 10*Type of document or other information used to identify person, or to verify their identity, and number of document or number associated with information
- 11*Jurisdiction and country of issue of document or other information
- 12Name of person’s employer
- 13Type of device used by person who conducts transaction online
- 14Number that identifies device
- 15Internet Protocol address used by device
- 16Person’s user name
- 17Date and time of person’s online session in which request is made
PART E
Information with Respect to Person Who Conducts Transaction and Is Not Client of Reporting Entity
- 1Person’s name
- 2Person’s alias
- 3Person’s date of birth
- 4Person’s address
- 5Person’s country of residence
- 6Person’s email address
- 7Person’s telephone number
- 8Nature of person’s principal business or their occupation
- 9Identification number assigned to person by reporting person or entity
- 10Type of document or other information used to identify person, or to verify their identity, and number of document or number associated with information
- 11Jurisdiction and country of issue of document or other information
- 12Name of person’s employer
- 13Type of device used by person who conducts transaction online
- 14Number that identifies device
- 15Internet Protocol address used by device
- 16Person’s user name
- 17Date and time of person’s online session in which request is made
PART F
Information with Respect to Entity That Conducts Transaction and Is Client of Reporting Entity
- 1*Entity’s name
- 2*Entity’s address
- 3Entity’s telephone number
- 4*Nature of entity’s principal business
- 5*Identification number assigned to entity by reporting person or entity
- 6*Name of each person — up to three — who is authorized to bind entity or to act with respect to account
- 7*Type of document or other information used to identify entity, or to verify its identity, and number of document or number associated with information
- 8*Jurisdiction and country of issue of document or other information
- 9*Entity’s registration or incorporation number and jurisdiction and country of issue of that number
- 10Type of device used by entity that conducts transaction online
- 11Number that identifies device
- 12Internet Protocol address used by device
- 13Entity’s user name
- 14Date and time of entity’s online session in which transaction is conducted
PART G
Information with Respect to Entity That Conducts Transaction and Is Not Client of Reporting Entity
- 1Entity’s name
- 2Entity’s address
- 3Entity’s telephone number
- 4Nature of entity’s principal business
- 5Identification number assigned to entity by reporting person or entity
- 6Name of each person — up to three — who is authorized to bind entity or to act with respect to account
- 7Type of document or other information used to identify entity, or to verify its identity, and number of document or number associated with information
- 8Jurisdiction and country of issue of document or other information
- 9Entity’s registration or incorporation number and jurisdiction and country of issue of that number
- 10Type of device used by entity that conducts transaction online
- 11Number that identifies device
- 12Internet Protocol address used by device
- 13Entity’s user name
- 14Date and time of entity’s online session in which transaction is conducted
PART H
Information with Respect to Person or Entity on Whose Behalf Transaction Is Conducted
- 1*Person’s or entity’s name
- 2*Person’s or entity’s address
- 3Person’s or entity’s email address
- 4Person’s or entity’s telephone number
- 5Nature of person’s or entity’s principal business or their occupation
- 6Identification number assigned to person or entity by reporting person or entity
- 7Type of document or other information used to identify person or entity, or to verify their identity, and number of document or number associated with information
- 8Jurisdiction and country of issue of document or other information
- 9*Relationship of person or entity to person or entity that requests transfer
- 10In the case of a person,
- (a)their alias
- (b)their date of birth
- (c)their country of residence
- (d)their employer’s name
- 11In the case of an entity,
- (a)name of each person — up to three — who is authorized to bind entity or to act with respect to account
- (b)its registration or incorporation number and jurisdiction and country of issue of that number
PART I
Information with Respect to Beneficiary
- 1*Beneficiary’s name
- 2*Beneficiary’s address
- 3Beneficiary’s email address
- 4Beneficiary’s telephone number
- 5Nature of beneficiary’s principal business or their occupation
- 6Identification number assigned to beneficiary by reporting person or entity
- 7*Type of document or other information used to identify beneficiary, or to verify their identity, and number of document or number associated with information
- 8*Jurisdiction and country of issue of document or other information
- 9Beneficiary’s user name
- 10If beneficiary is a person,
- (a)their alias
- (b)their date of birth
- (c)their country of residence
- (d)their employer’s name
- 11*If beneficiary is an entity,
- (a)name of each person — up to three — who is authorized to bind entity or to act with respect to account
- (b)its registration or incorporation number and jurisdiction and country of issue of that number
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