Port Agent Questionnaire

Unique Request ID

* Please enter the Request Identifier supplied in the email

Port Agent Details

* Port Agent Full Legal Entity Name
Port Agent Trading Name(If applicable)
Port Agent Name in local language
* Date of Incorporation
Company type
* Company Registration number
Principal business activity
* Operating Address Line 1
Operating Address Line 2
* City
State/ Province
Postal Code
* Operating Address Country
Please select this checkbox if the Registered Address is same as the Operating Address
* Registered Address Line 1
Registered Address Line 2
* City
State/ Province
Postal Code
* Registered Address Country

Franchise Arrangements

* Is the company part of a franchise, or does it operate under a franchise arrangement?

Port Agent Contact Details

* Contact Name
* Contact Email Address
* Contact Telephone Number (including country and area code)
Company website address

Port Agent Bank Details

* Payment Beneficiary (Account Name)
Explanation if Payment Beneficiary is different from Port Agent and the relationship with the agent
* Bank Name
* Bank Address Line 1
Bank Address Line 2
* City
State/ Province
Postal Code
* Bank Address Country
Account No
Bank Swift/BIC
Sort Code

List ALL Directors associated with this Port Agent

No.	Title	Name	Name in Local Language	Date of Birth	Nationality	Resident Country

Please fill in all the following details and click on the Add button to add a Director

Title
* First name
Middle name (s)
Surname (Family name)
Name in local language
* Date of Birth		Select date from Calendar
* Nationality
* Resident Country

Port Agent Ownership Details

Please list all shareholders owning over 10% of the company. For any shareholder that is a company, please identify the Ultimate Beneficial Owner i.e.,
add the ownership chain originating from the port agent and leading to the ultimate owners.

Please select a value from the Shareholder Type dropdown, fill in the subsequent details and click on the Submit Shareholder Data button
to submit the details of a shareholder.

Shareholding in Company

* Shareholder Type

* % Shareholding

Title

* Legal Name		Trading Name		Name in local language
* Registered Country		* Operating Country		* Date of Incorporation

* First name	Middle name (s)	Surname (Family name)
Name in local language	* Date of Birth	* Nationality
* Resident Country	* % Shareholding

Entity Name

RowId	ParentRowId	SNo	Type	%	Title	Name/ Legal Name	Name in local language	Trading Name	DoB/ Date of Inc	Nationality/ Registered Country	Resident Country/ Operating Country

Sub Agents

* Select the number of Sub Agents to be used for this port call

Sub Agent 1 Details

* Sub Agent Full Legal Entity Name
Sub Agent Trading Name(If applicable)
Sub Agent Name in local language
* Date of Incorporation
Company type
* Company Registration number
Principal business activity
* Operating Address Line 1
Operating Address Line 2
* City
State/ Province
Postal Code
* Operating Address Country
Please select this checkbox if the Registered Address is same as the Operating Address
* Registered Address Line 1
Registered Address Line 2
* City
State/ Province
Postal Code
* Registered Address Country

Sub Agent 1 Contact Details

* Contact Name
* Contact Email Address
* Contact Telephone Number (including country and area code)
Company website address

List ALL Directors associated with Sub Agent 1

No.	Title	Name	Name in Local Language	Date of Birth	Nationality	Resident Country

Please fill in all the following details and click on the Add button to add a Director

Title
* First name
Middle name (s)
Surname (Family name)
Name in local language
* Date of Birth		Select date from Calendar
* Nationality
* Resident Country

Sub Agent 1 Ownership Details

Please list all shareholders owning over 10% of the company. For any shareholder that is a company, please identify the Ultimate Beneficial Owner i.e.,
add the ownership chain originating from the port agent and leading to the ultimate owners.

Please select a value from the Shareholder Type dropdown, fill in the subsequent details and click on the Submit Shareholder Data button
to submit the details of a shareholder.

Shareholding in Company

* Shareholder Type

* % Shareholding

Title

* Legal Name		Trading Name		Name in local language
* Registered Country		* Operating Country		* Date of Incorporation

* First name	Middle name (s)	Surname (Family name)
Name in local language	* Date of Birth	* Nationality
* Resident Country	* % Shareholding

Entity Name

RowId	ParentRowId	SNo	Type	%	Title	Name/ Legal Name	Name in local language	Trading Name	DoB/ Date of Inc	Nationality/ Registered Country	Resident Country/ Operating Country

Sub Agent 2 Details

* Sub Agent Full Legal Entity Name
Sub Agent Trading Name(If applicable)
Sub Agent Name in local language
* Date of Incorporation
Company type
* Company Registration number
Principal business activity
* Operating Address Line 1
Operating Address Line 2
* City
State/ Province
Postal Code
* Operating Address Country
Please select this checkbox if the Registered Address is same as the Operating Address
* Registered Address Line 1
Registered Address Line 2
* City
State/ Province
Postal Code
* Registered Address Country

Sub Agent 2 Contact Details

* Contact Name
* Contact Email Address
* Contact Telephone Number (including country and area code)
Company website address

List ALL Directors associated with Sub Agent 2

No.	Title	Name	Name in Local Language	Date of Birth	Nationality	Resident Country

Please fill in all the following details and click on the Add button to add a Director

Title
* First name
Middle name (s)
Surname (Family name)
Name in local language
* Date of Birth		Select date from Calendar
* Nationality
* Resident Country

Sub Agent 2 Ownership Details

Please list all shareholders owning over 10% of the company. For any shareholder that is a company, please identify the Ultimate Beneficial Owner i.e.,
add the ownership chain originating from the port agent and leading to the ultimate owners.

Please select a value from the Shareholder Type dropdown, fill in the subsequent details and click on the Submit Shareholder Data button
to submit the details of a shareholder.

Shareholding in Company

* Shareholder Type

* % Shareholding

Title

* Legal Name		Trading Name		Name in local language
* Registered Country		* Operating Country		* Date of Incorporation

* First name	Middle name (s)	Surname (Family name)
Name in local language	* Date of Birth	* Nationality
* Resident Country	* % Shareholding

Entity Name

RowId	ParentRowId	SNo	Type	%	Title	Name/ Legal Name	Name in local language	Trading Name	DoB/ Date of Inc	Nationality/ Registered Country	Resident Country/ Operating Country

Anti Corruption User Confirmation

* Please confirm that the port agent, and any sub-agents entered above, comply with all anti-corruption laws. YES NO

If your response to the previous question was NO, please provide an explanation below

* Please confirm that the port agent, and any sub-agents entered above have not been convicted previously in relation to any matter concerning bribery, corruption or the making of facilitation payments. YES NO

If your response to the previous question was NO, please provide an explanation below

Please submit any additional information that may help us process your nomination request.

BP Privacy Notice

This notification relates to the collection of data by BP Shipping Limited, registered with the English Information Commissioner under no. Z1346577. We may obtain and hold information relating to your company as part of our "Know Your Counterparty" requirements incorporated into our internal policies. This may include information from independent searches or information provided by yourself regarding your company and its owners and controllers.

All the information we collect and process may be shared with, used and processed by other BP Group entities for similar purposes. As the BP Group operates globally, data may be transferred within the BP Group (subject to our Binding Corporate Rules) or to third parties situated outside of the European Union. We will take the appropriate steps to ensure that personal information is held in accordance with BP's 16 Data Privacy Rules, including individuals’ right to object to processing in certain circumstances, correct inaccurate personal information and to subject access.

By submitting any information relating to individuals such as shareholders or directors, or to third parties such as sub-agents, you undertake that this notification has been passed to them and that they agree to the provision of this information to and processing by BP.

Should you have any questions relating to the BP 16 Data Privacy Rules, please send the enquiry to the following address :-

Compliance and Ethics leader
BP Shipping Limited
Chertsey Road
Sunbury-on-Thames
Middlesex
TW16 7BP

Please see BP's 16 Data Privacy Rules on the following link: -Privacy Rules Document

BP may contact you to ask for further information or clarification before appointing your Agency

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