MOSSACK FONSECA 
Declaration Form

Source of Funds/Source of Wealth

 

Pursuant to Section 19(3)(d) of the Anti-money Laundering and Terrorist Financing Code,2008

 

NAME OF THE COMPANY (APPLICANT FOR BUSINESS): Audrey Holdings Group 

 

SPECIFIC ACTIVITIES CARRIED OUT BY THE COMPANY: An investment holding company that holds investment

portfolios with financial institutions in Switzerland.

 

MAIN COUNTRY (IES) WHERE THE ACTIVITIES ARE CONDUCTED: Bank accounts held in Switzerland

 

ESTIMATED VALUE OF THE TRANSACTIONS THAT WILL BE CARRIED OUT BY THE COMPANY (If It is a recurring
transaction, the value on an annual basis): Estimated total AUM is approximately USDZOO millions

 

 

NAME OF THE ULTIMATE BENEFICIAL OWNER: Vitaly Malkin

 

ALIASES (if applicable): -

 

DATE OF BIRTH 16 Sep 1952

 

 

 

 

 

 

 




Telephone Number and Fax Number:

 

 

1. Source of Funds: the origin of the monies being used by the Applicant for Business to execute the specific

transaction/activity

Z/Personal Savings. Proceeds of Inheritance/T rust Fund.
(3) Please indicate the specific activities that originate (3) Please enclose the applicable inheritance or trust
your personal savings: documentation:

 

 

 

income and sale of var'

 

 

 

mining and banking sectors. Please indicate the estimated value of the assets
inherited/held in
Please indicate the estimated amount of your savings: trust:
Borrowing/Loans. Proceed from Financial Investments.
(3) Please indicate the purpose of the loans and which Please indicate the specific financial investment
institutions were activities carried out and the involved financial
involved: institutions:

 

 

 

Please indicate the estimated amount of the

loan' Please indicate the source of funds initially invested:

 

 

Please indicate the estimated amount of the profits