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SAGRILAFT Form, Prime Factor

Dear Customer,

To comply with SAGRILAFT policies, we provide you with this form necessary to advance negotiations. Once completed, we will review the information in 1 to 4 business days. If it is correct, we will create an account for you with a temporary password that you must change immediately. All information will be sent to the registered email.

Thank you for your collaboration.

Sincerely,
Prime Factor Team

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PEPS (Politically Exposed Person) Declaration * Due to his position or administrative activity, he is in charge of managing public resources.
Due to his position or activity, he exercises some degree or type of public power.
Due to its activity, occupation or trade, it enjoys general public recognition.
Are you subject to tax obligations in a country other than Colombia.
Do you declare yourself a politically exposed person?
Country of origin of resources *
Economic activity *
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SAGRILAFT Authorization

I expressly declare, acting on my own behalf and/or on behalf of the legal company that I represent, that we comply with the regulations on prevention, control of money laundering and financing of terrorism, and that neither I nor the company I represent, nor its shareholders, directly or indirectly, nor their legal representatives, nor their members of the board of directors, appear on the restrictive lists binding for Colombia, in accordance with international law (United Nations lists) or on the OFAC lists and that, If we become aware that any of the persons mentioned above appear in a report on said lists, we will inform THE COMPANY in a timely manner. We recognize and authorize the right that THE COMPANY has to carry out the verifications it deems relevant in the restrictive lists and on the origin of the assets and resources that we manage, and to make reports to the control entities of the UIAF and to terminate the binding relationship between the parties if its verification finds merit for such purpose.

SAGRILAFT Authorization I expressly declare, acting on my own behalf and/or on behalf of the legal company that I represent, that we comply with the regulations on prevention, control of money laundering and the financing of terrorism, that neither I nor the company that I represent, nor its shareholders directly or indirectly, nor its legal representatives, nor its members of the board of directors, are on the restrictive lists binding for Colombia, in accordance with international law (United Nations lists) or on the OFAC lists and that in the event of becoming aware of If any of the previously mentioned people present a report on said lists, we will inform THE COMPANY in a timely manner. We recognize and authorize the right that THE COMPANY has to carry out the verifications that it considers relevant in the restrictive lists and on the origin of the assets and resources that we manage and to make reports before the UIAF control entities and to terminate the binding relationship. between the parties if in its verification it finds merit for such purpose.

Consent for the Processing of Personal Data

By completing this form, I give my free consent to the processing of personal data in accordance with the provisions of Colombian regulations, specifically Statutory Law 1581 of 2012 and Regulatory Decree 1377 of 2013. I recognize that I have the right to know, update, rectify and delete my information, as well as revoke my consent at any time. I am also informed that I am not required to authorize the processing of my data and that I am not conditioned to carry out any activity that requires providing sensitive data. The entity that receives this data is obliged to guarantee its security, inform me about the purpose of the collection and allow me access to my personal data.

Legal Compliance Statement

I declare that, in compliance with current legal provisions, including External Circular No. 029 of 2014 issued by the Financial Superintendency of Colombia, the Organic Statute of the Financial System (Decree 663 of 1993), Decree 2555 of 2010, Law 190 of 1995, Law 1474 of 2011 "Anti-Corruption Statute", and the Accounts Chapter of the company that I represent or of which I am a shareholder, the resources come from legal activities that comply with all the provisions of Colombian regulations. Besides:

The company's resources come from my own savings and resources obtained in the normal course of operations, in accordance with the company's corporate purpose.
I will not allow third parties to make deposits in my accounts with funds from illicit activities contemplated in the Colombian Penal Code or in any other regulation that complements it; Nor will I carry out transactions intended for such activities or in favor of people related to them.
I authorize the termination of any agreement, business or contract entered into with PRIME FACTOR in case of violation of any of the numerals contained in this document, exempting the entity from all liability derived from erroneous, false or inaccurate information provided by me, or the violation thereof.

Declaration Under Oath

Under the seriousness of the oath, I declare that the data contained in this document are true, therefore, I declare that I have read, understood and accepted this document.

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