COUNTERPARTY QUESTIONNAIRE — blank working form
Not an approval or acceptance. No submission channel is connected.

Legal name / registration:
Beneficial owners / authorised signatories:
Material type / origin / transit:
Supplier chain:
Applicable licences:
Assay and shipment evidence:
Payment route:
Sanctions / adverse-information review:
Responsible-sourcing controls:
Supporting-document index:
Reviewer / date / unresolved issues: