FCIM120050 | Where CDF offer is made up to 29 June 2014: appendices: appendix 5 - certificate of bank accounts operated

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TO: HM REVENUE & CUSTOMS

[……………Insert name…………………………]

I certify that to the best of my knowledge and belief the following is a complete list of all accounts with Financial Institutions (including but not limited to banks and building societies) whether current, deposit, savings, investment, safety deposit or loan, business or private inside or outside the United Kingdom.

1. in my own name, including any maiden name or alias I may have used

2. in the name of my minor children, where the children were minors at the time of account opening, and

3. in any other name or names in which I have, or have had, an interest or over which I have or have had power or control either jointly with another person, whether real or corporate, or persons or solely

Which are in existence now or which have existed at any time during the period from

………………………………………… to ……………………………………….

Signed ………………………………

Address ……………………………………………………………………………………………

Date …………………………………

FALSE STATEMENTS MAY RESULT IN A CRIMINAL INVESTIGATION WITH A VIEW TO PROSECUTION