Seal of the Eurabelt Custodial OrderEurabelt Fuels Ltd Supplier Due Diligence Declaration  ·  Version 1.0  ·  March 2026

Supplier Due Diligence & Compliance Declaration

This declaration must be completed in full by the proposed supplier before any transaction documentation is exchanged. All information provided will be treated as strictly confidential.

Commodity Supply Pre-Contract Stage Compliance Required
Completion
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Instructions: Please complete all sections. Fields marked * are mandatory. For each compliance checklist section, tick all items that apply to your organisation. On submission, a PDF will be generated for you to print, sign, and return to us.

Section 1 — Company Details

Required

Section 2 — Primary Contact for this Transaction

Required

Section 3 — Proposed Supply Details

Required

Section 4 — Beneficial Ownership & Control

Required

Section 5 — Banking & Payment Details

Required

Section 6 — Vessel & Logistics Information

Important

Section 7 — Sanctions & Regulatory Compliance

Required

Please confirm your company's status with respect to each of the following by selecting the appropriate response.

  • The company, its directors, and UBOs are NOT listed on the OFAC Specially Designated Nationals (SDN) list. High
  • The company, its directors, and UBOs are NOT listed on the EU Consolidated Financial Sanctions list. High
  • The company, its directors, and UBOs are NOT listed on the UK OFSI Financial Sanctions list. High
  • The company, its directors, and UBOs are NOT listed on the UN Consolidated Sanctions list. High
  • The proposed vessel (by IMO number) is NOT listed on any applicable sanctions vessel list. High
  • The receiving bank and all payment intermediaries are NOT subject to sanctions designations. High
  • The company has not been debarred, suspended, or excluded from any regulated market or exchange. Medium
  • The company has no outstanding criminal convictions relating to fraud, bribery, money laundering, or sanctions violations. Medium
  • The company maintains an anti-money laundering (AML) and compliance programme appropriate to the nature and scale of its business. Medium
  • Where applicable, the company confirms the proposed transaction complies with all relevant oil price cap regulations in force at the time of delivery. High

Section 8 — Supporting Documents Available

Important

Please indicate which of the following documents you are able to provide upon request. Do not attach documents to this form — they will be requested separately.

  • Certificate of Incorporation / Company Registration Certificate High
  • Memorandum and Articles of Association High
  • UBO Register / Beneficial Ownership Declaration High
  • Power of Attorney (if signing authority is delegated) Medium
  • Bank Reference Letter (issued within last 12 months) High
  • Proof of Funds / Financial Capability Statement High
  • Q88 Vessel Questionnaire High
  • Trade References (minimum two prior counterparties) Medium
  • Trading Licence / Commodity Trading Authorisation Medium
  • ISO or equivalent quality / compliance certification Low
  • Most recent audited financial statements Medium
  • Evidence of P&I Club and cargo insurance cover High

Section 9 — Additional Information

Optional

Section 10 — Declaration & Authorisation

Required

I, the undersigned, declare on behalf of [Company Name] that the information provided in this declaration is true, accurate, and complete to the best of my knowledge and belief. I understand that providing false or misleading information may result in immediate termination of the proposed transaction and may be reported to relevant regulatory authorities.


I confirm that I am authorised to make this declaration on behalf of the company named above, and that I have reviewed the contents of this form in full.

Once submitted, a PDF will be generated. Please print the PDF, sign in the designated signature box, and return it to Eurabelt Fuels Ltd together with the supporting documents indicated above. This digital submission does not constitute a binding declaration until the signed PDF has been received.

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