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USA Patriot Act - Certification Information

As a result of the enactment of the USA Patriot Act (Public Law No. 107-56 October 26, 2001), the U.S. Department of the Treasury has issued regulations requiring U.S. financial institutions to obtain certain information relating to foreign banks that maintain relationships at U.S. financial institutions using a certification form. This certification is needed to comply with provisions of the USA Patriot Act.

You can download the forms you need to complete from the box on the right-hand side of this page.

We request that you complete the form electronically as follows before printing, signing and returning. Please note that incomplete forms are not acceptable.

  • Indicate the legal name of your financial institution in response to Part A;
  • Check the appropriate box and provide any additional required information in response to Parts B through E;
  • Indicate the name and address of the U.S. entity acting as your institutions agent for service of process in response to Part F; and,
  • Add the appropriate signature(s) and related information in response to Part G.

Please note that a foreign bank may complete one certification for its branches and offices outside the U.S. However, the certification must list all of the branches and offices that are covered by the certification and must include the information required in Part C for each branch or office that maintains a relationship with HSBC. Although a single certification may be submitted covering the foreign banks branches, a separate certification must be filed for each bank affiliate or subsidiary of the foreign bank.

Under the applicable provisions of the USA Patriot Act, HSBC and HSBC Securities (USA) Inc. are required to obtain this information from you in order to assure that we can continue to maintain your relationship with us.

This certification must be signed by an officer who is authorized to make such a certification under the laws and rules applicable to your Bank. If under the laws or rules applicable to your Bank the signature of more than one officer is necessary to make such a certification, please have the appropriate number of officers sign the certification.

Please send the completed certification form by facsimile transmission to 001 212 642-1542.

If you have any questions concerning the certification or the requirements of the USA Patriot Act, please contact us at:

Email: CIBMcertification@us.hsbc.com
SWIFT: MRMDUS33
Telex: 62822

You may also wish to access the web site of the Institute of International Bankers at http://www.IIB.org for additional information relating to this certification and the requirements of the USA Patriot Act.

We very much appreciate your prompt attention to this matter.

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