Compliance Form for Individuals

Customer Information Instructions

Advanced United Refining Inc. is required by law, by corporate policy, and by good business practice to identify and know our customers, and to ensure that our transactions with them meet high standards of integrity. Accordingly we require customers to provide the following information and certification, as a condition to doing business.

The following Customer Identification Form seeks basic information that identifies a customer, and that permits  Advanced United Refining Inc. to verify that information, to check with third parties, and to make contractual commitments.  Advanced United Refining Inc. requires that all applicable information requested in this form be provided.

For each natural person who is identified as a customer,  Advanced United Refining Inc. requires a copy of a current government-issued photo identity document, such as a passport or driver’s license. This document must show the issuing government, document number, dates of issue and expiration, date of birth and signature of the individual, and a clear photograph.

SECURITY NOTICE: Your information is protected by 128-bit SSL encryption for enhanced security during submission.