BSA-AML Examiner School Case Study eBook

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Currency Transaction Report

Step 3. Person(s) Involved Information

Step 4. Amount and Type of Transaction(s)

Step 2. Transaction Location(s) Information

Step 1. Filing Institution Contact Information

Home

Part I Person Involved in Transaction(s) 1

of

+ -

1

Person on whose behalf transaction was conducted

Person conducting transaction on own behalf

Person conducting transaction for another

*2

Common carrier

a

c

d

b

Multiple transactions Check

3

If entity

*4 Individual's last name or entity's legal name

Unknown

SULZE

*5 First name

Unknown

AMY

J

6 Middle name

Suffix

MALE

7 Gender 8 Alternate name

9 Occupation or type of business

9a NAICS Code

Unknown

* 10 Address

1919 RIGHTWAY AVE

Unknown

* 11 City

OMAHA

Unknown

Unknown

68509

* 13 ZIP/Postal Code

* 12 State

NE

Unknown

*14 Country

US

Unknown 504-23-6652

SSN-ITIN

16 TIN type

* 15 TIN

Unknown 02/14/1962

*17 Date of birth

18 Contact phone number

308-627-4949

Ext.

19 E-mail address

SULAM@HOTMAIL.COM

* 20 Form of identification used to verify identity

Unknown

Driver's license/State ID

Passport

Alien Registration

Other

H1424153

Number

NE

Issuing State

US

Country

15,000

21 Cash in amount for individual or entity listed in Item 4

$

+ -

Account number

100965

22 Cash out amount for individual or entity listed in Item 4

$

+ -

500

Account number

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