BSA/AML Examiner School - Case Study Oct 2023

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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) 2

of

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2

Person conducting transaction on own behalf

Person on whose behalf transaction was conducted

Person conducting transaction for another

*2

Common carrier

a

b

c

d

3

Multiple transactions

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

If entity

Unknown

OVERLY

*5 First name

Unknown

ROB

6 Middle name

Suffix

7 Gender 8 Alternate name

MALE

BOOKKEEPER

9 Occupation or type of business

9a NAICS Code

Unknown

* 10 Address

1720 CEDAR ST

Unknown

* 11 City

FT. LAUDERDALE

Unknown

Unknown

55555

* 13 ZIP/Postal Code

* 12 State

TN

Unknown

*14 Country

US

Unknown 619-98-51710

SSN-ITIN

16 TIN type

* 15 TIN

Unknown 10/06/1971

*17 Date of birth

18 Contact phone number

507-999-2354

Ext.

ROB909@GMAIL.COM

19 E-mail address

* 20 Form of identification used to verify identity

Unknown

Driver's license/State ID

Passport

Alien Registration

Other

21027788

Number

TN

Issuing State

US

Country

12,456

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

$

+ -

7212559

Account number

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

$

+ -

Account number

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