Financial Sanctions Compliance Checklist Form
Use this checklist to screen counterparties and transactions for sanctions-related risk and record the review outcome.
Counterparty and Review Details
Legal entity or individual name
*
Organization name (if applicable)
Relationship to subject
*
Country or region of operation
*
Please Select
United States
Canada
United Kingdom
European Union
Middle East
Asia-Pacific
Latin America
Africa
Other
Review date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Reviewer name or team
*
Sanctions Screening Checklist
Screened against applicable sanctions lists
*
Yes
Exact or potential match identified
*
Yes
Operates in a restricted country or region
*
Yes
Adverse media or compliance flag identified
*
Yes
Ownership and control information reviewed
*
Yes
Linked to any sanctioned party
*
Yes
Resolution and Documentation
Review Outcome
*
Please Select
Clear
Review Required
Escalate
Other
Required Follow-up Action
*
Please Select
No further action
Enhanced review
Escalate to compliance
Request additional information
Monitor closely
Other
Notes / Comments
Supporting Documentation
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