Ours is quite simple, here you go.
High Risk Customer Site Visit Report
Business Name: _____________________________________________________________
Date of Site Visit:_____________________________________________________________
Account Officer (conducting visit, please print)___________________________________
While conducting the visit, Officer attested to the following:
Business is still in existence?
If the business stated that they did not offer MSB services, confirm that they still do not (sell money orders, conduct wire transfers for their customers, check cashing*, etc). Does the customer offer MSB services?
Does customer have an ATM on-site? If yes, refer to Private ATM procedures.**
*The customer is not a check casher under the MSB guidelines, as long as they do not cash checks exceeding $1,000 per day per customer and they do not charge more than $1.00 to cash checks.
** If the customer does not maintain their ATM account with XXX, at the time of the annual site visit due diligence, the Bank must request and obtain the three most recent bank statements for where their account is maintained.