FORM KYC

P8 KYC FORM

PERSONAL INFORMATION 01

FULL LEGAL NAME

DATE(S) OF BIRTH

NATIONALITY

(OTHER NATIONALITIES)

STREET

HOUSE NUMBER

CITY

POSTAL CODE

COUNTRY

(ADDITIONAL LOCATIONS)

PROFESSIONAL INFORMATION 02

PRIMARY OCCUPATION

BUSINESS SECTOR / INDUSTRY

PRIMARY LOCATION OF BUSINESS ACTIVITY / WORK

COUNTRY

(ADDITIONAL LOCATIONS)

FINANCIAL INFORMATION 03

ESTIMATED ANNUAL INCOME

NET WORTH

(ADDITIONAL SOURCES OF INCOME)

BUSINESS RELATIONSHIP INFORMATION 04

INTENDED USE OF INVOLVED ASSETS

ASSET CLASS / TYPE INVOLVED (CRYPTO, CASH, ETC)

ESTIMATED VALUE OF INVOLVED ASSETS

SOURCE OF INVOLVED ASSETS (SALARY, INVESTMENT RETURNS, INHERITANCE)

ACKNOWLEDGMENT OF TERMS
I/WE CONFIRM THAT I/WE HAVE RECEIVED AND READ THE SPECIAL TERMS AND CONDITIONS (STCS).
I/WE FURTHER CONFIRM THAT THE DETAILS GIVEN ABOVE ARE ACCURATE, COMPLETE AND TRUE.
I/WE AGREE THAT THE PROVIDED INFORMATION CAN BE SENT TO A THIRD PARTY
(LAWYER/CONSULTANT TO THE BANK) FOR THE PURPOSE OF DUE DILIGENCE.

VALID PROOF OF IDENTITY

Maximum file size: 5MB

PASSPORT, DRIVER LICENSE, ID CARD

RECENT PROOF OF ADDRESS (<3MO)

Maximum file size: 5MB

UTILITY BILL, BANK STATEMENT

SOURCE OF INCOME/WEALTH

Maximum file size: 5MB

TAX RETURN, EMPLOYMENT STATEMENT, SALARY SLIP

DOCUMENTS SHOWING INTENDED USE OF ASSETS

Maximum file size: 5MB

CONTRACTS, INVESTMENT STATEMENT

PLACE

DATE

SIGNATURE

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