COMPANY PROFILEGeneral InformationCompany Name (Legal + Trading Name) *Company Registration Number *Date of Incorporation *Country of Incorporation *Choose CountryAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFijiFinlandFranceGabonGambiaGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorth MacedoniaNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth SudanSpainSri LankaSudanSurinameSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamYemenZambiaZimbabweRegistered Address *Operational Address (if different)WebsiteExpected Turnover Monthly (EUR) *Expected Turnover Annually (EUR) *DOCUMENT UPLOADSCorporate DocumentsCertificate of Incorporation *Allowed files: PDF, PNG, JPG, DOC, DOCX (Max 10MB).Choose FileNo file chosenDelete uploaded fileMemorandum & Articles of Association *Allowed files: PDF, PNG, JPG, DOC, DOCX (Max 10MB).Choose FileNo file chosenDelete uploaded fileCorporate Structure Chart *Allowed files: PDF, PNG, JPG, DOC, DOCX (Max 10MB).Choose FileNo file chosenDelete uploaded fileDIRECTOR INFORMATIONManagement DetailsDirector Name *Date of Birth *Residential Address *DOCUMENT CHECKLISTDirector VerificationRegister of Directors *Allowed files: PDF, PNG, JPG, DOC, DOCX (Max 10MB).Choose FileNo file chosenDelete uploaded fileDirector Photographic ID *Allowed files: PDF, PNG, JPG, DOC, DOCX (Max 10MB).Choose FileNo file chosenDelete uploaded fileDirector Proof of Address *Allowed files: PDF, PNG, JPG, DOC, DOCX (Max 10MB).Choose FileNo file chosenDelete uploaded fileOWNERSHIP STRUCTURE1. Individual Shareholders (25%+)INDIVIDUAL SHAREHOLDERS (25% OR ABOVE)Please provide details for all individual (natural person) shareholders who hold 25% or more of the company's shares or voting rights. Do not list corporate entities in this section.Shareholder Name *Date of Birth *Residential Address *% Shareholding *OWNERSHIP STRUCTURE2. Corporate ShareholdersAre there any Corporate Shareholders (Companies) that own shares?NoYesCORPORATE SHAREHOLDER INFORMATIONPlease list any legal entities (companies) that hold shares in the applicant company. Do not list natural persons hereCorporate Shareholder Name *Registration Number *Registered Address *% Shareholding *OWNERSHIP STRUCTURE3. Ultimate Beneficial Ownership (UBO)Includes beneficial ownership of corporate shareholdersPlease list all natural persons who ultimately own or control 25% or more of the company. (If an individual from Section 1 is a UBO, please list them here as well)Shareholder Name *Date of Birth *Residential Address *% Shareholding *UBO Photographic ID (Driving License or Passport) *Allowed files: PDF, PNG, JPG, DOC, DOCX (Max 10MB).Choose FileNo file chosenDelete uploaded fileUBO Proof of Address (Utility Bill within 3 months.) *Allowed files: PDF, PNG, JPG, DOC, DOCX (Max 10MB).Choose FileNo file chosenDelete uploaded fileRegister of Members/Shareholders *Allowed files: PDF, PNG, JPG, DOC, DOCX (Max 10MB).Choose FileNo file chosenDelete uploaded fileAUTHORIZED SIGNATORIESList of persons authorized to signLIST OF AUTHORIZED SIGNATORIESSignatory Name *Date of Birth *Residential Address *Position *MLRO / COMPLIANCE OFFICERMoney Laundering Reporting Officer (or equivalent)MLRO Name *Date of Birth *Residential Address *LICENSE INFORMATIONRegulatory DetailsDoes the company hold any regulatory licenses? *NoYesDETAILS OF REGULATORY LICENSESLicense Type/Name *License Jurisdiction *Date Granted *Date Expires *Compliance DocumentsBusiness Operating License *Allowed files: PDF, PNG, JPG, DOC, DOCX (Max 10MB).Choose FileNo file chosenDelete uploaded fileAML and KYC Policies *Allowed files: PDF, PNG, JPG, DOC, DOCX (Max 10MB).Choose FileNo file chosenDelete uploaded fileBUSINESS ACTIVITY & SOURCE OF FUNDSOperational DetailsDescription of Company Activity, Purpose of Account, and Source of Funds *Please provide a detailed description. Include how the company generates wealth and why this account is required.SETTLEMENT BANK DETAILSBeneficiary Account InformationBeneficiary Name *Beneficiary Address *Beneficiary IBAN *Account Currency *Please select an optionEURUSDGBPCADAUDOtherBank Name *Bank Swift Code *Bank Sort/BIC CodeBanking VerificationSettlement Bank Statement *Must be within the last 3 months. Allowed files: PDF, PNG, JPG (Max 10MB).Choose FileNo file chosenDelete uploaded fileTECHNICAL SETUP DETAILSIntegration ConfigurationSandbox Email Address *Production Email Address *Type of Service Required *Processing Currencies Required *EURUSDGBPCADAUDOtherSUBMITTER DETAILSPerson completing this formSubmitter Name *Title *Date *DIRECTOR SIGNATUREFinal DeclarationDirector Name *Date of Signing *Declaration *I hereby certify that the information provided in this form is true, complete, and accurate to the best of my knowledge.Digital Signature *By typing your name above, you agree that this counts as your legal signatureSubmit
