Bank Account Opening Request Form

1. Account Type & Institution Preference

Type of Account Required *

Personal Account

Business Account

Preferred Institution Type *

Bank

Electronic Money Institution (EMI)

No Preference

Target Market Locations: (Jurisdiction Preference) *

Are You Open to Offshore Bank Accounts? *

Yes

No

2. Business Information

2. Personal Information

Title *

Mr

Mrs

Other

First Name (as per passport) *

Surname(s) *

Date of Birth *

Country of Birth *

Occupation *

Nationality *

Company Name *

Date of Incorporation *

Country of Incorporation *

Company Register & Number *

Expected Monthly Transactions *

Area of Activity *

Sources of Funds *

(Business revenue, Investments, Other (Specify)

Street / Number *

Registered Address

Town / Village *

Registered Address

Post Code *

Registered Address

Country *

Registered Address

Is the Mailing Address the same as the Registered Address?

Street / Number *

Mailing Address

Town / Village *

Mailing Address

Post Code *

Mailing Address

Country *

Mailing Address

Contact Full Name *

Telephone *

Email *

Mobile Phone *

Please include the country code.

Website

Do you need to set up a new company?

Do you need assistance in setting up a new company?

3. Banking Requirements

Purpose of the Account *

Required Banking Services *

Debit/Credit Card

Online Banking

Multi-Currency Account

IBAN / SWIFT Transfers

SEPA Payments

Cryptocurrency Transactions

Merchant Account (For processing payments)

Other (Specify)

Select all that apply

Do You Need an Introduction to a Relationship Manager? *

Yes

No

Are You Open to Using a Nominee for the Account Setup? *

Yes

No

Do You Require Assistance with Compliance & KYC Documentation? *

Yes

No