First Name :

Last Name :

Country of fiscal residence :

Phone number :

Your email :

The account is for : The account is for : An individual An entity Other

if other, please say :

Are you an intermediary? Are you an intermediary? Yes No

What is your current work position :

Are you a Politically Exposed Person? Are you a Politically Exposed Person? Yes No

If yes please give more details :

What will be the frequency of money transferred into the bank account: What will be the frequency of money transferred into the bank account: Daily Weekly Monthly Annually

Other

What will be the average amount transferred to the account (annually), please mention currency :

What will be the frequency of money transferred outside the account ? What will be the frequency of money transferred outside the account ? Daily Weekly Monthly Annually

Is the money will be used for investment ? Is the money will be used for investment ? Yes No

What will be the type of investments?

In case of investments, in which countries, will you invest ?

In case of crypto currencies, on which platform will you execute your orders (example: Binance, Coinbase,…)

In case the bank requires a deposit as a guarantee, would you accept to make a deposit of In case the bank requires a deposit as a guarantee, would you accept to make a deposit of $/€/CHF 50,000 $/€/CHF 100,000 $/€/CHF 200,000 $/€/CHF 500,000

What will be the maximum limit of the deposit which will be acceptable for you What will be the maximum limit of the deposit which will be acceptable for you $/€/CHF 50,000 $/€/CHF 100,000 $/€/CHF 200,000 $/€/CHF 500,000

Describe your project with accurate information :

You acknowledge that the information you provide must be accurate. Any request will not false information or information intended to deceive our company and our partners will be considered null and void and any fee you may pay will be non-refundable. We draw to your attention that by principle, we apply our own know your client (KYC) procedures, regulatory compliance and risk management rules. This service may be charged upon payment of upfront fee. Payment is required only if our compliance check is satisfactory. If our compliance procedure is satisfactory and our partner bank declines to open your bank account offer, fees for processing your file are not refundable. You acknowledge that the information you provide must be accurate. Any request will not false information or information intended to deceive our company and our partners will be considered null and void and any fee you may pay will be non-refundable. We draw to your attention that by principle, we apply our own know your client (KYC) procedures, regulatory compliance and risk management rules. This service may be charged upon payment of upfront fee. Payment is required only if our compliance check is satisfactory. If our compliance procedure is satisfactory and our partner bank declines to open your bank account offer, fees for processing your file are not refundable. I agree