Customer questionnaire (legal)

08.07.2019.

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Company details

Company's name *

Registration number *

Country of incorporation *

Registration address *

Country *

City/Region *

Village/district *

Village/Street/Number

Zip code *

Office address

Office address the same as Registration address

Country *

City/Region *

Village/district *

Village/Street/Number

Zip code *

Phone No. *

Website

Residence for tax purposes *

Tax identification number *

Add country

Business licence *

Yes No

Business profile/industry *

The company representatives

Person no.1

Representation person *

Name *

Country of residence *

Surame *

ID number *

Date of birth *

Add extra person

The company shareholders

Person no.1

Legal entity/Individual *

Number of shares, % *

Add extra person

The company economic beneficiaries

Person no.1

Name *

Surname *

ID number *

Date of birth *

Citizenship (country) *

Place of birth (country) *

Add country

Residence address *

Country *

City/Region *

Village/district *

Village/Street/Number *

Zip code *

Residence for tax purposes *

Tax identification number *

Add country

Number of shares, & *

Add extra person

The company key business partners

The company's key business partner no. 1

The company's name *

Country of incorporation *

Funds receiving from/funds sending to *

Add extra person

Transactions with dnb

Number of transactions (average, monthly) *

Approximate monthly turnover (EUR/month) *

Approximate monthly cash-in amount (EUR/month) *

Approximate monthly cash withdrawal amount (EUR/month) *

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