Introducers – Application Form

"*" indicates required fields

1Company Information

2Agreement Information

3KYC Merchant Documents

4Director Information

5Shareholders Information

6Sworn Statement of Funds

Agreement Information

Name of the person who will sign the Agreement*

Provide the full name of the Director or authorized signature that will sign the Agreement.

Email of the person who will sign the Agreement*

Email of the director or the authorized signature that will sign the merchant Agreement.

Name(s) of the person(s) or team(s) to receive legal notifications*

List the name(s) or team(s) for legal communications, separated by commas.

Email(s) of the person(s) or team(s) to receive legal notifications*

Input the email(s) of individuals or teams for legal communications, separated by commas.

Specify where the company will collect, process, and store users' personal data*

EU/EEA

Non-GDPR compliant country

None of the above

KYC Merchant Documents

Certificate of Incorporation*

Max. file size: 80 MB.

Memorandum and Articles of Incorporation/Association or Bylaws

Max. file size: 80 MB.

Certificate of Good Standing

A document, issued within the last 6 months, demonstrating the company's current active status. The document may vary based on the jurisdiction.

Max. file size: 80 MB.

Certificate of Incumbency

If applicable for the company's jurisdiction.

Max. file size: 80 MB.

Corporate structure chart showing ownership and control of the company

The chart should include: 1. UBOs owning 10% or more of the company. 2. Full names and ownership percentages in the group structure. 3. Directors' names for each entity. The document requires the signature of one of the current Directors.

Max. file size: 80 MB.

Bank account statement*

Submit the applying entity's bank account statement or an official Account Confirmation Letter from the bank, dated within the last 6 months.

Max. file size: 80 MB.

Shareholder Register*

Max. file size: 80 MB.

Director Information

Full name (Director 1)*

Color ID/Passport (Director 1)*

The document must include the legal name, date of birth, a clear picture, country of residence, and expiry date.

Max. file size: 80 MB.

Proof of address (Director 1)*

The proof of address can be a utility bill or bank statement showing the Director's full name, and current address, issued within the last 3 months.

Max. file size: 80 MB.

Add Director(s)

Full name (Director 2)*

Color ID/Passport (Director 2)*

The document must include the legal name, date of birth, a clear picture, country of residence, and expiry date.

Max. file size: 80 MB.

Proof of address (Director 2)*

The proof of address can be a utility bill or bank statement showing the Director's full name, and current address, issued within the last 3 months.

Max. file size: 80 MB.

Full name (Director 3)*

Color ID/Passport (Director 3)*

The document must include the legal name, date of birth, a clear picture, country of residence, and expiry date.

Max. file size: 80 MB.

Proof of address (Director 3)*

The proof of address can be a utility bill or bank statement showing the Director's full name, and current address, issued within the last 3 months.

Max. file size: 80 MB.

Full name (Director 4)*

Color ID/Passport (Director 4)*

The document must include the legal name, date of birth, a clear picture, country of residence, and expiry date.

Max. file size: 80 MB.

Proof of address (Director 4)*

The proof of address can be a utility bill or bank statement showing the Director's full name, and current address, issued within the last 3 months.

Max. file size: 80 MB.

Full name (Director 5)*

Color ID/Passport (Director 5)*

The document must include the legal name, date of birth, a clear picture, country of residence, and expiry date.

Max. file size: 80 MB.

Proof of address (Director 5)*

The proof of address can be a utility bill or bank statement showing the Director's full name, and current address, issued within the last 3 months.

Max. file size: 80 MB.

Shareholders Information

Are the company's Shareholder(s) a natural person, a legal entity or both?*

Natural Person

Legal Entity

Both

Are the shareholder and director the same person?*

Yes

UBO Declaration

I hereby declare that the ultimate beneficial owners are the individuals who arise from the end of the ownership thread, as evidenced by the documentation submitted. If this is not the case, we shall expressly communicate otherwise and submit the documents requested directly below. The term "ultimate beneficial owner" (UBO) refers to the natural person or persons who ultimately own or control the merchant. UBOs are the individuals who exercise significant influence or control over the entity. We need to identify UBOs having 10% or more of its shares or voting rights.

Color ID/Passport (UBOs)*

Provide documents for all UBOs holding 10% or more of company shares. The document(s) must include the legal name, date of birth, a clear picture, country of residence, and expiry date.

Max. file size: 80 MB.

Proof of address (UBOs)*

Provide documents for all UBOs holding 10% or more of company shares. The proof of address can be a utility bill or bank statement showing the Director's full name, and current address, issued within the last 3 months.

Max. file size: 80 MB.

Shareholder Information (Natural Person)

Full name (Natural Person)*

Color ID/Passport (Natural Person)*

The document must include the legal name, date of birth, a clear picture, country of residence, and expiry date.

Max. file size: 80 MB.

Proof of address (Natural Person)*

The proof of address can be a utility bill or bank statement showing the Director's full name, and current address, issued within the last 3 months.

Max. file size: 80 MB.

Add Shareholder(s) (Natural Person)

Full name (Natural Person 2)*

Color ID/Passport (Natural Person 2)*

The document must include the legal name, date of birth, a clear picture, country of residence, and expiry date.

Max. file size: 80 MB.

Proof of address (Natural Person 2)*

The proof of address can be a utility bill or bank statement showing the Director's full name, and current address, issued within the last 3 months.

Max. file size: 80 MB.

Full name (Natural Person 3)*

Color ID/Passport (Natural Person 3)*

The document must include the legal name, date of birth, a clear picture, country of residence, and expiry date.

Max. file size: 80 MB.

Proof of address (Natural Person 3)*

The proof of address can be a utility bill or bank statement showing the Director's full name, and current address, issued within the last 3 months.

Max. file size: 80 MB.

Full name (Natural Person 4)*

Color ID/Passport (Natural Person 4)*

The document must include the legal name, date of birth, a clear picture, country of residence, and expiry date.

Max. file size: 80 MB.

Proof of address (Natural Person 4)*

The proof of address can be a utility bill or bank statement showing the Director's full name, and current address, issued within the last 3 months.

Max. file size: 80 MB.

Full name (Natural Person 5)*

Color ID/Passport (Natural Person 5)*

The document must include the legal name, date of birth, a clear picture, country of residence, and expiry date.

Max. file size: 80 MB.

Proof of address (Natural Person 5)*

The proof of address can be a utility bill or bank statement showing the Director's full name, and current address, issued within the last 3 months.

Max. file size: 80 MB.

Shareholder Information (Legal Entity)

Legal entity name (Legal Entity)*

Shareholder Register (Legal Entity)*

Max. file size: 80 MB.

Certificate of Good Standing (Legal Entity)

A document, issued within the last 6 months, demonstrating the company's current active status. The document may vary based on the jurisdiction.

Max. file size: 80 MB.

Add Shareholder(s) (Legal Entity)

Legal entity name (Legal Entity 2)*

Shareholder Register (Legal Entity 2)*

Max. file size: 80 MB.

Certificate of Good Standing (Legal Entity 2)

A document, issued within the last 6 months, demonstrating the company's current active status. The document may vary based on the jurisdiction.

Max. file size: 80 MB.

Legal entity name (Legal Entity 3)*

Shareholder Register (Legal Entity 3)*

Max. file size: 80 MB.

Certificate of Good Standing (Legal Entity 3)

A document, issued within the last 6 months, demonstrating the company's current active status. The document may vary based on the jurisdiction.

Max. file size: 80 MB.

Legal entity name (Legal Entity 4)*

Shareholder Register (Legal Entity 4)*

Max. file size: 80 MB.

Certificate of Good Standing (Legal Entity 4)

A document, issued within the last 6 months, demonstrating the company's current active status. The document may vary based on the jurisdiction.

Max. file size: 80 MB.

Legal entity name (Legal Entity 5)*

Shareholder Register (Legal Entity 5)*

Max. file size: 80 MB.

Certificate of Good Standing (Legal Entity 5)

A document, issued within the last 6 months, demonstrating the company's current active status. The document may vary based on the jurisdiction.

Max. file size: 80 MB.

Do any of the Directors, Shareholders or UBOs qualify as PEP?*

A "Politically Exposed Person" (PEP) is an individual who is or has been entrusted with a prominent public function, either domestically or internationally. The definition of a PEP may include individuals holding high-ranking political positions, government officials, senior executives of state-owned enterprises, and high-ranking military officers. It also extends to the immediate family members and close associates of these individuals.

Yes

Provide their names and the reasons for their classification as PEPs*

Sworn Statement of Funds

I hereby declare I am an authorized representative of the Company, duly empowered to provide this statement and affirmations on behalf of it.

Therefore, I declare the following statements as true and accurate regarding the funds held by the Company and their intended use for processing through your entity:

The source of funds originated by the Company are legal and obtained through legitimate business operations. Furthermore, I hereby confirm that the Company is in complete alignment and compliance with the tax obligations in its applicable jurisdiction.

The aforementioned funds are not derived from any illegal activities, including related to money laundering, terrorist financing, and other criminal acts, as defined by international regulations such as the Financial Action Task Force (FATF) recommendations, the United Nations Convention against Transnational Organized Crime, United Nations Security Council Resolutions on countering terrorism and its financing, and any applicable national laws and regulations.

In that regard, I declare that the Company’s contributed funds/values are not originated or linked from any illegal activity and are not directly or indirectly related with, but not limited to, activities such as:

drug trafficking;
public corruption offense;
terrorism and its financing;
smuggling;
traffic of illegal arms;
explosives;
ammunitions or material intended for its production;
illicit traffic of organs tissues;
medicine;
nuclear substance;
works of art;
animals and toxic materials;
illicit traffic and human trafficking;
kidnapping;
extortion;
procuring;
swindle;
crimes against the intellectual property;
trademark crimes;
misappropriation;
currency counterfeiting or alteration;
conduct related to the child sale;
prostitution;
utilization of child pornography;
or about human trafficking;
people traffic or sexual exploitation;
fraudulent bankruptcy or insolvency;
corporate fraudulent insolvency;
illegal gambling;
genocide crime;
war crimes;
crimes of lese-humanity;
nor any other activity considered illegal under the applicable jurisdiction.

The funds will be utilized by the Company for lawful business objectives, and we hereby affirm that these funds will not be employed for any illegal or prohibited activities. Furthermore, we assure you that the funds will be used in accordance with the purposes specified in the agreement amongst us.

The Company acknowledges and understands that providing any false or deceptive information to the processor may result in the immediate termination of the business relationship and could potentially result in legal ramifications.

Thereby I affirm that in case of any changes in the information provided, we will promptly notify and present updated information as applicable.

(Please read carefully this Sworn Statement of Funds. By clicking on accept, you acknowledge and declare that you fully understand and accept the contents.)

Consent*

Accept declaration and statement of funds