KYC Information Collection

Applicant Information

Section 1

Full name of entity / individual

Contact Number

Email Address

Registered Address

Registered Country

Registered State / Province

Registered City

Registered Postal Code

Registered Street Address

Business Operating Address

Business Country

Business State / Province

Business City

Business Postal Code

Business Street Address

Authorized Signatory (AS)

Section 2

Is AS the same person as BO?

Business & Compliance Information

Section 2

Description of principal business activities of entity: (N/A for individuals)

Source of funds used for services provided by ChainUp:

PEP Status Is the applicant, AS or any BO a politically exposed person (PEP), or a family member or close associate of a PEP?

Regulated Entity Is the applicant regulated in any jurisdiction?

Sanctions Status Is the applicant or any of its BOs subject to sanctions by any competent authority?

Shareholder

Please provide shareholder information and passport or ID card documents.

0 Shareholders

KYC Documents

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Declaration

Declaration I/We confirm that all information provided is true, accurate and complete to the best of our knowledge, agree to provide any additional information or documents upon request, understand that any false or misleading information may result in termination of the business relationship; and acknowledge that I/we have read and understood ChainUp Group's Privacy Policy and consent to the collection, use and disclosure of our personal data in accordance with the Privacy Policy.

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Information Collection & Document Upload