Cryptocurrency Exchange Identity Verification Support Request Form
Use this form to request help with identity verification issues on your cryptocurrency exchange account.
Applicant Details
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Country / Region of Residence
*
Please Select
Afghanistan
Albania
Algeria
Andorra
Angola
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Chile
China
Colombia
Costa Rica
Croatia
Cyprus
Czech Republic
Denmark
Dominican Republic
Ecuador
Egypt
Estonia
Finland
France
Georgia
Germany
Ghana
Greece
Hong Kong
Hungary
Iceland
India
Indonesia
Ireland
Israel
Italy
Japan
Kenya
Kuwait
Latvia
Lithuania
Luxembourg
Malaysia
Mexico
Netherlands
New Zealand
Nigeria
Norway
Pakistan
Peru
Philippines
Poland
Portugal
Romania
Singapore
South Africa
South Korea
Spain
Sweden
Switzerland
Taiwan
Thailand
Turkey
United Arab Emirates
United Kingdom
United States
Vietnam
Other
Preferred Contact Method
*
Email
Phone
Verification Issue Details
Exchange/Platform Name
*
Verification Status or Issue Type
*
Account not approved
Document rejected
Selfie/liveness failed
Address verification issue
Name mismatch
Account locked during verification
Other
Description of the Problem
*
Support Routing Information
Urgency level
*
Low
Medium
High
Date issue started or first noticed
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Support reference number
Submit Request
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