Cryptocurrency Exchange Proof of Reserves Audit Request Form
Submit this form to request a proof-of-reserves audit for your cryptocurrency exchange. Please provide all relevant details to help us understand your requirements.
Exchange Name
*
Primary Contact Name
*
First Name
Last Name
Contact Email Address
*
example@example.com
Exchange Website URL
*
Brief Description of the Exchange (platform type, jurisdiction, user base, etc.)
*
Assets to be Included in the Audit
*
Bitcoin (BTC)
Ethereum (ETH)
Stablecoins (e.g., USDT, USDC)
Other Altcoins
Other
Audit Scope and Period (e.g., point-in-time, rolling, historical)
*
Sources of Reserves (e.g., cold wallets, hot wallets, third-party custodians)
*
Preferred Audit Timing
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Upload Supporting Documentation (wallet addresses, proof files, etc.)
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Submit Audit Request
Should be Empty: