Travel Rule Compliance Checklist Form
Complete this checklist to ensure all necessary information is captured for Travel Rule compliance in virtual asset transfers.
Originating Institution Name
*
Beneficiary Institution Name
*
Sender Full Name
*
First Name
Last Name
Recipient Full Name
*
First Name
Last Name
Virtual Asset Type
*
Please Select
Bitcoin (BTC)
Ethereum (ETH)
USDT (Tether)
Other
Amount and Currency
*
Transaction Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Jurisdiction of Originating Institution
*
Please Select
United States
European Union
Singapore
Other
Does this transfer meet the applicable Travel Rule threshold?
*
Yes
No
Have all required sender and recipient details been collected and verified?
*
Yes
No
Additional Notes or Compliance Comments
Submit Checklist
Should be Empty: