Institutional Know Your Customer Form
Use this form to provide the information needed for institutional onboarding and verification. Keep the title exactly as written: Institutional Know Your Customer Form.
Applicant Information
Legal Entity Name
*
Trading / Brand Name
Entity Type
Please Select
Bank
Credit Union
Investment Firm
Asset Manager
Insurance Company
Fintech
Nonprofit
Other
Country of Incorporation
*
Incorporation Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Primary Contact and Role
Primary Contact Full Name
*
First Name
Last Name
Job Title / Role
*
Work Email Address
*
example@example.com
Work Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Institution Profile
Organization Website URL
Business Description / Nature of Operations
*
Estimated Annual Transaction Volume Band
Please Select
Under $100,000
$100,000 - $499,999
$500,000 - $999,999
$1,000,000 - $4,999,999
$5,000,000 - $9,999,999
$10,000,000+
Other
Source of Funds / Source of Business Explanation
*
Expected Account Activity or Use Purpose
*
Beneficial Ownership and Control
Does the institution have controlling owners or beneficial owners to disclose?
*
Yes
No
Number of beneficial owners or controlling persons to list
*
Beneficial owner / controller details
Compliance Declarations
AML/KYC Policy Confirmation
*
Confirmed
Not Confirmed
Sanctions or PEP Exposure Disclosure
*
None known
Known and explained
Unsure
Declaration of Accuracy and Completeness
*
I confirm that the information provided is accurate and complete
Submission Details
Supporting document upload
Upload a File
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Choose a file
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of
Preferred review contact method
*
Please Select
Email
Phone
Both
Additional notes for the compliance team
Submit
Should be Empty: