PDF Form MCP

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Client Information Form

Identity:

Name
Martina Borbélyová
Phone number
680862240
Birth place
Date of birth
Professional situation
Sector of activity
Professional situation
Place of work
Personal Situation
Marital statuts
Other
Information regarding spouse
Family name
Firstname
Date of birth
Place of birth
Profession
Socio-economic background
Socio-economic background
How did you build your weath?
Could you tell us more about how you builtup your assets?

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Origin of funds
Bank information -
Bank Name
Bank Address
Bank Account Name
Private Banker Name
Additional comments regarding banking information
These specific funds originate from…
Professional income (salaries,bonuses, dividends…)
Inheritance / Gift / Succession
If Yes (specify date & relationship to donor or deceased)
Savings
If Yes (specify date & nature / sector of activity)
If Yes (specify date & relationship)
Real Estate Sale
Sale of movable property (works of art, vehicle, jewerly)
Sale of business assets or company shares
Benefit from a life insurance contract
Benefit or compensation (accident, divorce, death…)
Surrender of a life insurance / capitalization contract
Gambling winnings (casino, lotto, betting…)
Other
Yes (specify nature, date, home institution)
Political statuts
Do you hold or have yo
u held important publi
c functions in Monaco
or in a foreign countr
y during the last 12 m
onths
If Yes (specify)
Are you, or have you b
een closely associated
with a person holding
or having held import
ant public functions i
n Monaco or a foreign
country during the pas
t 12 months?
Yes (specify)
Additional comments
Certification
I certify on my honor that the sums which are or will be paid under this contract do not have a criminal origin in the sense of the regulation relating to money laundering.
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YES
I certify on honor that the elements appearing on the present document
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YES
Date:
01/31/2025
Signature
Item - signature 4
Submission ID
6141434533224004931
Submission IP
88.209.124.223

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About this template

PDF ATTACHMENT

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Created by
Monaco_Properties
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