Application for Foreign Exchange Corporate Account

Company Type *PrivatePublic

Company Name *

Trading Name *

Date of Incorporation *

Company Registration Number *

Country of Incorporation *

Company Registered Physical Address *Must not be PO Box

Address for Trading *Must not be PO Box

Company Primary Phone Number *

Email *

Purpose of Transactions *

USD

Nature of Business *

Source of Funds *

Company Structure

No file chosen

Please attach a Companies Office Extract or a Company Structure Diagram Signed and Dated by a Director or Lawyer.

Company Directors

As required by the Anti-money Laundering and Countering Financing Terrorism Act 2009, CFG need to obtain identity information on all company directors.

The personal identification requirements are as follows:

1. ID, valid ID includes: Passport; ID card (front and back) or driver's license + bank card showing your name.

2. Proof of residential address within three months, which needs to clearly show the issuing organization (bank, government department or public bill) .

Note: if CFG electronic verification or CFG face to face staff member collection is not used the documents must be certified.

Directors Info

Prefix

First Name

Middle Name

Last Name

Street Address *

Apartment, suite, etc *

City *

State/Province *

ZIP / Postal Code *

Country *

Id Type

Proof of Address

Company Shareholders

As required by the Anti-money Laundering and Countering Financing of Terrorism Act 2009, CFG need to obtain information on all shareholders who own more than 25% shares of the company.

The personal identification requirements are as follows:

1. ID, valid ID includes: Passport; ID card (front and back) or driver's license + bank card showing your name.

2. Proof of residential address within three months, which needs to clearly show the issuing organization (bank, government department or public bill) .

Note: if CFG electronic verification or CFG face to face staff member collection is not used the documents must be certified.

Shareholders Info

Prefix

First Name

Middle Name

Last Name

Street Address *

Apartment, suite, etc *

City *

State/Province *

ZIP / Postal Code *

Country *

Id Type

Proof of Address

* I am authorised to provide this identity documentation and I consent to this information being checked with third-party verification partners, which include verification by the document issuer, authorized record holder, or credit reporting agency, for the purpose of identity verification. *YesNo

High Risk Country’s: (Iran, North Korea, Mynmar, Panama, Guyana, Angola, Uganda, Yemen, Algeria, Bosnia, Iraq, Syria, Iran, Afghanistan, Laos, Papa New Guinea)

Will you remit/receive any money directly to/from a high risk country? *YesNo(Directly or via a third party)

Do you trade with any high risk countries? *YesNo(Directly or via a third party)

Do you receive/provide services from/to any high risk countries *YesNo(Directly or via a third party)

Do you company import/export products from/to any high risk countries? *YesNo(Directly or via a third party)

If you have answered “Yes” to any of the questions above, Please specify the country *

General Compliance Questions

Will you use your CFG account to make any kinds of political donations? *YesNo

Does your company has nominee directors and/or Nominee shareholders and /or nominee general partners? *YesNo

Is the Company, Director or any beneficiary a United States citizen or resident for taxation purposes? *YesNo

Estimated Account Volumes:

Approx Number Annual transactions *

Approx Frequency of Transactions *

Approx Average Transaction Value *

Countries Receive money from *

Countries Remit money to *

I warrant that:

All statements and information are true and fairly represent my position (financial and otherwise);

The funds used in trading are of legitimate source, and I am compliant with the provisions of all laws affecting the foreign exchange services;

I will immediately give written notice to CFG Global Limited of a change in details.

Name *

Position *