STARTUP KYC FORM

KYC form

Please complete the following KYC (Know Your Customer) form by answering all required questions accurately. This information is essential to verify your identity and comply with regulatory requirements. It helps us ensure a secure and compliant relationship with our clients. This form is encrypted via TLS and stored in compliance with EU AMLD & GDPR requirements. Access is restricted to authorised compliance staff. Your data will be stored securely in the EU and retained for 5 years after the end of the business relationship in accordance with AML laws.

Your details

What is your full name?

What is your email?

What is your address?

What is your phone number?

The startup

What is the startup's name?

What is the startup's registration number?

What is the legal form of the startup (SIA, LLC, Ltd)?

What is the startup's NACE code?

What is the legal address of the startup?

What is the actual address of the startup?

When was the startup established?

In what capacity do you represent the startup?

Identity verification

What is your date of birth?

What is your personal identification number?

What is your passport/ ID number?

What is the date of issue of your passport/ID number?

What is your passport/ID's issuing authority?

In which country was your passport/ID issued?

Beneficial ownership

Can the startup's ultimate beneficial owners (UBOs) be identified?

YesNo

Please list all shareholders of the startup (for private individuals - name, surname, personal ID number, country; for legal entities - legal name, reg.no., country)

Compliance screening

Is the company, its board members, UBOs, close associates or family members a politically exposed person (PEP)?

YesNo

Are you a US person? (a) an individual who is a US citizen or resident (b) a company, trust or partnership organized in or under the laws of the US (c) a non-US company controlled by one or several persons who are US persons

YesNo

Is the startup or any of its members, representatives, clients or partners connected with high risk countries or areas? (These are countries that don't have effective AML and CTF systems in place, pose significant threats to the EU financial system and are low or tax-free. You can see the up to date lists on the FATF, EU Regulation, and the Latvian Cabinet of Ministers websites)

YesNo

Please describe your business profile and principal activities, and list the countries or regions where your company currently operates or has active customers

Please upload your company registry extract (PDF) from your country’s commercial register

Click or drag your PDF here

Only one PDF no larger than 50MB allowed.

Is your commercial activity related to the following:

Organising gambling;Cash collection service;Real estate brokerage services;Trade of precious metals and precious stones;Trade of arms and ammunition;Reinsurance services (unless the service provider is appropriately licensed and supervised or the service provider is rated by international rating agencies in any of the investment categories);Monetary services (e.g. cash desks, exchange offices, money transfer intermediaries or other service providers offering money transfer services);Investment services and ancillary investment services (unless the service provider is duly licensed and supervised by a Member State or a third country where the anti-money laundering regulatory framework is equivalent to that applicable in the European Union);None of the above

Are any of the goods and services produced, sold, or purchased by the startup subject to an increased risk of sanctions or linked to third world countries?

YesNo

Financial information

Does the startup accept cash and virtual currencies, and in what proportion?

In which countries and with which credit institutions does the startup have payment accounts?

Please provide detailed information about the origin of the funds used for creating and running the company

Please list your top three clients and top three suppliers, including their names, registration numbers, countries of registration and industries

Please share how your startup addresses environmental impact, promotes diversity and fairness in hiring and operations, ensures transparency and data privacy, and whether you have specific ESG goals guiding your efforts?