Application Form

Licensing Application

Complete the questionnaire below to initiate your compliance screening.

Step 1 of 4

Company Profile

Legal Name of Business *

DBA (Trade Name) (Optional)

Country of Incorporation *

Date of Incorporation *

Company Share Capital *

Registered Office Address *

Mailing Address (Optional)

If different from registered address

Website URL *

Please list all individuals who need to be screened (Directors, Beneficial Owners, Shareholders).

How many individuals to screen? *

Primary Source of Funds *

Savings Investment Business Income Other

If "Other", please specify:

Projected Annual Volume / Turnover *

Target Jurisdictions *

Countries where you intend to operate

History of Criminal Convictions? *

Yes No

Regulatory Compliance (AML/KYC) *

Does the entity maintain full compliance with applicable regulations?

Yes No

I hereby certify that all information provided in this application is true and correct to the best of my knowledge.