Become a Member

MEMBERSHIP ADMISSION QUESTIONNAIRE

1. General information:
2. Address details:

2.1. Registered address (as appears in the incorporation forms of the company)

2.2. Business address (The physical location of the company)

2.3. Correspondence address (If correspondence address is different than registered or business address, please advise the difference):

3. Contact details:

Main contact person (This is the person we will contact for any inquiry):

4. Business activity:
5. Licence(s) (Please provide information about any gaming related licences, permits or registrations held by the Company)
6. Financial indicators of the client:
7. Bank details
8. Directors/legal representatives (Please use separate sheet if needed):

Director 1

Director 2

9. Ultimate Beneficiary Owners, for every UBO with 25% share, or more (Please use separate sheet if needed):

Beneficial Owner 1

Beneficial Owner 2

DECLARATION:

KYC DOCUMENTATION CHECKLIST

X
By signing this Questionnaire, you consent and confirm that all the individuals set out above have consented and grant us and any third parties we work with permission to make any enquiries with any third party we consider necessary to verify any information provided to us. This may include obtaining, checking and/or reviewing applicable credit reports and/or commercial register or databases. Where required, you remain obliged to submit the necessary documentation.
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