Client identification - natural person

Phone *

E-mail *

Personal ID document number *

Place of work *

Position *

Will you pay the bill? *

Yes

Are you Politically Exposed Person? (including related to or if the Ultimate Beneficial Owner is Politically Exposed Person)? *

Yes

If Yes, please describe relations, please provide name, surname, personal ID number (or birthday), personal ID document number, issue date, issuing authority, issuing state, country where the person is politically exposed, institution and position.

Name, Surname *

Relations *

Personal ID in Latvia or date of birth *

Personal ID document number *

Issue date *

Issuing authority *

Issuing state *

Country where person is politically exposed *

Institution *

Position *

Are you acting on someone’s behalf? If yes, who is the Ultimate Beneficial Owner(s)? *

Yes

Name, Surname *

Personal ID in Latvia or date of birth *

Personal ID document number *

Nationality *

Country of residence *

Type of income *

Way of control? *

Controls % of shares

Directly

Indirectly (specify way of indirect control)

Realizes control in another way (specify)

AML / KYC

Client identification – natural person

CONTACT DETAILS, ID DOCUMENT DETAILS

document upload