Private Client Questionnaire

1
We kindly ask to provide your personal information as it is important part of our “Know Your Customer“ procedure.
2
Full Name* This field is required.
First Name
Last Name
3
Personal Code or Date of Birth* This field is required.
4
Citizenship* This field is required.
5
Country and Residence Address* This field is required.
Country
Street Address
City
State / Province
Postal / Zip Code
Please Select
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
6
Mobile Phone Number* This field is required.
Country Code
Area Code
Phone Number
7
Email* This field is required.
example@example.com
8
Employment Status* This field is required.
Employed under employment agreements
Self employed
Retired
Student
Other
9
Other Employment Status
10
Occupation
11
Income Source* This field is required.
Salary
Allowance
Social securities
Inherit
Close family members support
Professional services
Investments
Forex trading
Cryptocurrency exchanges
Dividends
Loans
Other
12
Other Income Source
13
Please upload a proof of income* This field is required.This can be a payslip, work contract or a bank statement that shows your income.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
14
Purpose of account opening* This field is required.
0/200
15
PEP StatusPolitically exposed person is recognized as a natural person who is or has been entrusted with prominent public functions or his/her immediate family members or close associates have been entrusted
Politically exposed person
Non politically exposed person
16
Currencies planned to be Sent / Received* This field is required.
17
Main countries of inward payments* This field is required.
18
Main countries of outgoing payments* This field is required.
19
Average transactions valueValue In EUR
Up to 1000
1001 - 3000
3001 - 10000
10001 to 100000
From 100001
Inward
Outgoing
Inward
Outgoing
Up to 1000
1001 - 3000
3001 - 10000
10001 to 100000
From 100001
Up to 1000
1001 - 3000
3001 - 10000
10001 to 100000
From 100001
1 of 2
20
Expected monthly payments turnoverValue In EUR
Up to 15000
15001 - 30000
30001 - 150000
From 150001
Inward
Outgoing
Inward
Outgoing
Up to 15000
15001 - 30000
30001 - 150000
From 150001
Up to 15000
15001 - 30000
30001 - 150000
From 150001
1 of 2
21
Monthly frequency of payments
Up to 10
11 - 50
51 - 100
101 to 500
From 501
Inward
Outgoing
Inward
Outgoing
Up to 10
11 - 50
51 - 100
101 to 500
From 501
Up to 10
11 - 50
51 - 100
101 to 500
From 501
1 of 2
22
I hereby confirm that the information provided herein is accurate, correct and complete and that the documents submitted along with this application form are genuine. I confirm that I authorise UAB Pyrros Lithuania (Pyrros) to process this information in line with their Privacy Policy which is available on the www.pyrrosgroup.com Website and Client Portal. I undertake to inform Pyrros in writing of any changes to the information already provided and to update the information on this form whenever requested to do so by Pyrros.* This field is required.
Agree
Agree
Disagree
23
Full Name* This field is required.
24
Date* This field is required.
Date
Day
Month
Year
25
Signature* This field is required.
Clear
26
27
Unique Client IDThis your client ID, refer to it once you need to contact with support team.
28
Get Page URL
29
We're Done!How likely was that easy to complete the application
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