RAM SIMPLE CIS

Client Information Summary - CIS

Kindly provide the following information for initial review
Applicant*

Individual= Complete Section ACorporation = Complete Section B
Complete either A or B - then C & D & E & F

if Applicant is not a business place "0"s where numbers are required and "N/A" where text is required. Additionally place personal information in the required Business Questions
A - Individual Applicant
Individual's Name*
Nationality*
Passport Number*
Country of Issue*
Date of Issue*
Date of Expiration*
Is copy of Passport Attached*

YesNo
Date of Birth*
Place of Birth*
Identity Number/Social Security Number*
Residential Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Telephone Number*
Mobile Telephone Number*
Email*
example@example.com
Business Activity
Business Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Registration Number*
Phone Number

Area CodePhone Number
Email*
example@example.com
B - Corporate Applicant
Corporation Name*
Business Activity*
Business Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Corporation Business Registration Number*
Country of Incorporation*
Corporate Phone Number

Area CodePhone Number
Corporate Email*
example@example.com
Corporation Representative Name*
Position*
Nationality*
Passport Number*
Country of Issue*
Date of Expiration*
Is Copy of Passport Attached?*

YesNo2
Date of Birth*
Place of Birth*
Identity Number/Social Security Number*
Residential Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Mobile Phone Number*

Area CodePhone Number
Email*
example@example.com
C - Banking Information
Name of Bank*
Bank Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Account Name*
Account Number*
ABA Number*
SWIFT*
Account Signatory/ies*
Bank Officer Name*
Bank Officer Phone Number*

Area CodePhone Number
Bank Officer Email*
example@example.com
D - Funds
Currency/Amount of Funds Available*
Is Current Proof of Funds Available?*

YesNo
Is CURRENT Proof of Funds Attached?*

YesNo
Are Funds free and clear of any liens or encumbrances*

YesNo
Including Third Party Interests?*

YesNo
Are Funds freely transferrable?*

Yes 1No2
Prospective Applicant's Initial Information Summary
E - Origin of Funds
Source of Funds?*
Please set out briefly and clearly the source and origin of the funds
Languages(s)*
What Language(s) do you speak?
DECLARATION
I hereby under penalty of perjury that the information is both true and accurate.

I, the person issuing this Client Information Summary, am the Signatory on the above referenced Bank Account and confirm that all funds are good, clean, and cleared funds of non-criminal origin, and the origin of funds is in compliance with the Anti-Money Laundering Policies as set out by the appropriate authorities.

Signed Below:
Signature*
This Date*

MonthDayYear
Date
Signatory's Name

First NameLast Name
Passport Number*
Date of Issue*
Date of Expiration*
Issuing Country*
OR
For and on Behalf of : Full Name of Corporation
Signature - for a Corporation or Entity*
Name*

First NameLast Name
Position*
Passport Number*
Issuing Country*
Please attach your Passport picture and credentials, and the front and back of your Driver's license - BELOW IN FILE UPLOAD
FILE UPLOAD - SEARCH FILES AND ATTACH THEM HERE*

Browse Files

Cancelof
Please verify that you are human*
Should be Empty:

Client Information Summary - CIS

Complete either A or B - then C & D & E & F

A - Individual Applicant

B - Corporate Applicant

C - Banking Information

D - Funds

Prospective Applicant's Initial Information Summary

E - Origin of Funds

DECLARATION