Applicant Information

Basic Information
Today's date*

MonthDayYear
Date
Main contact full name*

First NameLast Name
Main contact phone number*

Country CodePhone Number
Main contact email*
example@example.com
Corporate Information
Registered company name*
Formal registered company name
Registered company registration number*
Formal registered company registration number
Registered address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Website (if applicable)
(e.g. http://www.company.com)

Authorized Signers
Authorized Signer #1*

First NameLast Name
Authorized Signer #1 email*
example@example.com
Authorized Signer #2

First NameLast Name
Authorized Signer #2 email
example@example.com
Authorized Signer #3

First NameLast Name
Authorized Signer #3 email
example@example.com

Required Onboarding Documents
Authorized Signer Documents
Please upload the authorized signer #1 passport*

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Please upload the authorized signer #1 POA (proof of address)*

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Please upload the authorized signer #2 passport

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Please upload the authorized signer #2 POA (proof of address)

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Please upload the authorized signer #3 passport

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Please upload the authorized signer #3 POA (proof of address)

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Corporate Documents
Certificate of Incorporation*

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Corporate license (if applicable)

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Articles of Association*

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Latest Certificate of Incumbency (dated within 3 months)*

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Latest Register of Shareholders*

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Latest Register of Directors*

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Organizational chart including UBOs*

A UBO is a natural person who directly or indirectly owns or controls 10% or more of the shares or voting rights, or exercises control over the management of the entity.
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UBO #1 passport or ID card*

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UBO #1 POA (proof of address)*

Bank statement or utility bill dated within 90 days
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UBO #2 passport or ID card

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UBO #2 POA (proof of address)

Bank statement or utility bill dated within 90 days
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UBO #3 passport or ID card

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UBO #3 POA (proof of address)

Bank statement or utility bill dated within 90 days
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Signed Source of Funds and KYC Policy Attestation (sample below)*

Please include all supporting documents, such as at least three months of bank statements, on-chain addresses, or any other relevant materials.
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Source of Funds sample letter
Corporate board resolution*

This document should be specific to an election of the BOD/directors to register with Westeros Capital Management for OTC onboarding as a client, and be signed by all directors.
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Corporate POA (proof of address)*

Bank statement or utility bill dated within 90 days
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Bank Details and Receiving Wallets
Corporate bank wire instructions *

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Cryptocurrency wallet (BTC only)
Please copy and paste the exact and full crypto wallet address
Wallet Type
'Other' explained
Please clarify what the wallet type is if 'other' was selected
Cryptocurrency wallet (ERC20 only)
Please copy and paste the exact and full crypto wallet address
Wallet Type
'Other' explained
Please clarify what the wallet type is if 'other' was selected

Trade Activity
Expect monthly trade volume ($USD)?*
Expect monthly trade quantity?*
Please describe the main utility of your OTC account with the Company*

Additional Services
Please select any additional services of interest.

AdvisoryMarket-makingPrivate Wealth Management (PWM)Treasury management
Additional notes
Should be Empty:

Basic Information

Corporate Information

Authorized Signers

Required Onboarding Documents

Trade Activity

Additional Services