Clone of Ainslie Crypto Personal Account

1
Legal Name* This field is required.
First Name
Middle Name
Last Name
2
Email* This field is required.
example@example.com
3
Phone Number* This field is required.
4
Date of birth* This field is required.
Date of birth
Day
Month
Year
5
Address* This field is required.
unit/flat number
Street Number
Street Name
Street Type
Street Type
ALLEY
ACCESS
ALLEYWAY
AMBLE
ANCHORAGE
APPROACH
ARCADE
ARTERY
AVENUE
BASIN
BEACH
BEND
BLOCK
BOULEVARD
BRACE
BRAE
BREAK
BRIDGE
BROADWAY
BROW
BYPASS
BYWAY
CAUSEWAY
CENTRE
CENTREWAY
CHASE
CIRCLE
CIRCLET
CIRCUIT
CIRCUS
CLOSE
COLONNADE
COMMON
CONCOURSE
COPSE
CORNER
CORSO
COURT
COURTYARD
COVE
CRESCENT
CREST
CROSS
CROSSING
CROSSROAD
CROSSWAY
CRUISEWAY
CUL-DE-SAC
CUTTING
DALE
DELL
DEVIATION
DIP
DISTRIBUTOR
DRIVE
DRIVEWAY
EDGE
ELBOW
END
ENTRANCE
ESPLANADE
ESTATE
EXPRESSWAY
EXTENSION
FAIRWAY
FIRE TRACK
FIRETRAIL
FLAT
FOLLOW
FOOTWAY
FORESHORE
FORMATION
FREEWAY
FRONT
FRONTAGE
GAP
GARDEN
GATE
GARDENS
GATES
GLADE
GLEN
GRANGE
GREEN
GROUND
GROVE
GULLY
HEIGHTS
HIGHROAD
HIGHWAY
HILL
INTERCHANGE
INTERSECTION
JUNCTION
KEY
LANDING
LANE
LANEWAY
LEES
LINE
LINK
LITTLE
LOOKOUT
LOOP
LOWER
MALL
MEANDER
MEW
MEWS
MOTORWAY
MOUNT
NOOK
OUTLOOK
PARADE
PARK
PARKLANDS
PARKWAY
PART
PASS
PATH
PATHWAY
PIAZZA
PLACE
PLATEAU
PLAZA
POCKET
POINT
PORT
PROMENADE
QUAD
QUADRANGLE
QUADRANT
QUAY
QUAYS
RAMBLE
RAMP
RANGE
REACH
RESERVE
REST
RETREAT
RIDE
RIDGE
RIDGEWAY
RIGHT OF WAY
RING
RISE
RIVER
RIVERWAY
RIVIERA
ROAD
ROADS
ROADSIDE
ROADWAY
RONDE
ROSEBOWL
ROTARY
ROUND
ROUTE
ROW
RUE
RUN
SERVICE WAY
SIDING
SLOPE
SOUND
SPUR
SQUARE
STAIRS
STATE HIGHWAY
STEPS
STRAND
STREET
STRIP
SUBWAY
TARN
TERRACE
THOROUGHFARE
TOLLWAY
TOP
TOR
TOWERS
TRACK
TRAIL
TRAILER
TRIANGLE
TRUNKWAY
TURN
UNDERPASS
UPPER
VALE
VIADUCT
VIEW
VILLAS
VISTA
WADE
WALK
WALKWAY
WAY
WHARF
WYND
YARD
Street Type
Suburb
State/Territory
State/Territory
NSW
VIC
QLD
SA
WA
ACT
NT
TAS
State/Territory
Postcode
6
Drivers License (Front)* This field is required.Provide a clear image of the front of your license.
Drag and drop files here
Select files to upload
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7
Drivers License (Back)* This field is required.Provide a clear image of the back of your license.
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8
How to do: Ainslie Selfie-IDSimply write "Ainslie" and today's date on a piece of paper, grab your ID and hold them both in one hand while ensuring you can see both clearly, then with your other hand, take a selfie with your phone. It doesnt have to be a selfie, you can get someone else to help take the photo.
9
Selfie-ID* This field is required.Simply write "Ainslie" and today's date on a piece of paper, grab your ID and hold them both in one hand while ensuring you can see both clearly, then with your other hand, take a selfie with your phone. It doesnt have to be a selfie, you can get someone else to help take the photo.
Drag and drop files here
Select files to upload
Simply write "Ainslie" and today's date on a piece of paper, grab your ID and hold them both in one hand while ensuring you can see both clearly, then with your other hand, take a selfie with your phone.
Cancelof
10
Bank Statement* This field is required.Provide a bank statement for the account which you will be paying us with. The bank statement must be within last 3 months.
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11
What is your Source of Wealth?** This field is required.
Please Select
Please Select
Savings from employment
Business earnings
Sale of assets
Inheritance
Pension/Retirement
Gambling and Lotteries
Other Sources
12
Upload proof of your Source of Wealth* This field is required.eg. Payslip, Tax Return, Certificate from your accountant.
Drag and drop files here
Select files to upload
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13
What is your source of funds (for funding your acount)?** This field is required.
Please Select
Please Select
Personal Savings
Salary/Employment Earnings
Business Income
Inheritance
Investment Returns
Loans or Credit Facilities
Gifts
Retirement Withdrawals
Pension Funds
Insurance Settlement/Payout
Gambling Winnings
Other
14
Industry and occupation details* This field is required.What industry do you work in and what is your occupation?
15
Accept* This field is required.
You agree that by transacting with Ainslie Crypto you are: NOT Purchasing on behalf of someone else NOT Being pressured or forced into making this transaction
16
Accept* This field is required.
I understand that Ainslie will close or restrict my account if it takes an informed view that I am at risk of fraud or scam.
17
Accept* This field is required.Terms Of Trade / Privacy Policy
I confirm that I have read and accept the terms and conditions and privacy policy.
18
Signature* This field is required.
Clear
19
Please verify that you are human* This field is required.
Should be Empty: