Application - GinsGlobal

Acc No (Office Use Only) - Jon please check if this works as a numeric field

Application Type(Required)

Individual

Entity

Applicant Name (FICA docs apply to this name)(Required)

Account Details

Account Name

Account No (Office Use Only)

Physical Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Postal Address (if different to physical address)

City State / Province / Region ZIP / Postal Code Country

Telephone No

Mobile No

Email(Required)

ID / Passport No(Required)

South African Resident?(Required)

Yes

Country of Residence(Required)

Marital Status(Required)

Income Tax Reference No

Entity Structure(Required)

Simple

Complex

Entity Type(Required)

Entity Jurisdiction(Required)

Business Activity(Required)

Target Country(Required)

Designation(Required)

Source of Funds(Required)

Purpose for Establishing Relationship(Required)

Shareholders (Click + to add shareholders)

Shareholder Name

Percentage

Directors ( Click + to add directors)(Required)

Authorised Signatories ( Click + to add signatories)(Required)

ID Document(Required)

Max. file size: 12 MB.

Proof of Address(Required)

Max. file size: 12 MB.

Signature

Notes (For Office Use Only)

Name

This field is for validation purposes and should be left unchanged.