First Name:
Last Name:
Organization Name:
Type of Individual / Organization:
Auditor, External accountant, Tax advisor
Casino and other provider of gambling services
Company service provider
Credit Institution / (Branch)
Estate agent
Financial Institution - Bureaux de change (currency exchange office) / ( Branch)
Financial Institution - Insurance Intermediary / (Branch)
Financial Institution - Insurance Undertaking / (Branch)
Financial Institution - Investment Firm / (Branch)
Financial Institution - Other than credit institution undertaking / (Agent)
Financial Institution - Undertaking Collective Investment / (Branch)
Notary and Legal professional
Trust service provider
Transaction Currency:
Afghanistan Afghani - ( ؋ )
Albania Lek - ( Lek )
Argentina Peso - ( $ )
Aruba Guilder - ( ƒ )
Australia Dollar - ( $ )
Azerbaijan Manat - ( ₼ )
Bahamas Dollar - ( $ )
Barbados Dollar - ( $ )
Belarus Ruble - ( Br )
Belize Dollar - ( BZ$ )
Bermuda Dollar - ( $ )
Bolivia Bolíviano - ( $b )
Bosnia and Herzegovina Convertible Marka - ( KM )
Botswana Pula - ( P )
Brazil Real - ( R$ )
Brunei Darussalam Dollar - ( $ )
Bulgaria Lev - ( лв )
Cambodia Riel - ( ៛ )
Canada Dollar - ( $ )
Cayman Islands Dollar - ( $ )
Chile Peso - ( $ )
China Yuan Renminbi - ( ¥ )
Colombia Peso - ( $ )
Costa Rica Colon - ( ₡ )
Croatia Kuna - ( kn )
Cuba Peso - ( ₱ )
Czech Republic Koruna - ( Kč )
Denmark Krone - ( kr )
Dominican Republic Peso - ( RD$ )
East Caribbean Dollar - ( $ )
Egypt Pound - ( £ )
El Salvador Colon - ( $ )
Euro Member Countries - ( € )
Falkland Islands (Malvinas) Pound - ( £ )
Fiji Dollar - ( $ )
Ghana Cedi - ( ¢ )
Gibraltar Pound - ( £ )
Guatemala Quetzal - ( Q )
Guernsey Pound - ( £ )
Guyana Dollar - ( $ )
Honduras Lempira - ( L )
Hong Kong Dollar - ( $ )
Hungary Forint - ( Ft )
Iceland Krona - ( kr )
India Rupee - ( )
Indonesia Rupiah - ( Rp )
Iran Rial - ( ﷼ )
Isle of Man Pound - ( £ )
Israel Shekel - ( ₪ )
Jamaica Dollar - ( J$ )
Japan Yen - ( ¥ )
Jersey Pound - ( £ )
Kazakhstan Tenge - ( лв )
Korea (North) Won - ( ₩ )
Korea (South) Won - ( ₩ )
Kyrgyzstan Som - ( лв )
Laos Kip - ( ₭ )
Lebanon Pound - ( £ )
Liberia Dollar - ( $ )
Macedonia Denar - ( ден )
Malaysia Ringgit - ( RM )
Mauritius Rupee - ( ₨ )
Mexico Peso - ( $ )
Mongolia Tughrik - ( ₮ )
Mozambique Metical - ( MT )
Namibia Dollar - ( $ )
Nepal Rupee - ( ₨ )
Netherlands Antilles Guilder - ( ƒ )
New Zealand Dollar - ( $ )
Nicaragua Cordoba - ( C$ )
Nigeria Naira - ( ₦ )
Norway Krone - ( kr )
Oman Rial - ( ﷼ )
Pakistan Rupee - ( ₨ )
Panama Balboa - ( B/. )
Paraguay Guarani - ( Gs )
Peru Sol - ( S/. )
Philippines Peso - ( ₱ )
Poland Zloty - ( zł )
Qatar Riyal - ( ﷼ )
Romania Leu - ( lei )
Russia Ruble - ( ₽ )
Saint Helena Pound - ( £ )
Saudi Arabia Riyal - ( ﷼ )
Serbia Dinar - ( Дин. )
Seychelles Rupee - ( ₨ )
Singapore Dollar - ( $ )
Solomon Islands Dollar - ( $ )
Somalia Shilling - ( S )
South Africa Rand - ( R )
Sri Lanka Rupee - ( ₨ )
Suriname Dollar - ( $ )
Sweden Krona - ( kr )
Switzerland Franc - ( CHF )
Syria Pound - ( £ )
Taiwan New Dollar - ( NT$ )
Thailand Baht - ( ฿ )
Trinidad and Tobago Dollar - ( TT$ )
Turkey Lira - ( )
Tuvalu Dollar - ( $ )
Ukraine Hryvnia - ( ₴ )
United Kingdom Pound - ( £ )
United States Dollar - ( $ )
Uruguay Peso - ( $U )
Uzbekistan Som - ( лв )
Venezuela Bolívar - ( Bs )
Viet Nam Dong - ( ₫ )
Yemen Rial - ( ﷼ )
Zimbabwe Dollar - ( Z$ )
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Email Address:
Telephone Number:
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