Open Account

1 Client Data 2 Information on the Beneficial Owner 3 FATCA Form 4 Optional 5 Complete

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Client Data

Client

Name, Surname

E-mail address *

Phone

Date of birth

Month

Day

Year

Place of birth

Individual - PIN Number

PIN number:

Citizenship

Corporate client

If the Client is a legal entity?

Name of the company

Beginning of activity

Month

Day

Year

Headquarter and corresepondents address

Other data of the legal entity

Registration number

Tax address

Will someone else be representing you?

Yes

Name and Surname of the representative

Name, Surname

PIN:

Address

Country

Address 1

Address 2

Postal code

City

ID Document:

ID Document / Passport of the Client:

Type:

Number:

Date of issue:

Issued by:

Valid till:

ID Document / Passport of the Attorney:

Type:

Number:

Date of issue:

Issued by:

Valid till:

Contacting data:

Permanent address

Country

Address 1

Address 2

Postal code

City

Temporary address

Country

Address 1

Address 2

Postal code

City

Corresponding address

Country

Address 1

Address 2

Postal code

City

Bank account of the client:

Name of the bank:

Account number (IBAN):

Add another bank account

Name of the bank:

Account number (IBAN):

Add another bank account

Name of the bank:

Account number (IBAN):

Tax Office

Tax office name

Tax office address

Country

Address 1

Address 2

Postal code

City

Agent (optional)

Agent code

We inform you that the administrator of your personal data, as defined by the Bulgarian Law for protection of the personal data (Prom. SG.1/4 Jan 2002 with amendments) is IP Intercapital Markets AD registered in Sofia, at Dobrudja 6 str., and that giving personal data is voluntary and that you have the right to access and correct them. Personal data will be processed for the purpose of opening a brokerage account.

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