TriumphFX

Corporate Entity

Corporate Entity Info

Username

Company Name

Website

Date of Incorporation

Type of Company

Company’s Registration Number

Legal Entity Identifier (LEI)

Nature of Business

Country of Incorporation

Other Country

Are You Part of a Group?

Country of Incorporation (Parent Company)

Other Country

Financial Info

Tax Residency/ies

Tax Identification Number (TIN)

Tax Code

United States Tax Code

Compliance Info

Which countries do you expect the majority of your clients, will be coming from?

Other Country

Are you Regulated?

Please Specify Name of Regulated body:

Have you ever been denied registration or registration suspended, revoked or conditioned by any governmental or regulator authority?

Please Specify:

Has the company ever declared bankruptcy? If yes, please provide the date of bankruptcy and details

Please Specify Date of Bankruptcy and Details:

Have you ever been or any of any of your principals, under investigation or litigation from a customer or a government, at any financial institution?

Street

House/Building

Zip Code

City

State

Country

Other Country

Principal Place of Business Address

Same as Register Address

Street

House/Building

Zip Code

City

State

Country

Other Country

Email Address

Phone

Company Website

Authorized Person

First Name

Last Name

Date of Birth

Nationality

Passport

Profession

Relationship to account holder

Capacity

Email Address

Phone

Tax Residency/ies

Tax Identification Number (TIN)

Tax Code

United States Tax Code

Politically Exposed

Authorized Person Address

Street

Zip Code

City

State

Country

Other Country

FATCA - The Foreign Account Tax Compliance Act

In order to comply with the The Foreign Account Tax Compliance Act (FATCA) regulations of the United States, clients must declare the following:

I am not a citizen of United States, including born in United States but a resident of another country who has not renounced my United States citizenship.

I am not a United States Green Card Holder.

I have no ownership of or any link to a Non United States entity that has at least one United States person as a Substantial Beneficial Owner

I am not part of an entity that has linkage or ownership to United States or United States territories.

Agreement

I have read, understood and accept the terms and conditions described in the Affiliates Agreement. I hereby consent to be contacted through phone calls, messages or emails for any purposes in regard to my account. I agree to receive electronic communications from TriumphFX including TriumphFX new products/updates, market analysis and reports. I acknowledge and accept that TriumphFX will keep and process my personal data according to all the relevant laws and regulations that needs to abide with.

Affiliate Registration