TriumphFX (Cyprus)

Individual

Personal Particulars

First Name

Last Name

Username

Date of Birth

Nationality

Passport

Profession

Email Address

Phone

Address

Street

Zip Code

City

State

Country of Residence

Financial Info

Tax Residency/ies

Tax Identification Number (TIN)

Tax Code

United States Tax Code

Politically Exposed

Compliance Info

Website:

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

Other Country:

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

Please Specify Details:

Have you ever declared bankruptcy? If yes, please provide the date of bankruptcy and details

Please Specify Date of Bankruptcy and Details:

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

FATCA - The Foreign Account Tax Compliance Act

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

I am not a citizen of the United States, including being born in the 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 the United States or any 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 (Cyprus) including TriumphFX (Cyprus) new products/updates, market analysis and reports. I acknowledge and accept that TriumphFX (Cyprus) will keep and process my personal data according to all the relevant laws and regulations that needs to abide with.

Country Selected Services Not Provided

Dear client we thank you for your interest in our services, however you should be informed that our Company does not provide services to your country.

Affiliate Registration