Client Application

Application

Barox International

Anti-Money Laundering & Legal Requirements. Anti-Money Laundering (the AML Act) requires Barox International Limited to collect identification information and documentation from prospective investors.

Barox International Limited

Our application Form captures personal information about investors to comply with the requirements of the AML Act. This includes details such as your occupation (for individuals) or business activity (for companies & other entities) as well as your source of funds. Under the AML Act, Barox International Limited is prohibited from processing your application until we have received all the required information and identification documents. Please note, in some cases Barox International Limited may need to collect further information and/or documentation from you in order to comply with our obligations under the AML Act. Start filling out the requested information in the corresponding fields.

Should you decide to print out your documentation, when your Forms have been completed and ensured that no mistakes have been made, please sign, date, scan and together with the compliance requirements, send the following Forms back via email as advised below. Should you complete your documentation online, please be sure to keep a copy for your own records. If you have any questions or need further assistance to complete your documentation, please contact us via email or telephone and one of our advisors will be happy to assist you.

Opening an Account

In order to establish your Account here with Barox International Limited, please complete all of the sections below. Barox International Limited will use the information you provide to open and service your Account/s, communicate with you and to use the information provided below to verify your identity.

Please type in your details and select the appropriate answers to complete this Application Form.

I - YOUR COMPLETE DETAILS.

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First Applicant

Title:

Mr.
Mrs.
Ms.
Other

First Name: *

Last Name: *

Previous Name:

(If applicable)

Date of Birth: *//

Place of Birth:

Nationality: *

Current Residential Address and Postcode: *

Write in full. (Please note C/O or P.O. Box is not acceptable)

Country:

Home Telephone Number:

Mobile Telephone Number: *

Email: *

Second Applicant (If applicable)

Title:

Mr.
Mrs.
Ms.
Other

First Name:

Last Name:

Previous Name:

(If applicable)

Date of Birth://

Place of Birth:

Nationality:

Current Residential Address and Postcode::

Write in full. (Please note C/O or P.O. Box is not acceptable)

Country:

Home Telephone Number:

Mobile Telephone Number:

Relationship to First Applicant:

Email:

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First Applicant

Occupation: *

Job Title: *

Length of Service: *

If Retired or Unemployed:

Please provide details of your last employment before retirement or unemployment.

Second Applicant (If applicable)

Occupation:

Job Title:

Length of Service:

If Retired or Unemployed:

Please provide details of your last employment before retirement or unemployment.

II - INVESTMENT PORTFOLIO DETAILS.

FINANCIAL PROFILE:

OTHER INVESTMENTS:

Please provide us with additional information about your other investments to help us more fully understand your investment profile and identify what types of investments or strategies may be suitable for you.

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Type of Investment:

Firm Holding the Investment :

Amount (USD) $:

III - APPLICANT(s) and BAROX INTERNATIONAL LIMITED ADVISORY DECLARATION.

I/We confirm that I/we have the necessary powers to take out this Client Portfolio Account and enter into a relationship with Barox International Limited.

My/Our signature(s) below confirm(s) that: I/We declare that the information supplied in this application is complete and correct to the best of my/our knowledge and belief at the time of this declaration.

I/We agree to provide Barox International Limited with any further information as may be required.

I/We agree to notify Barox International Limited of any material changes in the information provided in this application including but not limited to, changes in personal details, which may occur after the date of this application.

I/We agree/disagree to Barox International Limited using my/our personal information for marketing purposes. You may change your mind at any time about receiving marketing messages by contacting us as described in the Barox International Limited Terms and Conditions.

I/We confirm that I/we have read and understood the Barox International Limited Terms and Conditions.

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First Applicant

Signature

First Applicant Signed Here

Date://

Second Applicant (If applicable)

Signature

Second Applicant Signed Here

Date://

UPLOAD REQUIRED DOCUMENTATION:

A) Valid government ID (i.e., passport main page, or driver license front and back)
B) Utility bill dated within the last 3 months (i.e., water, electric, mobile phone bill, bank statement)

UPLOAD THE DOCUMENTATION THAT IS REQUIRED:

Click or drag files to this area to upload. You can upload up to 4 files.

Please upload related photographs and documents in the following formats (DOC, DOCX, JPG, PNG, PDF) with 20MB each.