Simplex | Onboarding

General Information

Registered Business Legal Name

Business Brand Name

Company's Full Registered Address

Company’s Full Operational Address Where Your Office Is Located

Company’s Registered Number

Number of Employees in the applying company

Country of Incorporation

Business Model

Please describe in details what is your company's business model - what the company has been doing until now?

Please clarify step by step flow of crypto purchase through Simplex on your platform(s)

What is your website address for Simplex integration?

On which platform would you like to have Simplex's integration?

Please provide the link to 'Privacy Policy'

Please make sure that the company’s legal name is displayed in the Privacy Policy

Please provide the link to 'Terms and Conditions'

Please make sure that the company’s legal name is displayed in the Terms and Conditions as the website owner and service provider

Crypto-currencies Activity

Are you a Wallet Service Provider?

YesNo

Wallet Service Provider Comments

Is the Crypto of the End User held in a Hot or Cold Wallet?

Hot WalletCold Wallet

Hot or Cold Wallet Comments

Is the Private Key held by the End User?

YesNo

Private Key Comments

Do you have security measures in place in order to protect your end users' crypto? If so, please provide details

Do you have a plan in order to cover lost funds if crypto is stolen from your system? If so, please provide details

Do you hold or are you planning to apply for an authorization or a license with a financial regulator? If yes, please specify what type of authorization/license

Contact Person Information

Contact First Name

Contact Last Name

Personal Corporate Email Address

Contact Phone

Director/CEO Information

Please note: The director/CEO/Authorized representative should be the one who will be signing the Agreement.

First Name

Last Name

Personal Corporate Email Address

Phone Number

Title At The Company

Ultimate Beneficial Owners (UBOs)

How many UBOs who hold 25% or more shares does your company have?

Owner First Name

Owner Last Name

Owner Email

Owner Phone

Owner Full Address

Second Business Owner / Founder Information

Second Owner First Name

Second Owner Last Name

Second Owner Email

Second Owner Phone

Second Owner Full Address

Third Business Owner / Founder Information

Third Owner First Name

Third Owner Last Name

Third Owner Email

Third Owner Phone

Third Owner Full Address

Forth Business Owner / Founder Information

Forth Owner First Name

Forth Owner Last Name

Forth Owner Email

Forth Owner Phone

Forth Owner Full Address

Business and Compliance Information

Please name if in the top management, directors or UBOs of your company you have persons:

Whose residence is in Russia and/or Belarus:

Name

Who possess citizenship of Russia and/or Belarus:

Name

Who pays Taxes in Russia and/or Belarus:

Name

Who has ownership of other businesses established in Russia and/or Belarus:

Name

Attachments

Certificate of Incorporation

Shareholders Documents

A document displaying the directors of the company

A copy of the director’s passport

If the person who will be signing the Agreement is not a director - please attach the power of attorney which allows him to sign the Agreement. Please note this document must be issued or certified by a notary public

License or relevant proof of registration with the regulator (if applicable)

Please attach any relevant file that will help us understand your business model, e.g. screenshots of the website or app where the integration is planned, if the platform is not ready.

Your information will be used in accordance with our Privacy Policy

Lead ID

Opportunity ID

Sales Owner

Rep/Help

Account ID

Contact Information

Onboarding

Your information will be used in accordance with our Privacy Policy

Need help choosing your perfect payment solution?