Declaration of Source of Funds for Companies & KYB

Dear Trader,
Thank you for choosing Coinify. Now that you have signed up for our services, we need to better understand your relationship with Coinify. Therefore, we kindly request you to complete the following Declaration of Source of Funds for Companies & KYB.

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* 1. Coinify Trader Account E-mail ID

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* 2. Company Name

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* 3. Company Website

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* 4. Country of Incorporation

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* 5. Industry

Wholesale and Retail Trade

Accommodation and food service

Information & Communication

Financial and Insurance activities

Real estate activities

Professional, scientific and technical activities

Administrative and support service activities

Education

Human health

Arts, entertainment and recreation

Other (please specify)

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* 6. Please briefly describe your business activity and pricing model.

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* 7. Please indicate the yearly expected volumes you are to trade using Coinify:

0 - 10 000 €

10 000 - 50 000 €

50 000 € or above

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* 8. Are any of your beneficial shareholders on PEP (Politically Exposed Person) list? Are you or your company on the Sanction list?

Yes

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* 9. I hereby declare that funds traded through Coinify are derived from legitimate sources through our business and that we agree to provide necessary documentation of the source of funds if required to do so in future. I also declare that all details stated in this form to be true and correct.

Acknowledge

Thank you for completing the Know Your Business Form. This is a part of our efforts to maintain ourselves as a highly trusted financial institution in the eyes of our regulators, partners and customers.

Best regards,

Coinify Compliance Team