Individual Client KYC Form

Section A

Personal Information

Please enter the details exactly as they appear on your identification documents.

Full Legal Name (as per ID)

Date of Birth

Place of Birth

Nationality

Country of Residence

Which identification document will you provide?

Emirates ID Number Passport Number

Emirates ID Number

Passport Number

Passport Issue Date

Passport Expiry Date

UAE Residence Permit No. (if applicable)

Permit Issue Date

Permit Expiry Date

Section B

Contact Information

Residential Address (Line 1)

Residential Address (Line 2)

City

Country

Mobile Number

Email Address

Section C

Employment & Occupation

Employment Status

Employer / Business Name

Job Title / Occupation

Business Address

Annual Income (approx.)

Currency

Section D

Source of Funds & Source of Wealth

Primary Source of Funds

Please provide details

Primary Source of Wealth

Please describe the origin of your wealth

Section E

Purpose of Introduction Relationship

Purpose

Are you the beneficiary owner of the account?

Name of Carrying Broker to be Introduced to

Expected Trading Volume (approx.)

Currency

Section F

Politically Exposed Person Declaration

Are you, or have you ever been, a Politically Exposed Person (PEP)?

Is any immediate family member or close associate a PEP?

Is any third party funding or controlling your account?

Do you expect cross-border transactions or complex trading activity?

Do you use virtual assets/crypto as source of funds or wealth?

If Yes to either question, please provide details below

Section G

Sanctions & Adverse History

Are you, or have you ever been, subject to any sanctions or regulatory enforcement action?

Have you ever been convicted of a financial crime, fraud, or money laundering?

If Yes to either question, please provide full details

Section H

Documents Submitted

Select whether each document has been submitted and provide the expiry date where applicable.

Document Submitted

Status & Expiry Date