🔐 Know Your Customer (KYC) Application

My Company | Secure & Compliant Onboarding

Personal
Info

Identity
Documents

Address &
Residency

Employment
& Finance

Declarations
& Signature

👤 Personal Information

First Name * This field is required.

Last Name * This field is required.

Email Address *

Required.

Phone / Mobile * Required.

Date of Birth * Required.

Gender * Required.

Place of Birth

Nationality * Required.

Known Aliases / Other Names

Leave blank if not applicable

Step 1 of 5

📒 Passport Details

Passport Number * Required.

Passport Issuing Country

Issue Date

Expiry Date * Required.

Upload Passport Copy * (at least one ID document required)

📒

Click to upload or drag & drop

PDF, JPG, PNG — max 5MB

Please upload a Passport or Emirates ID copy.

🇺🇦 UAE Identity & Residency

Emirates ID Number

Residency Visa Number

Visa Expiry Date

Upload Emirates ID Copy *

🇺🇦

Click to upload (front & back)

PDF, JPG, PNG — max 5MB

Upload Proof of Address

🏠

Click to upload

Utility bill / bank statement (3 months)

Step 2 of 5

🏠 Residential Address

Street Address * Required.

City * Required.

State / Emirate

Postal / P.O. Box

Country * Required.

Step 3 of 5

💼 Employment Information

Employment Status * Required.

Occupation / Job Title

Employer / Company Name

Years in Current Role

Employer Address

💰 Financial Information

Source of Funds *

Select all that apply to your transaction funds

Salary

Source of Wealth

How was your overall wealth accumulated?

Salary

Purpose of Transaction * Required.

Preferred Payment Method * Required.

Annual Estimated Income *

AED

Enter your gross annual income in UAE Dirhams

Currency

Select currency if income is not in AED

Step 4 of 5

🏢 Politically Exposed Person (PEP) Declaration

A Politically Exposed Person is an individual who holds, or has held, a prominent public function. This includes heads of state, senior politicians, senior government/judicial/military officials, senior executives of state-owned companies, and senior political party officials.

Are you, or have you been, a Politically Exposed Person? * Required.

PEP Details

📔 Consents & Declarations

✍️ Digital Signature

Please sign below to confirm that all information provided is correct and you consent to this KYC application. Use your mouse or finger (on touch devices).

Please draw your signature.

By submitting, you confirm this signature represents your legal consent to this application.

Step 5 of 5

🔒 Your information is encrypted and handled in strict accordance with UAE AML/CFT regulations.
My Company | 123456789 | sample@sample.com