NEXGRA

GLOBAL IDENTITY VERIFICATION

Know Your Customer

Complete your identity, address, tax and source-of-funds information. Your submission is reviewed by authorised AKCEL compliance administrators.

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01 — PERSONAL IDENTITY

Legal personal information

LEGAL FIRST NAME *

LEGAL LAST NAME *

LEGAL MIDDLE NAME

DATE OF BIRTH *

PLACE OF BIRTH *

NATIONALITY *

02 — RESIDENTIAL ADDRESS

Current home address

ADDRESS LINE 1 *

ADDRESS LINE 2

CITY *

STATE / PROVINCE

POSTAL CODE

ADDRESS COUNTRY *

03 — IDENTITY DOCUMENT

Government-issued identification

DOCUMENT TYPE *

ISSUING COUNTRY *

DOCUMENT NUMBER *

EXPIRY DATE *

ISSUE DATE

FINANCIAL PROFILE

Purpose and expected activity

OCCUPATION *

EMPLOYER / BUSINESS

SOURCE OF FUNDS *

SOURCE OF FUNDS DETAILS

SOURCE OF WEALTH *

SOURCE OF WEALTH DETAILS

EXPECTED MONTHLY ACTIVITY (USD) *

PURPOSE OF ACCOUNT ACTIVITY *

TAX RESIDENCE

Tax identification information

PRIMARY TAX RESIDENCE *

SECONDARY TAX RESIDENCE

TAX IDENTIFICATION NUMBER

SECONDARY TAX ID

DOCUMENT EVIDENCE

Upload verification documents — Accepted formats: PDF, JPEG or PNG. Maximum 10 MB per file.

Identity front / passport bio page *

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Identity document back *

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Selfie / identity photo *

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Declaration

Compliance declarations and consent

POLITICALLY EXPOSED PERSON STATUS

PEP DETAILS, POSITION, COUNTRY AND DATES

I am acting on my own behalf and not for an undisclosed third party.

I confirm I am not knowingly subject to applicable sanctions and will provide accurate information for screening.

I declare the information and documents provided are complete, authentic and current.

I consent to identity verification, compliance screening, secure processing and legally required record retention.

I will notify NEXGRA if my identity, address, tax residence or risk information changes.

APPLICATION HISTORY

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shashank Kr

shashank Kr

GLOBAL IDENTITY VERIFICATION

Know Your Customer

01 — PERSONAL IDENTITY

02 — RESIDENTIAL ADDRESS

03 — IDENTITY DOCUMENT

FINANCIAL PROFILE

TAX RESIDENCE

DOCUMENT EVIDENCE

Declaration

APPLICATION HISTORY