EU Holding Structure-intake form

NOMIS INCORPORATIONS

UBO (Ultimate Beneficial Owner)

Passport copy

Selfie holding passport

Proof of address (dated within 3 months)

Structure Details

Do you need nominee for one or both entities?

Yes No

Do you want us to assist with bank integration?

Yes No

Legal & Ownership

Should your name remain 100% anonymous?

Yes No

Are you onboarding with a crypto exchange or financial platform?

Yes No

I confirm that all provided information is accurate

I agree to the Privacy Policy & Terms of Use

I understand this request becomes binding upon payment

Date