Ebury New Zealand (Rayt) - Private Account Application Form

Ebury New Zealand - Private Account Application Form
As a regulated Payment Institution Ebury is legally obliged to verify its customers identity. All documents and information you provide us with or which we collect from publicly available sources are kept in compliance with our data protection policy and GDPR.

Client Information

Client
Name*

First NameLast Name
Date of Birth*

DayMonthYear
Nationality*
Email *
nombre@example.com
Telephone Number*
Residential Address*

Street

Street Address Line 2

CityState / Province

Postal CodeCountry

Signatory Details
Is this a joint account?*

Other Signatory
Name*

First NameLast Name
Date of Birth*

DayMonthYear
Nationality*
Email *
nombre@example.com
Telephone Number*
Residential Address*

Street

Street Address Line 2

CityState / Province

Postal CodeCountry

Authorised Contact
Do you have an authorised contact on the account?*
Please provide details of any other individuals who will be authorised to trade and instruct payments.

Authorised Contact
Name*

First NameLast Name
Date of Birth*

DayMonthYear
Nationality*
Email *
nombre@example.com
Telephone Number*
Residential Address*

Street

Street Address Line 2

CityState / Province

Postal CodeCountry

Your relationship with Ebury
Where will the funds come from? *
Others*
Please specify
Origin of Funds*
Destination of Funds*
Currency Conversion
Sell*
Buy*
Number of payments (per year)*
Estimated Annual Volume (AUD)*
Do you have any activities (direct or indirect) relationship with any of the following countries?*

Terms & Conditions
Date of Contract*
Name
What happens next?

The account owner will receive an email to verify their identity and to sign the form via adobesign. Once your application is approved you will receive an email giving you access to our online platform.
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