Questionnaire - Atlas Nominee Services

Have you ever been charged with or convicted of a financial crime?

Yes

No

Have you ever been subject to a regulatory investigation?

Yes

No

Have you ever declared bankruptcy?

Yes

No

Is any beneficial owner a politically exposed person (PEP)?

Yes

No

Is any beneficial owner acting on behalf of an undisclosed third party?

Yes

No

Existing bank account?

Yes

No

Do you plan to use payment processors?

Yes

No

Have you ever had a bank or processor account closed?

Yes

No

Nominee Service Eligibility Questionnaire