Partner Registration

Company Information (form 1A)

(a) Company Name

Please provide full company name as listed in the official company registry. If the official name is not in English, please provide the company name in the local language and the commonly used English name for identification purpose.

(b) Address along with Website Address

Please provide the location of the registered office as listed in the official company registry, and the main business address. Provide copies of the incorporation document and/or trade licence as supporting evidence.

(d) Name of the Chairman of the Company’s / firm’s governing/ supervisory board
(e) Name of Key Principals and titles with contact details (e.g.MD/ED or CEO)
(f) Name of Contact Persons

Please state the name, position and contact details of any persons who are authorized to act on behalf of that company, if different from (d) to (e) above

(g) Name of Shareholders

For each corporate or individual shareholder holding more than 25% interest in the Company , please provide additional information as in (a) to (f) above on separate sheets.

(h) Type of Association

For each corporate or individual shareholder holding more than 25% interest in the Company , please provide additional information as in (a) to (f) above on separate sheets.

For each corporate or individual shareholder holding more than 25% interest in the Company , please provide additional information as in (a) to (f) above on separate sheets.

Please provide relevant information on the party providing payment to SafeBoard (the “Company”), if it is not the Company.

Payer’s Information (form 1B)

Company Name:
Full Name:
Place of Incorporation:
Occupation:
Registered/Principal Office:
Nationality and Country of residence:
Business Address:
Residential or Business Address:
Relationship with the Customer:
Relationship with the Customer:
If the Payer is a company,

provide full company name as listed in the official company registry. If the official name is not in English, please provide the company name in the local language and the commonly used English name for identification purpose.

If the Payer is an individual,

please provide full passport name, nationality and full residential or business address

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