PDF Form MCP

Client Information Form

Identity:

Name

Martina Borbélyová

martina@mpmonaco.com

Phone number

680862240

Birth place

Date of birth

Professional situation

Sector of activity

Professional situation

Place of work

Personal Situation

Other

Information regarding spouse

Family name

Firstname

Date of birth

Place of birth

Profession

Socio-economic background

How did you build your weath?

Could you tell us more about how you builtup your assets?

Origin of funds

Bank information -

Bank Name

Bank Address

Bank Account Name

Private Banker Name

Additional comments regarding banking information

These specific funds originate from…

Professional income (salaries,bonuses, dividends…)

Inheritance / Gift / Succession

If Yes (specify date & relationship to donor or deceased)

Savings

If Yes (specify date & nature / sector of activity)

If Yes (specify date & relationship)

Real Estate Sale

Sale of movable property (works of art, vehicle, jewerly)

Sale of business assets or company shares

Benefit from a life insurance contract

Benefit or compensation (accident, divorce, death…)

Surrender of a life insurance / capitalization contract

Gambling winnings (casino, lotto, betting…)

Other

Yes (specify nature, date, home institution)

Political statuts

Do you hold or have yo

u held important publi

c functions in Monaco

or in a foreign countr

y during the last 12 m

onths

If Yes (specify)

Are you, or have you b

een closely associated

with a person holding

or having held import

ant public functions i

n Monaco or a foreign

country during the pas

t 12 months?

Yes (specify)

Additional comments

Certification

I certify on my honor that the sums which are or will be paid under this contract do not have a criminal origin in the sense of the regulation relating to money laundering.

YES

I certify on honor that the elements appearing on the present document

YES

Signature

Submission ID

6141434533224004931

Submission IP

88.209.124.223

About this template

PDF ATTACHMENT

Categories

Go to Category: Personal Records

Details

0 Clone

Created by

Monaco_Properties

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