NRB Registration Form | New RiverBank

Applicant Details

Relationship Manager *

Name

Business Name

Business Registration Number

Business Address

Apt, suite, etc.

Country

City

State

Zip code

Country of Incorporation

City and Zip

Telephone

All Country Codes Accepted

Fax

Beneficiary Details

Name

Date of Birth

Nationality

Passport No.

Date of Issue

Date of Expiry

Telephone

Fax

Address for Communication

Apt, suite, etc.

Country

City

State

Zip code

Business Name

Business Registration No.

Is business address same as address for communication?

YES

Business Address

Please skip if same as mailing address.

Apt, suite, etc.

Country

City

State

Zip code

Beneficiary name to be used for Service

First and Last Name

Business Name

Request Details

Amount and Currency you are applying for

Currency Denomination

USD

EUR

Additional Signatory

Third Party Authorization

Do you have a third party acting on your behalf?

YES

Authorized User Information #1

Please skip this page if you do not have a broker or other authorized individuals you would like to register at this time.

Name

Comments

Authorized User Information #2

Name

Comments

Submit

Name

Please type name for electronic signature

Designation

Date

I Attest as a legally appointed director, member, executive, or otherwise legally authorized and appointed individual to the applicant company that the information inputted here with any and all attached documentation is true and correct to the best of my knowledge.

I Agree

Beneficiary Identification

Photo of ID, Drivers License or Passport of the beneficiary

Business Validation

Provide a Certificate of Incorporation or Certificate of Good Standing, and Articles of Incorporation

Third Party Authorization

Associated or authorized third party must provide Passport and/or Drivers License identification

Proof of Residency

Bank Statements, Utility Bills, Posted Mail with Name of Applicant, Insurance Card, etc.

Proof of Funds

All applications must provide a statement showing the funds available for funding of account and/or payment of bank fees.

Captcha *

For security verification, please enter any random two digit number. For example: 42