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Declarations of Identity of The Beneficial Owner and Account Holder
Declarations of Identity of The Beneficial Owner and Account Holder
Declarations of Identity of The Beneficial Owner and Account Holder
2018
*D5-V180321-R* A
DECLARATIONS OF IDENTITY OF THE BENEFICIAL OWNER
AND ACCOUNT HOLDER
I hereby declare that the person listed below is the account holder and the sole
beneficial owner of the assets to be deposited on the account.
I understand that it is a criminal offence to deliberately provide false information on this
form (article 251 of the Swiss Criminal Code, document forgery).
I expressly confirm that I am not a “US person” as defined in the Title 22 of the United
States Code i.e. I am not a US citizen (by single or multiple citizenship) and I do not have
the “resident alien” status (by holding a “Green Card” or meeting the "Substantial Presence
Test" requirements as stated in: https://www.irs.gov/individuals/international-taxpayers/
substantial-presence-test ).
I have read, understood and agreed with General Terms and Conditions for Current
Accounts published on https://www.dukascopy.com/swiss/english/about/docs/ including
confidentiality waiver in favour of Dukascopy Group (chapter 27).
I hereby undertake to immediately inform the bank of any changes.
Date Signature