By signing below, the individual named in this application is: a) applying for banking services, b) attesting that the information provided in this document is true and accurate to the best of his/her knowledge and that he/she will notify the bank immediately of any substantial changes in this information, c) indicating that he/she has read, understood and agrees to the terms and conditions set out in the Operation of Account Agreement (as may be amended from time to time).

I hereby indemnify the Bank and hold it harmless of any and all claims that may be brought against it, as a result of the information that have provided above or falsified that may result in any claim being brought against the Bank.

I further understand that the Anguilla Confidential Relationships Act applies and that the bank may be obliged to disclose the information on an account holder to bank regulators or law enforcement authorities, if requested.

I hereby authorize the Bank and/or its agents to verify the information provided in this document by whatever means necessary. Further, I agree to pay the Bank all costs uncured.

I hereby acknowledge and agree that any deposit(s) to my account(s) whether single or aggregate that exceeds US$9,999.99 or its equivalent agree to provide the source of the said funds and evidence of its source. Further, I agree to pay to the Bank all costs incurred I also acknowledge and agree that if over a 30-day period, deposits made to my account(s) aggregately exceeds US$9,999.99 or its equivalent, I may be required to declare the source of said funds and provide documentation to support its source.

As soon as we receive your application and if your eligibility to hold the account can be determined on the basis of the application form and the documents submitted therewith, the Bank will promptly open the account as requested. If there are any questions concerning your documentation or eligibility, the Bank will conduct inquiries if you, are prepared to cover the costs.