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Swiss Bank Account Sample Application Form
Confidential Data

*Please make sure you have got acquainted with requirements. If no, you can read them here.

* The electronic application is 128 bits SSL encrypted
* For successful application, give as many details as possible.
* If the account has more than one beneficial owner, each of them must fill in a separate form.
Please indicate how the beneficial owners are related, if there is more than one:
1 Personal details of the beneficial owner (give as many details as possible)
Title: __ Surname: __ Given name(s): __
Birth date: __ __ Place of birth: __
Address of legal domicile: (update regularly)
Country of origin: __
Passport information: # __ Place of issue: __
Date of issue: __ __ Expiry date: __ __
Phone: __ Fax: __ e-mail: __
Nationality: __ Languages: __
Marital status: __ Hobbies: __
Is beneficial owner a public figure in his/her country of origin or residence:Yes __ No __
References available: (list of bank references, business references etc.)
Important Notice: Be prepared to provide a copy of passport and references indicated in this section of application
2 Spouse/Partner
Surname: __ Given name(s): __ Birth date: __ __
3 Children
Surname: __ Given name(s): __ Birth date: __ __
Surname: __ Given name(s): __ Birth date: __ __
Surname: __ Given name(s): __ Birth date: __ __
Surname: __ Given name(s): __ Birth date: __ __
4 Person to notify in case of death, serious impediment or loss of communication for over 2 years
Surname: __ Given name(s): __ Tel: __
5 Professional status of the beneficial owner
__ Salaried employee __ Self employed __ Not gainfully employed
Precise description of his/her present or past profession:
Name and address of the company:
Duties in the company: __
Position held: __
For self-employed persons, indicate:
annual revenue __ __ number of staff: __
Important Notice: Be prepared to provide available documents related to this section of application (e.g. company reports/financial statements/business card, etc.).
6 Net worth/Origin of the beneficial owner's assets
Estimated net worth: __ __ Of which, estimated liquid assets: __ __
Value of initial deposit: (amount expected) __ __
Form: (cash, cheque, bank transfer, securities, etc.) __
Previous custodian: __
Future deposits anticipated: __
Origin of assets: (indicate in details how the money was acquired)
7 Planning visit to Switzerland
For completing bank account opening procedure you should plan to visit Switzerland for 3-6 hours during business day.
Please choose the day preferable for you (3 variants)
1) __ __ 2) __ __ 3) __ __
Other information
Special instructions:
I will pay the application fee and the account opening fee by:
__ I can provide the documents confirming the information stated in the application form.
__ I agree with terms and conditions.
__ __