Caribbean Bank Accounts application form

OffshoreSimple.com

Caribbean Bank Account Application



Caribbean 2
Select your account type:
Corporate account	($500)
Personal account	($450)
Corporate Payment System (only with Caribbean 2)	($999) (debit cards payment system)

Personal information
(Should be spelled exactly as in the ID)

Date of birth
In the format dd/mm/yyyy

Street, office/apartment number

Your E-mail address

Identification document details
(valid passport, DL or ID card)

ID was issued on
In the format dd/mm/yyyy

ID expires on
In the format dd/mm/yyyy

City and country where ID was issued

Corporate details

Company name
Street, office/appartment number
City
State/province
Country
Zip/postal code
Registration number
Registration date Date in format dd/mm/yyyy
Country of registration
Position of company's representative

Maestro NoName Debit Card $ 150
(No Name embossed, only card number embossed on the card)

No debit card. Thank you

Bank account package delivery service:

Courier delivery service.
Please note that it costs an extra 100 $

DHL FedEx UPS

In case you don't select courier delivery, the package will be delivered by registered post.

Cards DELIVERY option.
The cards can be prepared and sent to you only AFTER the account will be activated.
It means that we have to send you another package with the cards.

Cards courier delivery service.
Please note that it costs an extra 100 $

DHL FedEx UPS

In case you don't select courier delivery, the CARDS will be delivered by registered post.

Delivery details

Name	*
Street, office/apartment number	*
City	*
State/province	*
Country	*
Zip/postal code	*

Phone number	*
Write here please any comments or observations related to your order.

Insert here any promotional code or special offer:

Payment Methods

I will pay by: Please check here all accepted payment methods

Total of your order $:
(don't forget to click the "Send Order Now" button below)

After you submit your order,
we will reply with a tracking number and payment instructions.

IMPORTANT NOTES:

1/ Please quote your name or e-mail address as a reference with your wire transfer. Otherwise we may not be able to tie in receipts with specific orders, which can delay the opening of your account!

2/ Please ensure that the GROSS order value is wired to our account. All currency exchange and wire costs, including those of any intermediary banks, MUST be debited from YOUR account.

ALL INFORMATION SUPPLIED IS TOTALLY CONFIDENTIAL AND WILL NOT BE DIVULGED TO ANY THIRD PARTY OTHER THAN TO ANY BANK CONCERNED WITHOUT EITHER YOUR EXPRESS PERMISSION IN WRITING OR UNDER THE TERMS OF A COURT ORDER.

Warning - before you order: receipt of this form plus accompanying payment by any means will constitute a confirmed and irrevocable order. Please also read the Disclaimer on our Introduction Page.
If an application is denied by the bank, for reasons beyond our control, we will refund what you paid -39%.

Information presented by me is true and correct

back to banking page

Please send a copy of your passport, either scanned and attached to an email,
either faxed to: US fax: +1 212 202-6468 or UK fax: +44 207 900 1987
Thank you.

I have read and agree to provide due diligence requirements and
I have read and agreed to the terms and conditions as posted on this Website.

Please ensure your spam/junk mail filter allows emails from OffshoreSimple.com

Title
First name	*
Middle name
Last Name	*
Date of birth In the format dd/mm/yyyy	*
Street, office/apartment number	*
City	*
State/province
Country	*
Zip/postal code	*

ID number	*
ID was issued on In the format dd/mm/yyyy	*
ID expires on In the format dd/mm/yyyy	*
City and country where ID was issued	*