Name *

First Name

Last Name

Phone *

(###)

###

####

DOB *

MM

DD

YYYY

Current Residential Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Nominee Name *

A nominee must be provided on your investment for any unforeseeable event in the future

First Name

Last Name

Nominee's address (if different from yours)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Nominee's phone *

(###)

###

####

I hereby confirm that the information provided is true and accurate to the best of my knowledge. I understand that any intentional misrepresentation or dishonesty may result in the refusal of this application or the immediate termination of my shareholding in the company. *

Yes

In accordance with data protection principles and the guidelines set by the Information Commissioner's Office (ICO), we are committed to handling all personal data securely. This includes ensuring appropriate safeguards are in place to protect against unauthorized or unlawful processing, access, or loss of data. Information will only be disclosed to official company representatives—such as accountants or solicitors—on a need-to-know basis, or when required by law or in compliance with government regulations.