Test Form

E-mail address *

Type of company *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

IAE Code (Form 036/037) *

Do you need a licence or certification for your activity? *

Are you subject to the law on money laundering and terrorist financing? *

Attach census registration document *

Click or drag a file to this area to upload.

In which countries do you serve? *

Where will you use Bitnovo Pay? *

Physical shop
Online

How will you use the service? *

POS
Mobile App
Ecommerce integration
Integration via API

Estimated sales volume per month *

Average ticket volume *

Type of management body *

Administrators

Type of administrator *

Name *

First

Last

DNI/NIE *

E-mail address *

Nationality *

Country of residence *

Please attach both sides of your DNI/NIE document. *

Click or drag a file to this area to upload.

Please attach proof of representation *

Click or drag a file to this area to upload.

Company name *

NIF *

Name of legal representative *

First

Last

DNI/NIE of the legal representative *

E-mail of the legal representative *

Email

Confirm Email

Nationality of the legal representative *

Country of residence of the legal representative *

Please attach both sides of your DNI/NIE document. *

Click or drag a file to this area to upload.

Proof of representation *

Click or drag a file to this area to upload.

Do any persons directly or indirectly control more than 25% of the capital or voting rights of a legal person? *

Actual headlines

Name *

First

Last

DNI/NIE *

Nationality *

Country of residence *

E-mail address *

Percentage of share capital *

Please attach both sides of your DNI/NIE document. *

Click or drag a file to this area to upload.

Does the company have a code of ethics or conduct? *

Is there a compliance department and a compliance policy? *

Does the company maintain a whistleblower channel? *

Are there any known potential conflicts of interest? *

Currency *

IBAN *

Certificate of title *

Click or drag a file to this area to upload.

GDPR *

By ticking this box I authorise Capital Crypto Technology SLU to manage the registration of my establishment in Bitnovo Pay® and I agree to the processing of my personal data and those of my company in accordance with the provisions of the Privacy policy of this website.

Torrevieja Crypto

Buy with cryptocurrencies at your local retailer in Torrevieja

Field #11 (copy)

Test Form

Field #11 (copy)

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