Registration form for private clients

Contact details

First name *

Last name *

Email address *

Phone number *

Prefix	Number

Where did you hear about us?

Name of the conference (other)

Name of the conference *

Name of the referral (other)

Name of the referral *

Name of the social media (other)

Name of the social media *

Where did you hear about us? (other)

Please specify *

Is the information in this form for the renewal of your existing account with Guru Pay? *

Acceptance

By ticking this box, I confirm that I have read the Privacy notice and I hereby give my consent to UAB Guru Pay to process the specified contact data for direct marketing purposes.

Basic personal details

Date of birth *

Citizenship *

Passport/ID card number *

Personal code *

Country of tax residence *

Restricted countries and industries list

Tax Identification Number *

Tax identification number or TIN - is a unique number set for individuals and companies for tax purposes. Please find more information on TIN here.

Are you PEP or relative to PEP? *

Politically Exposed Person or PEP - an individual who is entrusted with prominent public functions and immediate family members or persons known to be close associates of such person. Prominent public functions shall mean the following functions in the Republic of Lithuania, the European Union and international or foreign state institutions: 1) heads of State, heads of government, ministers, vice-ministers or deputy ministers, secretaries of State and chancellors of parliament, government or ministry; 2) members of parliament; 3) members of supreme courts, of constitutional courts or of other high-level judicial bodies whose decisions are not subject to further appeal; 4) mayors of municipalities, directors of municipal administrations; 5) members of the management bodies of supreme audit and control institutions or chairs of the boards of central banks, deputy chairs or board members; 6) ambassadors, chargés d'affaires, envoys extraordinary and ministers plenipotentiary or high-ranking officers in the armed forces; 7) members of the management or supervisory bodies of state enterprises, public limited liability companies and private limited liability companies whose shares or a part of shares carrying more than 1⁄2 of all the votes at the general meeting of shareholders of these companies are held by the right of ownership by the State; 8) members of the management or supervisory bodies of municipal enterprises, public limited liability companies and private limited liability companies whose shares or a part of shares carrying more than 1⁄2 of all the votes at the general meeting of shareholders of these companies are held by the right of ownership by municipalities and which are considered to be large undertakings under the Law of the Republic of Lithuania on Financial Reporting by Undertakings; 9) heads and deputy heads of international intergovernmental organisations and members of their management or supervisory bodies; 10) heads and deputy heads of political parties and members of their management bodies.

Are you US citizen or US tax resident? *

Are you the owner of funds in Guru Pay account *

Owner of funds

Information

Please fill information about the Owner of funds.

First name *

Last name *

Date of birth *

Citizenship *

Restricted countries and industries list

ID/ Passport number *

Personal code *

Country of tax residence *

Restricted countries and industries list

Tax Identification Number *

Tax identification number or TIN - is a unique number set for individuals and companies for tax purposes. Please find more information on TIN here.

Are you PEP or relative to PEP? *

Are you US citizen or US tax resident? *

Would you like to use Fast Onboarding? *

Fast Onboarding takes up to 2 business days, additional fees apply.

Comments

Personal contact details

Permanent residential country *

Restricted countries and industries list

Permanent residential city *

Permanent residential street and number *

Permanent residential postcode *

Is your communication address different than your residential address? *

Communication details

Communication country *

Restricted countries and industries list

Communication city *

Communication street and number *

Communication postcode *

Comments

Advanced details

Employement status *

Employed
Unemployed
Student
Self-employed
Other

Employement status (place)

What is your current position? *

What is your current employer's name? *

Employement status (area and industry)

Please specify the area of activity *

Specify the industry *

Employement status (education)

Indicate the institution of your education *

Employement status (other)

Other *

Purpose of the account *

Deposits/ Savings
Receipt of monthly salary/ Income
Household expenses
Loan
Business
Other

Purpose of the account (other)

Other *

Relation to Lithuania

Question for non-residents

Place of business activities
Business partners
Family members
Real Estate
Other

Relation to Lithuania (other)

Other *

What will be the source of incoming funds to your account? *

The source of funds refers to the origin of the particular funds or other assets which are the subject of the Business Relationship or Occasional Transaction.

Salary
Savings
Dividends
Investment activity
Loans
Pension or government grants
Inheritance
Sale of Real Estate
Scholarship
Freelance
Winnings (gambling/ lotteries)
Income from family members or close relatives
Other

Source of incoming funds (loans)

Loans (please specify) *

Source of incoming funds (other)

Other *

Source of wealth *

The source of wealth refers to the origin of the person’s entire body of wealth (i.e., total assets). This information will usually give an indication as to the volume of wealth the Customer would be expected to have, and a picture of how they acquired such wealth.

Income from salary
Inheritance
Gifts/ donations
Scholarship
Divorce Settlement
Government grants (retirement income, grants for veterans, research grant, etc.)
Company profit/ dividends
Sales (of property, goods, shares, etc.)
Loan or investment
Other

Source of wealth (inheritance)

Inheritance (please specify) *

Source of wealth (gifts)

Gifts/ donations (please specify) *

Source of wealth (other)

Other *

Indicate the expected type of transactions *

European payment or SEPA - this type of transfer is beneficial when you need to transfer funds in euros to accounts in EU Member States or United Kingdom, Switzerland, Monaco, San Marino, Andorra as well as in EEA – Norway, Iceland and Lichtenstein.
Cross-border payment or SWIFT - this method is used to transfer funds to just about all countries of the world. The transfer is performed via correspondent accounts opened with correspondent banks, therefore you have to specify the details of your selected correspondent bank as well as the beneficiary’s account number and the bank’s BIC code.

SEPA (European payments)
SWIFT (Cross-border payments)

Please specify your planned monthly turnover *

Up to 2,000 EUR
Up to 5,000 EUR
Up to 10,000 EUR
Other

Monthly turnover (other)

Other *

Please specify your planned amount of average one-time transaction *

Up to 1,000 EUR
Up to 2,000 EUR
Up to 5,000 EUR
Other

Average transaction amount (other)

Other *

Please specify the planned amount of incoming transactions per month *

Up to 10
Up to 20
Up to 50
Other

Incoming transactions amount (other)

Other *

Please specify the planned amount of outgoing transactions per month *

Up to 10
Up to 20
Up to 50
Other

Outgoing transactions amount (other)

Other *

Please specify all countries from where you will receive funds *

Restricted countries and industries list

3 major persons or businesses for incoming transactions and short description about them *

1	Partner's name * Short description (add their internet presence, if needed) *
1	Partner's name * Short description (add their internet presence, if needed) *

+ Add counterparty

Please specify all countries to where you will send funds *

Restricted countries and industries list

3 major persons or businesses for outgoing transactions and short description about them *

1	Partner's name * Short description (add their internet presence, if needed) *
1	Partner's name * Short description (add their internet presence, if needed) *

+ Add counterparty

Comments

Acceptances

Information

In accordance to the legislation of the Republic of Lithuania and Directive (EU) 2018/843 of the European Parliament and of the Council regarding prevention of money laundering and terrorist financing, financial institutions are required to collect accurate and up-to-date information about the customer, beneficial owner, purpose and intended nature of the business relationship.

Acceptance *

Check here to confirm that the information you provide in this form is accurate and up-to-date.

Acceptance *

Check here to indicate that you have read and agree to Guru Pay Terms and Conditions and Privacy policy.

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