MCP

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Client Information Form

Identity:

Name
Martina Borbleyova
Phone number
0639857894
Birth place
Date of birth
29/04/1992
Professional situation :
Sector of activity
Professional situation
Place of work
Personal Situation :
Marital statuts
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Single
Other
Information regarding spouse :
Family name
Firstname
Date of birth
Place of birth
Profession
Socio-economic background :
Information on the origin of the assets
How did you build your weath?
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Professional income (salaries)
Could you tell us more about how you builtup your assets?

Monaco Properties, 14 boulevard d'Italie, 98000 Monaco

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Origin of funds
Bank information
Bank Name
Bank Address
Bank Account Name
Private Banker Name
Additional comments regarding banking information
These specific funds originate from…
Professional income (salaries,bonuses, dividends…)
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NO
Inheritance / Gift / Succession
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NO
If Yes (specify date & relationship to donor or deceased)
Savings
If Yes (specify date & relationship to donor or deceased)
If Yes (specify date & nature / sector of activity)
If Yes (specify date & relationship)
Real Estate Sale
Sale of movable property (works of art, vehicle, jewerly)
Sale of business assets or company shares
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NO
Benefit from a life insurance contract
Benefit or compensation (accident, divorce, death…)
Surrender of a life insurance / capitalization contract
Gambling winnings (casino, lotto, betting…)
Other
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YES
Yes (specify nature, d
ate, home institution)
Other info
Political statuts
Do you hold or have you held important public functions in Monaco or in a foreign country during the last 12 months
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NO
If Yes (specify)
Are you, or have you been closely associated with a person holding or having held important public functions in Monaco or a foreign country during the past 12 months?
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NO
Yes (specify)
Additional comments
Certification
I certify on my honor that the sums which are or will be paid under this contract do not have a criminal origin in the sense of the regulation relating to money laundering.
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YES
I certify on honor that the elements appearing on the present document
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YES
Date:
01/31/2025
Signature
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Monaco Properties, 14 boulevard d'Italie, 98000 Monaco

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Monaco Properties, 14 boulevard d'Italie, 98000 Monaco

About this template
Categories
Details
1 Clone
Created by
Monaco_Properties
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