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New Coin Questionnaire
General Information
Registered Business Name
Business Brand Name
Company Registration Number
VAT Number
Number of Employees
Business Start Date
Do you hold or are you planning to apply for an authorization or a license with a financial regulator?
If yes, please specify what type of authorization/license
Articles of Incorporation
Business Model
Please describe in details what is your company's business model - what the company has been doing until now
Attach the Legal Opinion of your crypto coin
Legal Opinion Comments
What is your website address to work with Simplex?
Coin Activity
Is it a Utility or Security token?
What would be the intended use of this coin?
Are there any specific uses that would induce consumers to buy (invest)?
Is the coin already listed? If so, where?
What is the current market capitalization?
Has your company secured minimum trading from any Market Maker(s) to ensure liquidity to support stable market price?
Has your company (and the project) received any institutional investments?
Please provide us with a list of any investors who invested 25% or more into the initial launch of the coin
Please provide a breakdown of the funds raised from institutional vs. private investors
Please specify any other partnerships that you already have in place to promote or market the coin
Do you have a KYC check on your investors? If so, please share the procedure and any 3rd parties or tools you have used in order to identify the investors
Business Details
Company's Full Operational Address
Company's Full Registered Address
Business Phone Number
Contact Person Information
Contact First Name
Contact Last Name
Contact Email
Contact Phone
Contact Full Address
Contact Title at the Company
Business Owner / Founder Information
Number of owners the business has?
Please select...
1
2
3
4
Does the contact person is the owner?
Yes
No
Owner First Name
Owner Last Name
Owner Email
Owner Phone
Owner Full
Address
Second Business Owner / Founder Information
Second Owner First Name
Second Owner
Last Name
Second Owner
Email
Second Owner
Phone
Second Owner
Full Address
Third Business Owner / Founder Information
Third Owner First Name
Third
Owner
Last Name
Third
Owner
Email
Third
Owner
Phone
Third
Owner
Full Address
Forth Business Owner / Founder Information
Forth Owner First Name
Forth
Owner
Last Name
Forth
Owner
Email
Forth
Owner
Phone
Forth
Owner
Full Address
Your information will be used in accordance with our
Privacy Policy
Contact Information
Your information will be used in accordance with our
Privacy Policy
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