Agent - Application - Concorde Bank Ltd.

Is your client an Individual or a Business?

Incorporated? your Incorporation

Please enter your agency details in the section below.

Agency Name

Agent Email Address

Agent Name

Agent Contact #

Please enter all require client information in the fields below.

Client Phone Number

Client Email

What Industry Do They Operate Within?

Select all that apply

Which of CBL services is your client currently interested in?

Select all that apply

Which currency/(ies) will your client be transacting In?

Select all that apply

What is your client initial deposit?

Minimum amount required is USD$250,000

How would you like us to contact you?

What is the best time to contact you?

Please note that Concorde Bank operates within the AST Timezone.

Declaration

By proceeding I declare that the information provided in this form is accurate and complete to the best of my knowledge. I understand that this Pre-onboarding Form is for preliminary assessment purposes only, and does not constitute approval or acceptance for onboarding.