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Subscription Application Form for Multibanking
Customer is a legal entity
Company Name
Legal Entity
Unique enterprise number (UEN) or VAT number
VAT System
VAT registered
Not registered
Headquarter address
Street/number/box
Building/place/floor
City
Postcode
Country
Clear lookup field
Launch lookup modal
Lookup records
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Contact person
Name
Language
English
Dutch
French
Telephone Number
E-mail
Billing
Use the same address as headquarters
Street/number/box
Building/place/floor
City
Postcode
Country
Clear lookup field
Launch lookup modal
Lookup records
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Contact Person of invoices
Language of Invoices
English
Dutch
French
Telephone number
E-mail
Add a User to a Multibanking subscription
User information
Type of user
Physical person
Function user
Attention! Function cards cannot be granted signing rights.
Attention! Since we no longer provide certificates, new users will not be able to log in to e-government applications.
First and last name
Job title or department name
National Register Number
Identity card number
Date of Birth
Language
English
Dutch
French
The user has a Belgian eID or E(+) card and knows his/her PIN code
Delivery address and contact information of the user
Use the same address as headquarters
Street/number/box
Building/place/floor
City
Postcode
Country
Clear lookup field
Launch lookup modal
Lookup records
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Error completing request.
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E-mail
Phone number
Add new user
(uncheck to remove)
User information
Type of user
Physical person
Function user
Attention! Function cards cannot be granted signing rights.
Attention! Since we no longer provide certificates, new users will not be able to log in to e-government applications.
First and last name
Job title or department name
National Register Number
Identity card number
Date of Birth
Language
English
Dutch
French
The user has a Belgian eID or E(+) card and knows his/her PIN code
Delivery address and contact information of the user
Use the same address as headquarters
Street/number/box
Building/place/floor
City
Postcode
Country
Clear lookup field
Launch lookup modal
Lookup records
×
Close
We're sorry, an error has occurred.
There are no records to display.
You don't have permissions to view these records.
Error completing request.
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Error
×
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E-mail
Phone number
Add new user
(uncheck to remove)
User information
Type of user
Physical person
Function user
Attention! Function cards cannot be granted signing rights.
Attention! Since we no longer provide certificates, new users will not be able to log in to e-government applications.
First and last name
Job title or department name
National Register Number
Identity card number
Date of Birth
Language
English
Dutch
French
The user has a Belgian eID or E(+) card and knows his/her PIN code
Delivery address and contact information of the user
Use the same address as headquarters
Street/number/box
Building/place/floor
City
Postcode
Country
Clear lookup field
Launch lookup modal
Lookup records
×
Close
We're sorry, an error has occurred.
There are no records to display.
You don't have permissions to view these records.
Error completing request.
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Error
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E-mail
Phone number
Add new user
(uncheck to remove)
User information
Type of user
Physical person
Function user
Attention! Function cards cannot be granted signing rights.
Attention! Since we no longer provide certificates, new users will not be able to log in to e-government applications.
First and last name
Job title or department name
National Registration Number
Identity card number
Date of Birth
Language
English
Dutch
French
The user has a Belgian eID or E(+) card and knows his/her PIN code
Delivery address and contact information of the user
Use the same address as headquarters
Street/number/box
Building/place/floor
City
Postcode
Country
Clear lookup field
Launch lookup modal
Lookup records
×
Close
We're sorry, an error has occurred.
There are no records to display.
You don't have permissions to view these records.
Error completing request.
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Error
×
Close
We're sorry, an error has occurred.
E-mail
Phone number
Add new user
(uncheck to remove)
User information
Type of user
Physical person
Function user
Attention! Function cards cannot be granted signing rights.
Attention! Since we no longer provide certificates, new users will not be able to log in to e-government applications.
First and last name
Job title or department name
National Registration Number
Identity card number
Date of Birth
Language
English
Dutch
French
The user has a Belgian eID or E(+) card and knows his/her PIN code
Delivery address and contact information of the user
Use the same address as headquarters
Street/number/box
Building/place/floor
City
Postcode
Country
Clear lookup field
Launch lookup modal
Lookup records
×
Close
We're sorry, an error has occurred.
There are no records to display.
You don't have permissions to view these records.
Error completing request.
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Error
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E-mail
Phone number
SEPA Direct Debit Mandate - CORE
Use the same company name and legal entity
Debtor name
Unique enterprise number (UEN) or VAT number
IBAN
Use the same address as headquarters
Street/number/box
Building/place/floor
City
Postcode
Country
Clear lookup field
Launch lookup modal
Lookup records
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Close
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You don't have permissions to view these records.
Error completing request.
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Information request form related to KYC/AML Legal obligations
KYC related information
Legal representative of the company
UBO('s) of the company
Politically Exposed Person (PEP) - if available
Activity of the company - if available
Check this box, if there are multiple legal representatives and UBO's within your company.
Additional legal representatives/UBO's
Legal representative of the company
Is this person a UBO
(1)
?
Is this person a UBO
(1)
?
Yes
Is this person a UBO
(1)
?
No
Is this person a politically exposed person (PEP)
(2)
?
Is this person a politically exposed person (PEP)
(2)
?
Yes
Is this person a politically exposed person (PEP)
(2)
?
No
Legal representative of the company
Is this person a UBO
(1)
?
Is this person a UBO
(1)
?
Yes
Is this person a UBO
(1)
?
No
Is this person a politically exposed person (PEP)
(2)
?
Is this person a politically exposed person (PEP)
(2)
?
Yes
Is this person a politically exposed person (PEP)
(2)
?
No
Legal representative of the company
Is this person a UBO
(1)
?
Is this person a UBO
(1)
?
Yes
Is this person a UBO
(1)
?
No
Is this person a politically exposed person (PEP)
(2)
?
Is this person a politically exposed person (PEP)
(2)
?
Yes
Is this person a politically exposed person (PEP)
(2)
?
No
Executed on
Name
