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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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Error completing request.
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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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Error completing request.
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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
×
Close
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There are no records to display.
You don't have permissions to view these records.
Error completing request.
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Error
×
Close
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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
×
Close
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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
×
Close
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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.
Loading...
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
×
Close
We're sorry, an error has occurred.
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
×
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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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
*
