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A. DESCRIPTION
Surname
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First name
*
Gender:
*
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Date of birth
*
Format: DD.MM.YYYY
Place of birth
*
Country of birth
*
Nationality 1
*
Nationality 2
Civil status
*
single
maried
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separated
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civil partnership (PACS)
Legal address / tax residence
Street, No.
*
Postal code
*
City/Town
*
Country of legal residence
*
Is your tax residence different from your legal address?
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Country of tax residence
Tax identification number (TIN)
Mobile phone number
*
Format: +352 123 456
Email
*
Format: email@example.com
* Mandatory field
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