Personal KYC Application

Personal KYC
Application

Full Name

Telegram Username

How did you hear about us?

Why do you want a KYC certificate?

Date of Birth

Contact Number

Address

City

State

Zip Code

Country

Contact Number agreement

Your contact number will never be shared to anyone other than the team regardless and will be used only to contact you as needed. We may also randomly send a verification code at anytime, we would then contact you for this code. Any verification not correctly returned will result in the termination of your KYC certificate. It is mandatory for all applicants to submit a contact number. By accepting this notice you agree that you have sent in a working contact number and understand the requirements for certification and your number will not be used or shared by Fuddoxx, other then verification and contact purposes as stated above.

First form of Identification (Government issued ID, Driving License, Passport, ID Card, Etc.)

Second form of Identification different then what was used above. (Government issued ID, Driving License, Passport, ID Card, Letterhead, Etc.)

Video Proof - Short video clip stating - your name, your project and todays date and ''I agree to be doxxed by Fuddoxx'. At the end look over your right shoulder

Agreement

I agree to have FUDDOXX securely retain the above information and understand that in the case of fraud or a scam of any sort concluded by FUDDOXX we will release the name(s), photographs, and videos of all verified applicants at fault on to our website, socials or relevant government bodies. (investigation will be made in house before an outcome is concluded). Please note we will not accept applicants who do not agree to this criteria

I have read and agree to the above statement about my/our information being shared - by giving your ID you also acknowledge this section.

I agree to share my form responses to the Fuddoxx team.

Safer.Crypto.Investing

Personal KYC
Application

DISCLAIMER