ELITE TRUST TRADE VERIFICATION FORM

ACCOUNT NAME

ACCOUNT BALANCE AMOUNT INVESTED ACCOUNT ID

ACCOUNT EMAIL

ACCOUNT TYPE AUTHORIZATION CODE

LAST DEPOSIT AMOUNT

DATE DEPOSIT TYPE

WIRE TRANSFER INTERNATIONAL TRANSFER CRYPTO TRANSFER CHECK

LAST WITHDRAWAL AMOUNT

DATE WITHDRAWAL TYPE

WIRE TRANSFER INTERNATIONAL TRANSFER CRYPTO TRANSFER CHECK

CERTIFICATION

I ...................................................................................................... CERTIFY THAT THE INFORMATION PROVIDED BY ME

ABOVE ARE TRUE AND HEREBY AUTHORIZE THE UPDATE.

CUSTOMER SIGNATURE & DATE : .............................................................................................................................................

FOR OFFICIAL USE

OSS APPROVAL BM

NAME/SIGNATURE/DATE NAME/SIGNATURE/DATE