Power of Attorney

Your Information – Step 1 of 2

How did you hear about us?

Name

First

Last

Are you contacting us

As a Private Person
On behalf of a Company

Home Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Employer's Address

Address Line 1

City

State / Province / Region

Postal Code

Country

Company Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Your Contact Information as a Company Representative

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Mobile Phone

Business Phone

Occupation

Photo Id Serial number

Digital copy of your Identification document

Drag & Drop Files, Choose Files to Upload You can upload up to 6 files.

Driver’s Licence, Birth Certificate, Passport, etc. Accepted file types are .jpg, .png, .pdf

Main Trustee

First

Last

Main Trustee Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Secondary Trustee

Add Secondary Trustee

Secondary Trustee Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Alternate Trustee

First

Last

In case the Main is not able to act as a trustee

Alternate Trustee Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country