Merchant Application Form

It will take a couple of minutes to fill in the data. We will contact you once you're done with the submission. All your progress is saved in each stage of the form.

E-mail *

I agree with Terms of Use

Merchant Application Form

It will take a couple of minutes to fill in the data. We will contact you once you're done with the submission. All your progress is saved in each stage of the form.

OTP Verification

Enter the 6 number code sent to:

Code valid for: 14:59

Didn't receive the OTP? Resend OTP. (available in 30s)

Merchant Application Form

SECTION I · Company Information.

It will take a couple of minutes to fill in the data. We will contact you once you're done with the submission. All your progress is saved in each stage of the form.

Legal Name of Entity *

This field is required.

Business ID # *

This field is required.

Legal Entity Type *

This field is required.

DBA (if different that legal name):

Industry *

This field is required.

Website Address *

Enter a valid URL (e.g. https://example.com).

Primary Phone # *

Enter a valid phone number.

Business Email *

Enter a valid email address.

Country *

This field is required.

Date of Formation *

Please select a valid date.

Business Physical Address *

This field is required.

Mailing Address (if different)

Does the Company belong to a group? *

Yes (please provide a Group Structure)

Please select an option.

Merchant Application Form

SECTION I · Company Information.

It will take a couple of minutes to fill in the data. We will contact you once you're done with the submission. All your progress is saved in each stage of the form.

Company Representative(s) *

No representatives added yet. Click "Add Representative" to begin.

Add at least one company representative.

Tell us about your business *

Nature of your business *

This field is required.

Products and/or services that you offer *

This field is required.

Locations where you operate *

This field is required.

Do you need a license for your business? *

Yes

Please select an option.

Merchant Application Form

SECTION II · Initiative Overview.

It will take a couple of minutes to fill in the data. We will contact you once you're done with the submission. All your progress is saved in each stage of the form.

Who are the intended customers that you wish to onboard? (Ex. Employees for payroll) *

Please enter at least 15 characters.

Location of customers (Provide countries, specific states/locales if applicable) *

This field is required.

Technical Contact for Integration *

Name *

This field is required.

E-mail *

Enter a valid email address.

Phone *

Enter a valid phone number.

Merchant Application Form

SECTION III · KYC Information.

It will take a couple of minutes to fill in the data. We will contact you once you're done with the submission. All your progress is saved in each stage of the form.

What is the company's yearly revenue? *

Please select a revenue range.

What is the company's total net assets? *

Please select a net assets range.

What is the company's detailed source of funds? *

Please enter at least 15 characters.

Is any of the involved persons in the company considered as a PEP? *

Yes

Please select an option.

Is the company a regulated financial intermediary? *

Yes (please provide a license approval letter)

Please select an option.

Merchant Application Form

SECTION IV · Transactional & Settlement Details.

It will take a couple of minutes to fill in the data. We will contact you once you're done with the submission. All your progress is saved in each stage of the form.

A. Crypto Settlement Information *

Provide address to receive payment, in USDT o USDC

This field is required.

B. Fiat Settlement Information *

Bank Name *

This field is required.

SWIFT / Routing Number *

This field is required.

Account Number *

This field is required.

Currency *

Please select a currency.

Merchant Application Form

SECTION V · Beneficial Owner(s) information.

It will take a couple of minutes to fill in the data. We will contact you once you're done with the submission. All your progress is saved in each stage of the form.

Is the company considered an operative active company or a domiciliary company? (please tick the respective box) *

Operative active company

A company that carries out commercial activities with an actual business purpose (e.g. production, trade, provision of services). It has employees, offices, and generates operating income from its business activities.

Domiciliary company

A company without its own business operations in Switzerland or abroad. Typically, it has no physical office space, no staff, and does not generate operating income from business activities. Instead, it mainly holds assets, manages investments, or serves as a holding/letterbox company.

Please select an option.

This distinction helps us to assess the economic background of the company and to determine the appropriate level of due diligence.

Merchant Application Form

SECTION V.1 · Beneficial Owner(s) information.

It will take a couple of minutes to fill in the data. We will contact you once you're done with the submission. All your progress is saved in each stage of the form.

Layer 1: Natural Persons / Legal Entity Shareholders who have an ownership stake in your company

#	Company (Y/N)	Name/Company Name *	Residential Address / Registered Address *	Direct Ownership (Shares %) *	Direct Ownership (Voting Rights %) *

Shares total: 0% | Voting Rights total: 0%

Please add at least one entry for Layer 1.

Layer 2: Natural Persons / Legal Entity Shareholders who have an ownership stake in layer 1 company

#	Company (Y/N)	Name/Company Name *	Residential Address / Registered Address *	Direct Ownership (Shares %) *	Direct Ownership (Voting Rights %) *

Shares total: 0% | Voting Rights total: 0%

Please add at least one entry for Layer 2.

Layer 3: Natural Persons / Legal Entity Shareholders who have an ownership stake in layer 2 company

#	Company (Y/N)	Name/Company Name *	Residential Address / Registered Address *	Direct Ownership (Shares %) *	Direct Ownership (Voting Rights %) *

Shares total: 0% | Voting Rights total: 0%

Please add at least one entry for Layer 3.

Merchant Application Form

SECTION VI · Upload Documents.

Please provide the following documents.

Valid ID of any shareholder owning at least 25% of the company *

Upload pending

Click to add file here

Please upload this document.

Copy of a commercial register extract of the company or certificate of good standing, certificate of incumbency *

Upload pending

Click to add file here

Please upload this document.

Screenshot of regulator's website with information of the legal entity

Upload pending

Click to add file here

Last 3 months of processing reports *

Upload pending

Click to add file here

Please upload this document.

License Approval Letter *

Upload pending

Click to add file here

Please upload the license approval letter.

Merchant Application Form

The authorized representative hereby undertakes to automatically inform Unblock of any changes to the information contained herein.

It is a criminal offence to deliberately provide false information on this form (article 251 of the Swiss Criminal Code, document forgery)

Customer's Name *

This field is required.

Date *

Please select a valid date.

Position *

This field is required.

Thank you for filling out the form!

We'll get in contact with you shortly via e-mail.

Merchant Application Form

Merchant Application Form

Merchant Application Form

Merchant Application Form

Merchant Application Form

Merchant Application Form

Merchant Application Form

Merchant Application Form

Merchant Application Form

Merchant Application Form

Merchant Application Form

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