Individual Account Registration - Genesis Block

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About Genesis Block
Services
- OTC Trading
- Event Space
Crypto Classroom
Contact Us
Register
香港中文版
English

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Step 1 of 4

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Individual Account Registration
Thank you for your interest in registering for a Genesis Block account. You will be required to upload your Passport and Proof of Residential Address (bank statement/utility bill no older than 3 months) at the end of this form. Please have them ready before you begin. Once you have submitted your application, we aim to process your account as soon as possible. Our compliance officer will notify you by email upon successful verification and a dedicated trading group will be set up for you. Should you have any questions, please contact us at compliance@genesisblockhk.com. Please note the minimum deposit or withdrawal size is $200,000 HKD (or $20,000 USD).
Preferred Communication*
Please indicate your preferred instant messenger (IM) for your trading group.
Full Name*
First Last
Your name as it appears in your identification document
Alias/Other/Former Name(s)(if any):
Chinese Name*
- No
- Yes
Chinese Name*
Gender*
- Male
- Female
Marital Status*
- Single
- Married
Date of Birth*
MM slash DD slash YYYY
Country of Birth*
Nationality*
Do you hold multiple nationalities? If so, please list*
Your Passport or ID number*
Mobile Number*
Email*
Telegram (if applicable)
Please enter you Telegram username
Permanent Address
Please state your permanent address below:
Street Address*
City*
Country*
State / Province / Region*
Zip or Post Code*
US Residents
Zip Codes must be 5 digits and your respective State must use the appropriate USPS abbreviation, for example CA, AK, and TX. *We are currently not onboarding US Citizens.
UK Residents
Postcodes must be filled out correctly, for example SW4 6EH (with or without the space)

Gross Annual Income*
Employment Status*
Occupation*
If you selected Other above, please explain what your Occupation is*
Name of Your Company / Employer*
Source(s) of Funds*
- Personal Savings
- Earnings from Employment
- Inheritance
- Business Profit
- Other
Please check all that apply
If you selected Other, please explain the source of your funds*
Please State The Purpose of Opening a Genesis Block Account*
Currency*
- USD
- HKD
Expected Transaction Size Per Trade*
Please indicate the US$ amount you expect to trade per transaction. WARNING: If your transaction size is less than US$6,000 your account may not be opened.
Expected Monthly Trading Volume*
Please indicate the US$ amount you expect to trade per month.
Bank Information
Bank account name must match the legal person’s/entity’s name provided. Genesis Block will only receive/remit funds from the bank account set forth below.
Account Holder Name*
Full Beneficiary Address*
Bank Name*
Full Bank Address*
Account Number*
SWIFT Code*
Routing Number (ABA) (if any)
Is There an Intermediary Bank?*
- Yes
- No
Intermediary Bank Information
*If applicable
Intermediary Bank Name*
Full Intermediary Bank Address*
Intermediary Account Number*
Intermediary SWIFT Code*
Intermediary Routing Number (if any)

Please indicate, if applicable*
- I am a Politically Exposed Person
- My family/spouse/close associate is a Politically Exposed Person
- I am related to a Politically Exposed Person
- I have been bankrupt
- I have been convicted of a crime or felony offence
- I am not a Politically Exposed Person
A Politically Exposed Person (PEP) is an individual who is or has been entrusted with a prominent public function (for example, members of government or Parliament).
Name of the Politically Exposed Person:*
How are you or the person you are related to Politically Exposed?*
Years of experience trading digital/crypto assets*
- Less than 1 year
- 1 to 3 years
- More than 3 years
Will any person other than the applicant of this account have control or manage the trading account?*
- No
- Yes
If "Yes" please download and return a letter of authorization. Please contact us for the template either by our site chat or email compliance@genesisblockhk.com.
How did you hear about us?*
- Social Media
- Website
- Friend or Staff Referral
- Search Engine
If you were referred by a client or GB member, please let us know by writing their name.
Which friend or GB staff referred you?*
Please name the GB staff member or friend who referred you

Documents Upload
Please attach the required documents below, alternatively, you may it send to compliance@genesisblockhk.com. Failing to upload the relevant documentation may cause your application to be delayed.
Proof of Address
Max. file size: 128 MB.
Please provide a bank, utility, or authorised entity statement in PDF format no older than 90 days.
Letter of Authorization*
Max. file size: 128 MB.
If any other person will be operating your trading account please submit the signed document provided by our staff.
Passport ID copy (for nominated persons)*
Max. file size: 128 MB.
If any other person will be operating your trading account please submit a copy of their passport.
Personal Information Collection Statement & Privacy Policy
I acknowledge that I have read and understood the Privacy Policy, Terms of Use, and all Legal Conditions in their entirety and agree to abide by them (https://genesisblockhk.com/legal/).
Preferred Language*
Consent*
I agree to the privacy policy.

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1/F, 269 Hennessy Road,
Wan Chai, Hong Kong

Solo Building,
G/F, 41-43 Carnarvon Road
Tsim Sha Tsui, Hong Kong

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