Addition information №2
ADDITION INFORMATION ABOUT THE NATURAL PERSON FOR THE MAIN CLIENT PROFILE FOR WALLET ONE

* By Client’s Wallet one profile ________________________________________________________________________________________ 

□ Shareholder
□ Founder
(participant)	□ Member
of the Board_________________ 
(specify position)	□ The sole executive body / head of the organization	□ A person who has power of attorney is authorized to act on behalf of the organization, client - physical persons and legal entities	□ other:
______________ 
(indicate)	

General information	
1. Full name	*	
	
Например: Иванов Иван Сергеевич	
2. Citizenship	*	
	
Например: РФ	
3. Date and place of birth	*	
	В соответствии с паспортным данными
Например: 24.02.1987, Кировская обл., г.Киров	
4. Details of the document proving the identity 

* Further request our expert, you must submit the original (ly) or copy (s) of the document (s) certifying (them) the person (s)	Name		*	
		For example: passport	
	Series, number	*	
		For example: 5468 646424	
	Date of issue	*	
		For example: 24 September 1986	
	Name of the authority issuing the document	*	
		For example: 76 police department	
	Unit code (if any)	*	
		
For example: 782-276	
5. Address	Place of residence (registration)	*	
		For example: 107123, Moscow, st. Kedrov, 10, of. 64	
	The actual place of residence	*	
		For example: 122123, Moscow, st. Vavilov, 8, of. 13	
6. Individual Taxpayer Identification Number		
	If any	
7. SNILS (Insurance Number of Individual Ledger)	*	
	Be sure to specify, for example: 120-198-064-23
If you have not received SNILS select NO	
8. Other an additional document (eg policy number)		
9. Contact phone number	*	
	For example: +7 (916) 324-23-34; +7 (495) 545-51-10	
10. E-mail		
11. For citizens - non-residents of the Russian Federation	Information about the migration card
(Card number, date of commencement of the period of stay and expiration date of your stay)		
	Data on the document confirming the right of a foreign citizen or stateless person to stay (reside) in the Russian Federation
(Series (if available), and number of the document, the date of commencement of the residence rights (residence), date of expiry of the right of residence (stay))	

	
12. Attitude to "public officials" category 
(Persons -ispolnyayuschie important state functions, or are (were not more than 1 year ago) persons in positions of public trust назад) лицами, облеченными общественным доверием
	*
 It is not TDL
 TDL    	
	In the case related to the category of TDL (RPDL, MPDL, FPO) must specify the job title, the name and address of the employer.
 In the case of kinship with PEPs must specify the degree of relationship or the status of your (spouse) in relation to PEPs, full name and position of TDL.	
Origin of funds and (or) other property	
13. Origin of funds and (or) other property is
(Underline the correct version)

Field is required only for the categories: Insurance Beneficiary, beneficial owner, representative of the individual. In other cases, filling NOT REQUIRED	*
- income from state benefits
- income from personal earnings
_____________________________________________________ 
_____________________________________________________ 
(Specify what)
- other_______________________________________________ 
_____________________________________________________
(provide details)
		
	For example, revenues from personal income, income from government benefits, etc.	
14. Size of the obtained income 
Field is required only for the categories: Insurance Beneficiary, beneficial owner, representative of the individual. In other cases, filling NOT REQUIRED	*
- Up to 50 000 rubles;
- from 50 000 rubles to 100 000 rubles;
- More than 100 000 rubles.
	
For Representative of the Client	
15. Details the document confirming the authority of the client's representative (name, date of issue, expiration date) 
Field is required only for the category: A representative a natural person. In other cases, filling NOT REQUIRED	Name	Date of issue	Validity	Number of the document confirming the authority of the client's representative	
	*

For example: Power of Attorney	*

For example: 08/15/2015	*

For example: 08/15/2018	* 

For example: 5468 646424	
Information about the use of payment systems and transactions with electronic money	
16. Specify the name of the payment systems, which are used (use) 
(Insert the correct option or enter your own)
Field is required only for the category: A representative a natural person. In other cases, filling NOT REQUIRED 	*
1. Yandex
2.WebMoney
3.OOO NSCA «RIB» (Robokassa)
4.OOO RNKO "Rapid"
5. Other: _____________________________________________________
(Insert name)
For example, Yandex. Money 
Например:  Яндекс. Деньги	

For customer RNKO:
Accuracy and completeness of these details confirm.
About changes in the information about an individual, I undertake to notify the Wallet one by means of the direction of the information letter or the questionnaire as amended.

*		
*
		
*
	
	Customer data (full name)
		(Signature)		(Date of completion)	
     Stamp (in the presence of)

For the employee responsible RNKO:
* The information stated by the client, tested and verified
	
*		

	
	Name of the Responsible Officer RNKO
		(Signature)		(Date of completion)	
The fields marked * are obligatory for filling

In accordance with the legislation of the Russian Federation, identity documents are:

1. For citizens of Russian Federation:
Passport of a citizen of the Russian Federation;
passport of a citizen of the Russian Federation, diplomatic passport, service passport, identity document of a citizen of the Russian Federation outside the Russian Federation;
a birth certificate of a citizen of the Russian Federation (for Russian citizens under the age of 14 years);
temporary identity card of a citizen of the Russian Federation, which is issued prior to the issuance of the passport of the Russian Federation;
2. for foreign nationals:
passport of a foreign citizen;
3. for stateless persons:
document issued by a foreign state and recognized in accordance with the international treaty of the Russian Federation as a document certifying the identity of the person without citizenship;
a residence permit;
a document certifying the identity of the person without a valid identity document for the period consideration of the application for recognition of a citizen of the Russian Federation or for admission to the citizenship of the Russian Federation;
refugee certificate, certificate of examination of an application for refugee status on the territory of the Russian Federation;
4. other documents, recognized identity documents of a citizen of the Russian Federation in accordance with Russian law and the documents certifying the identity of the foreign citizen and stateless persons in accordance with Russian and international treaty law