Dear Customer,

‘Source of funds’ refers to the activity, event, business, occupation or employment generating the funds used in a particular transaction, or to be used in future transactions.

Meridian Gaming (CY) Limited has a regulatory requirement to collect the following information and to collect documentary evidence to support the source of any deposit.

Please complete the following form:

Personal details:

Title

First name

Middle nameOnly to be entered if shown on the document

Last name

Date of birth

I hereby declare that the source of funds used in my Meridianbet account is:

Personal statement

Confirming your details are correct

I declare and represent that the funds uploaded to my Meridianbet account have been acquired legitimately.

Files upload

*Click on the empty field to uploadPDF, PNG, JPEG, JPG

*Please select and attach supporting documents as proof of source of funds. If multiple files are being uploaded, make sure to attach them all at once. Kindly refer to the below examples of documents, which can serve as evidence of source of funds and note that one of the documents from the provided list will suffice.

EXAMPLES OF DOCUMENTARY EVIDENCE

Salary / Self Employed Income

Last 3 months payslips

3 months of bank statements showing salary payments

Contract / agreement for self-employed services

Copies of invoices for self-employed services

Savings

3 months bank statement demonstrating buildup of deposit /capital repayment /gifted monies

Sale of investments/ Sale of property

Statement from investment provider showing last 12 months portfolio valuation or bank statement showing settlement from investment provider

Signed letter from – Solicitor / Advocate or Estate Agent or Contract of Sale / settlement statement

Lottery / Gambling win

Evidence from the lottery company, or a winning’s receipt

Cryptocurrencies

Screenshots of purchase and withdrawal confirmation displaying your account ID and all transaction details

Confirmation emails which provide proof of purchase or withdrawal

Inheritance

Copy of will

Signed letter from solicitor

Grant of Probate or letter from Executor

Maturity or surrender of life assurance policy

Closing statement or letter from the policy provider

Dividends or Profits from company

Latest audited company accounts / dividend statement

Divorce/other court award (e.g. compensation)

Copy of court order or judicial separation agreement

Court order signed letter from solicitor/advocate

Gift

Fully completed & signed gift letter will be required

Signature

Self (print name)

*Signing date

Signature

*Please sign this document.

Confirmation

*Confirming your details are correct

I hereby declare that the information provided is true and correct and that I have checked it before submitting.

Agreement

I have read and agree to the:

Terms & conditions - Privacy policy

Meridian Gaming (CY) Ltd HE314265

Amathountos 180, Block A, 1st Floor, Parekklisia, 4533 Limassol, Cyprus, Tel.: 70003247

SOF English

Dear Customer,

Please complete the following form:

EXAMPLES OF DOCUMENTARY EVIDENCE