Information on insurance policy and about ordering card
* Currency of card account is identical with the currency of payment of the life insurance policy
Self-Certification Form for identification of individuals tax residency
1. Have you given or are you going to give standing order to transfer funds to an account maintained in abroad?

2. Have you granted or are you going to grant power of attorney or signatory authority to a person with a foreign address?

3. Are you going to submit "in-care-of" address or "hold mail" address as your sole address to the financial institution?

4. Do you have a foreign phone number?

5. Do you have a "Green Card" (regardless of the validity period)?

6. Do you meet the requirements of Abroad Presence Test? (You meet the requirements of the Test if you are present in abroad 183 days or more. For identifiying U.S. residency calculation is carried out as follows: [All the days (at least 31 days) in the current year]+ [1/3 days in the immediately preceding year] + [1/6 days in the second preceding year] ≥ 183 days. This rule doesn't apply with respect to diplomats, teachers, students and athletes).

7. Are you a political figure?
Political figures include persons who hold or held before important public positions in the government (heads of states or governments, members of the government, judges of supreme courts, senior military personnel, senior officials of state bodies, representatives of political parties), members of their families and close relatives

8. Have you ever been held criminally liable?

9. Have you ever had a conviction?

10. Are you a tax payer in any other country than Azerbaijan?

11. Are you a U.S. Citizen?

  I verify the accuracy of information I entered and I assume personal responsibility for the accuracy of entered information

  I agree with General Service Agreement. Read here the General Service Agreement