OTC Registration Form - CoinTime Bitcoin ATM

CoinTime Whiteglove OTC Service Account Setup

Fill out this form to begin setting up your CoinTime account for OTC Bitcoin trades.

Whiteglove OTC Service Registration Form

Start your application now to expedite your registration for CoinTime's Whiteglove OTC Service. Once your account setup is complete, you'll be ready to make large-scale Bitcoin trades of $10,000 or more!

Name

Phone Number

Whiteglove OTC Service Registration Form

Address Line 1

Address Line 2

City

State

Zip Code

Date of Birth (DOB)

Tax ID (SSN or EIN)

Take Photo or Upload Photo of ID (Driver License)

The Image should be in jpg or png format and must not exceed 5MB in size

Whiteglove OTC Service Registration Form

Are you a US citizen, Non-Resident Alien, or Foreign National?

Are you, or anyone in your immediate family, a senior foreign political figure, either in a foreign country or the US. If so, please explain.

Source of Funds / Occupation

Are you involved in any of the following Industries?

Reason for Buying / Selling Bitcoin

Optional: Supporting Documents Upload

CoinTime Whiteglove OTC Service Account Setup

Whiteglove OTC Service Registration Form

Whiteglove OTC Service Registration Form

Whiteglove OTC Service Registration Form

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