Increase My LimitsPlease enable JavaScript in your browser to complete this form.Start - Step 1 of 6This form is for established CoinMover customers who have already conducted a transaction on one of our machines, and want to increase their daily maximum from the current $9,000 up to over $50,000 per day. Daily purchases of up to $2,995 or $9,000 may be done by visiting any one of our CoinMover kiosks and simply entering your phone number to start the process directly on the machine. No account set up is required. Click NEXT to acknowledge and continue:NextLegal Name & Current AddressPlease enter your legal name as it appears on your primary identification document along with your current mailing address.Name *FirstLastAddress *Address Line 1City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePreviousNextDate of Birth & SSNDate of Birth (DOB) *Social Security Number (SSN) *Mobile Phone & E-Mail AddressIf you have not used a CoinMover ATM before, please enter your primary mobile phone number and e-mail address. If you have previously used a CoinMover ATM, please input the same mobile phone number you used to receive your SMS confirmation code. If you elected to receive a receipt via email at the machine, please enter the same e-mail address below.Mobile Phone *E-Mail Address *EmailConfirm EmailPreviousNextFinancial InformationBeing up-front with our customers is a top priority. We ask these questions because government regulations require us to perform due diligence on each of our customers. The purpose is to better understand your financial position and how you obtain the funds you will use with our machines. Please answer the following truthfully and to the best of your knowledge.What is your occupation? *How much do you expect to transact with us (in USD) per month? *What will be the general purpose of your transactions with CoinMover (Check all that apply)Investing in digital currency for the futureSending money to someone else like friends or family inside the USASending money to someone internationally located outside the USAPurchasing goods or services either in-person or onlinePaying a bill or a companyOnline games or gamingWhat is the source of funds you you will use to transact with CoinMover? (Check all that apply) *Salary & WagesSavingsInheritance401(k) / Pension / RetirementInvestments / Stocks / Dividends / InterestWhat is your overall annual income? *Less than $50,000$50,000 to $100,000$100,000 to $250,000Greater than $250,000What is your overall net worth? *Less than $50,000$50,000 to $250,000$250,000 to $750,000Greater than $750,000Are you a Politically Exposed Person (PEP)?NoYesIf you do now know what this question means, you may keep no as the default answer. Politically Exposed Persons (PEPs), also known as "foreign agents" are generally foreign heads of state, ministers, members of parliament, members of the highest court, members of the highest policymaking body auditing international state finances, members of a central bank board, an ambassador or chargé d’affaires, general officer, or executives of a wholly owned state company.PreviousNextDocumentation UploadPlease select one piece of documentation from each of the three groups below and attach proof. We accept a wide range of formats including camera images from your mobile phone if you do not have a scanner. Any statement, letter, or bill must be dated within the past 90 days. Any insurance policy, mortgage, or tax document must be for the current year.Primary Identity Document *Choose one from this list:Drivers LicensePassportPermanent Resident Card (DHS Form I-551)Certificate of Citizenship (DHS Form N-560/N-561)Certificate of Naturalization (DHS Form N-550/N-570)OTHER DOCUMENTPrimary Identity Document Upload * Click or drag a file to this area to upload. Address Verification Document *Choose one from this list:Auto Insurance BillBank StatementCredit Card StatementEmployer Pay StubExcise Tax BillFirearms Identification CardHomeowners Insurance BillJury Duty SummonsMedicare/Medicaid StatementMortgage StatementProperty Tax BillRetirement/Pension StatementSchool Enrollment LetterSchool TranscriptSchool Tuition BillUtility Bill (Electric, Water, Heat)OTHER DOCUMENTAddress Verification Document Upload * Click or drag a file to this area to upload. Source of Funds Verification Document *Choose one from this list:Paystub(s) showing income supportive of transaction volumePrior Year’s Tax Return or IRS Form W-2 Tax DocumentationBank/Accountant Letter Listing AssetsBank and/or Equities Statement(s)Accountant Letter Listing Net Worth: Real Estate Holdings and/or InheritanceOther document not listed above that satisfies the requirement stated belowDue to regulatory requirements, we ask you to provide at least one document dated within the prior year that will support your transaction volume. For example, uploading a Social Security Statement or a Bank Statement showing monthly deposits of less than $2,000 does not allow us to let someone transact over $500,000 per year. While we recognize that people have multiple sources of income and assets, we require some evidence of the source of funds that are being used at our machines. We reserve the right to set purchase limits that correspond to the documents we are provided. Source of Founds Document Upload * Click or drag a file to this area to upload. PreviousNextAttestationI certify that the information contained in this identity verification form is accurate and correct to the best of my knowledge. I affirm that I am the person identified in the documents that have been attached and uploaded on the previous pages. I also agree to the CoinMover Terms & Conditions, Data Privacy Policy, and the CoinMover BSA/AML Compliance Policy, copies of which are located in the footer of each page on this website. PENALTY FOR FALSE OR FRAUDULENT STATEMENT: U.S.C. Title 18, Sec. 1001, provides: “Whoever, in any matter within the jurisdiction of any department or agency of the United States knowingly and willfully falsifies, or makes any false, fictitious or fraudulent statements or representation, or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry, shall be fined not more than $10,000 or imprisoned not more than five years, or both.”Signature *Type your full name in the box above.Date Signed *Choose today's date above.Paragraph TextEmailSubmit
