Customer Identity Verification

BTE Identity Verification Form

Identity Verification Form
Full Name

First NameLast Name
Permanent Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Current Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
E-mail
Identification proof provided/Type of ID:
ID number:
Expiry of ID proof (if applicable):
Signature
Please use your phone camera to take pics of your state driver's license and credit card.
Please upload pic of driver license

Browse Files
front of DL with your picture Cancelof
Please upload pic of credit card (Front)

Browse Files
Use phone camera to take pic & upload here Cancelof
Please upload pic of credit card (Back)

Browse Files
Use phone camera to take pic & upload here Cancelof
Should be Empty: