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Section 1: Application Identification


Section 2: other msb relationships


Section 3: Compliance


Personal Information

For security reasons, CambioReal INC require all agents to be provide the following information and, in addition upon our discretion, we may ask to see and copy other identifying documents as part of our review process.


The applicant(s) represent(s) that all statements contained in this form and in the other documentation submitted in support of this application are true and correct. Permission and authorization is hereby granted by the applicant to CambioReal INC and/or its designee or third party vendor assigned by CambioReal INC background check, consumer credit services, and to state and federal government agencies or representatives, to verify, receive, exchange, and obtain business and/or personal credit and other information as part of this application or at anytime thereafter in connection with the ongoing application evaluation, review of Money Service Business activities and/or compliance or collection related actions. and to state and federal government agencies or representatives, to verify, receive, exchange, and obtain business and/or personal information as part of this application or at anytime thereafter in connection with the ongoing application evaluation, review of Money Service Business activities and/or compliance or collection related actions. The undersigned further agrees to hold harmless any individual or business entity who does furnish, or has furnished, any information to CambioReal INC directly or indirectly, concerning the applicant, its business and/or the undersigned, from any losses or damages, and/or any claim resulting from any verification, receipt, exchange, or obtaining business and/or personal credit or other business and/or personal information. The person(s) signing this application further represents that s/he is authorized to make the above representations, waiver of claims and authorizations, and if applicable, is an authorized representative of any business entity making this application. I CERTIFY, UNDER PENALTY OF PERJURY, UNDER ANY AND ALL APPLICABLE FEDERAL AND STATE LAWS, THAT: The federal taxpayer identification number shown on this application is the correct taxpayer identification number of the applicant.