Token Distribution

Before continuing you are required to read our Distribution Agreement. If you do not already have a wallet capable of holding Carbon Dollar X ERC20 Tokens, you are required to create one. You can read our Wallet Recommendations. After having attested to the Distribution Agreement and have in hand your Wallet Address, please fill out the following form with the most accurate data. All fields are required. Upon submitting your details and agreeing to our Distribution Agreement and standard KYC norms, you will be automatically redirected to enter your secure Payment Information. A payment can only be taken from an account belonging to the person electronically signing this agreement. Distribution of Tokens will not occur until Suria Global (L) Ltd has verified your identity and confirmed your payment settlement. You will receive a confirmation email when Tokens have been distributed to your Wallet. This process can take up to 10 business days.

IMPORTANT: All personal details entered below must be the same information entered in the Payment Gateway. Failure to do so may prevent or delay Token distribution to your Wallet. Do not use an “autofill” for this form and ensure your Ethereum Wallet Address begins with “0x”, for example; 0x22fB47Fa92250ff9C6936f2F8A55289f8F964b6B.

Full NameGenderMarital StatusGovernment Issued IdentificationGovernment Issued Identification NumberHome AddressCityStatePostal CodeCountryPhone NumberEmail AddressEthereum Wallet AddressRecommending EntityI hereby declare that the details furnished above are true and correct to the best of my knowledge and belief and I undertake to inform you of any changes therein, immediately. In case any of the above information is found to be false or untrue or misleading or misrepresenting, I am aware that I may be held liable for it. I hereby declare that I am not making this application for the purpose of contravention of any Act, Rules, Regulations or any statute of legislation or any notifications directions issued by any governmental or statutory authority from time to time. I hereby authorize sharing of the information furnished on this form with all SEBI registered KYC Registration Agencies/SEBI Registered Intermediaries.I have taken independent action to understand, create and secure my own Ethereum-based wallet compatible of receiving ERC20 Tokens such as the Carbon Dollar X Token. I further understand and agree that the Ethereum Wallet Address I have provided in this form will be the recipient Wallet Address in this Token Distribution.I, by attesting to this distribution agreement, hereby agree to all of the terms, conditions, warranties, and representations included, and accept the Amount of CDX Tokens of the Company’s Token Distribution and Total Purchase Amount (RM) which will be set subsequent to this submission. Payment will be collected upfront and your order will be submitted for distribution, making all sales final. Distribution can take up to 10 business days. All Token Distributions verifiable on Etherscan (https://etherscan.io) will be considered as received by the attestant and will not be contested.I, by checking this box, am providing my electronic signature for all of the above.

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Token Distribution

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