Asura Coin ICO Whitelist/KYC Registrations

Asura Coin ICO Whitelist/KYC Registration

Please fill in the form below.
Full Name*

First NameLast Name
D.O.B

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Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Country of residence*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*

Confirmation Email
NEO Wallet Address*
DO NOT ENTER EXCHANGE WALLET ADDRESS
If you do not have a NEP-5 compatible NEO wallet yet, please follow this tutorial on how to create a NEON wallet.
Photo Authentication
Identity Document*

PassportNational Identity Card / Driver's Licence
Upload Your I.D*

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Please upload a clear picture of your Identity Document. All the text needs to be clearly visible and readable. If you are uploading a National Identity Card, both sides will need to be scanned (Back and Front). Cancelof
Upload a selfie with your I.D*

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Please upload a selfie with your Identity Document. Make sure your face and ID don't overlap and are clearly visible Cancelof
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