CLOUT Network KYC Form
Name
First Name
Last Name
Email
example@example.com
Identity Documents
Browse Files
Please upload a clear photo of your passport , driving licence or national identity card
Cancel
of
Selfie Holding ID
Browse Files
We require a photo of you holding the Identity document you submitted above
Cancel
of
ETH Address to receive CLOUT tokens
Promo Code
if you have a promo code please enter it here
I understand that minimum contribution is 10 ETH or 1 BTC
YES
How much ETH or BTC are you contributing (minimum 10 ETH 1 BTC)
Please include the unit ETH/BTC
I AGREE I AM NOT A CITIZEN OF ISRAEL or The UNITED STATES.
YES
Submit
Should be Empty: