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Crypto Shield Pro Application
Institutional-grade custody insurance
Email
*
Named Insured
*
Website Domain(s)
*
WhatsApp Phone Number
*
Telegram Handle
Physical Address
(Street, City, State or Country, Zip)
*
Are you working with an insurance broker?
*
Are you working with an insurance broker?
Yes
No
Please describe your nature of operations/entity type:
(i.e. Asset management, law firm, e-commerce)
*
*
Year Established
*
Number of Employees
*
In USD
Current Year Revenue
*
Prior Year Revenue
*
Future 12 months Revenue
*
Gross Profit / Net Revenue (expected over the next 12 months)
*
Assets Under Custody
*
Assets Under Custody
A
under $25,000,000
B
$25,000,000 - $75,000,000
C
$75,000,000 - $150,000,000
D
over $150,000,000
E
Other
What percentage of Assets Under Custody do you desire to have insured?
*
What percentage of Assets Under Custody do you desire to have insured?
A
1-10%
B
10-25%
C
25-50%
D
more than 50%
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