Platx Private Sale participation form
Please fill out this form completely if you want to participate in the PLTX token private sale. For more information please visit : www.Platx.io
Email address *
Full Name *
Are you a USA Resident/ Citizen ? *
Waves wallet address (Eg: 3PLTX3VdXvgFXvHq2KxVu63mJL7zDvu6hsi) *
Currency you want to invest *
Amount you want to invest? *
I acknowledge that I am NOT A RESIDENT OF CUBA, IRAN, NORTH KOREA, SYRIA AND THE CRIMEA REGION: PLATX COIN ARE NOT BEING OFFERED OR DISTRIBUTED TO ANY RESIDENT OF OR ANY PERSON LOCATED OR DOMICILED IN CUBA, IRAN, NORTH KOREA, SYRIA, THE CRIMEA REGION OR ANY OTHER COUNTRY OR TERRITORY THAT IS SUBJECT OF COUNTRY-WIDE OR TERRITORY-WIDE SANCTIONS. *
A copy of your responses will be emailed to the address you provided.
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