DDC Authorized Retailer Application For AGS Members

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DDC Online Trading Platform Application
for AGS Members

DDC Authorized Retailer

Applicant's Information

* Indicates required field

Name *

First

Last

Mid Initial/s *

Home Address *

Apt # *

City *

State *

Zip Code *

Country *

Home Telephone *

Cell Phone *

Include Country Code if Outside US

Personal Email Address *

Date of Birth *

(MM/DD/YYYY)

Country of Citizenship *

Picture *

Max file size: 20MB

Please upload a picture of yourself.

Other Shareholders

Name *

Title *

Ownership *

Name *

Title *

Ownership *

State of Incorporation/Business Certificate

State *

County *

Federal Tax ID Number *

Experience in the Diamond, Jewelry, or Gemstone Business

What is the Nature of Your Business? *

Are you listed in JBT? *

Yes No

If Yes: *

JBT Number

Are you or have you ever been member of a diamond club that is affiliated with the World Federation of Diamond Bourses? *

Yes No

If Yes: *

Name of WFDB Diamond Bourse

Year of Admission *

Are you party to any pending arbitration or lawsuit? *

Yes No

Have you any unpaid judgments or arbitration awards against you or your company? *

Yes No

Have you ever filed a bankruptcy petition personally or on behalf of your company? *

Yes No

Have you ever been arrested for, charged with, or convicted of a felony or a misdemeanor? *

Yes No

(If yes, please include an explanation in the comment box below)

Please use the box below for any additional information or explanation. *

Terms & Conditions

DDC Online Trading Platform Application for AGS Members​DDC Authorized Retailer

Applicant's Information

Company Information

Other Shareholders

State of Incorporation/Business Certificate

Experience in the Diamond, Jewelry, or Gemstone Business

DDC Online Trading Platform Application
for AGS Members

DDC Authorized Retailer