Required Documentation

Proof of Origin of Funds

Complete and sign this form prior to sending your wire transfer payment.

Legal Residency Costa Rica

L.R.C.R. Real Estate Costa Rica

Division of RPGSE of San Mateo SRL

Cedula Juridica 3-102-693041

P.O. Box 733-6150 Santa Ana, Costa Rica

legalresidencycostarica@outlook.com | www.legalresidencycostarica.com

IMPORTANT: We have been advised by our bank that in order for us to receive initial payment, an actual signed contract/agreement must be in place. By including the following information, the above quote/invoice will be treated as a signed contract by our bank.

Should you plan on wiring payments for commission earned or for our charges for obtaining your legal status, please complete and return this form which we will then forward to our bank as wiring instructions provided.

This form is used as part of the know your client requirement & is a requirement of Banking system here in Costa Rica.

Three easy ways to complete and return this form:

1.Fill it in below and tap Send via WhatsApp — the fastest option.
2.Fill it in below and tap Send via Email — it opens your email app with everything ready to send.
3.Tap Download / Print Form to save a PDF or print a copy, sign it by hand, and email it back to legalresidencycostarica@outlook.com.

Proof of Origin of Funds

Quote / Invoice Number

Name of Applicant

Amount of Transfer

US$

Passport Number

Home Country Address

I confirm the information above is accurate. By submitting this form, I authorize it to serve as my signed agreement (Signature of Applicant) for the purpose of processing this wire transfer.

Prefer paper? Download the form to print, sign by hand, and email back to us — or print a blank copy by leaving the fields empty.

Wire Transfer Details

For full bank wire transfer instructions, visit our Bank Wire Transfers in USD page.