Application Form

Apply for the deposit in three steps: 1: Fill out the form 2: Sign 3: Send. 

Simply download the application form in PDF format. You can then send the completed deposit application directly to:

Active Brokers AG
Binningerstrasse 95
CH-4123 Allschwil

or Fax to: +41(0)61 425 70 05

or Email to:

Insurance terms and conditions: AVB

The Active Brokers Ltd is a nationally active independent insurance broker. Supervising authority in Switzerland: FINMA, Registration Number: 25412.