Current Account Application Form for a Legal Entity

Transcription

1 Current Account Application Form for a Legal Entity Client information Client name Registration number Place of registration client code HE 57 Cyprus country, state etc. Client s confirmation I hereby apply for opening a multicurrency current account. I hereby confirm that all the information provided in this application is true and undertake to immediately tify the bank of any change in the information. I have read ABLV Bank, AS General Terms of Business, fully understand them and undertake to comply with them. Client s representative Place client representative s signature Moscow, Russian Federation city, country ABLV Bank, AS / Registration No. 59 / SWIFT: AIZK LV K / VEI. / /... /

2 Card of Specimen Signatures and Seal for a Legal Entity Customer Information Legal Name Place of Registration Cyprus country, state, etc. Customer Code Authorisation. Customer Specimen Signatures and Seal The customer is hereby authorising each of the persons named herein below to represent the customer vis-à-vis the bank individually. The representative shall be entitled to enter, on behalf of the customer, any kind of agreements with the bank, including the effecting and receipt of payments, making of vation of obligations and acceptance of fulfilment of the bank s obligations. The representative is t entitled to pass the rights granted by this Authorization to any other person. This authorization shall remain valid until a Card of Specimen Signatures and Seal for a Legal Entity is submitted by the customer to the bank. Representative No. attorney position X passport / identification document series and number specimen signature.., Fruzensky district Department of Internal Affairs, Moscow passport / identification document date and place of issue Representative No. position X passport / identification document series and number specimen signature passport / identification document date and place of issue Representative No. position X passport / identification document series and number specimen signature passport / identification document date and place of issue Customer s Representative attorney position signature date Place of issue Moscow, Russian Federation city, country ABLV Bank, AS / Registration No. 59 / SWIFT: AIZK LV authorised seal K / VEI.9 / Versija: 5 / Spēkā :.5.9. /

3 Card of Specimen Signatures and Seal for a Legal Entity Certification Signatures of the hereinabove persons are hereby certified. Agreement Nr.999 signature position and full name date ABLV Bank, AS / Registration No. 59 / SWIFT: AIZK LV K / VEI.9 / Versija: 5 / Spēkā :.5.9. /

4 Client Questionnaire Information about company s business activities Client company name of legal entity client code Contact information Telephone Physical location of the Russia client or authorised country representative info@abcltd.com Moscow city 5 Kirova Street, office 79, postal code street, house No., office / flat No., zip code Website Language of communication N/A English Latvian Russian Information on tax residency according to FATCA and OECD CRS (explanation available on Is a client a U.S. person? If the answer is, please submit the form W-9 to the bank. Is a client tax resident of a country which is in the list of participating jurisdictions OECD CRS? If the answer is, please submit the Tax Residency Declaration for a Legal Entity to the bank. Information on planned transactions Maximum number of outgoing payments per up to Maximum balance of accounts (EUR) up to Maximum ly account credit turver (EUR) up to Cash transactions including use of payment cards up to 5 above 5 please indicate number up to above please indicate balance up to above please indicate value please indicate maximum ly amount of cash transactions (EUR) please clarify the purposes of cash transactions Accounts held with other banks XXX Bank please indicate names of banks client representative s signature ABLV Bank, AS / Registration No. 59 / SWIFT: AIZK LV K / VEI. / /... /

5 Client Questionnaire Company information (pursuant to financial report for the previous or forecast, if financial report is available) Number of employees less than more than 5 Annual net turver million EUR million EUR 5 million EUR above 5 million EUR Reasons for account opening in Latvia (to be filled by foreign client only) Accessibility (working time, Internetbank, etc.) Individual services Property in Latvia or Latvian residence permit Cost of services Return on deposits and investments Partners in Latvia Stable financial system Other please indicate Information about company s business activities Description of company s principal activities Trading of household appliances, computer equipment, electronics and their components. Purchasing of products of famous brands in European and Asian countries, selling of goods in CIS countries. Areas of company s activities according to the international NACE classifier Agriculture, forestry and fishing (A) Real estate activities (L) Mining and quarrying (B) Professional, scientific and technical activities (M) Manufacturing (C) Administrative and support service activities (N) Electricity, gas supply (D) Public administration, defence, compulsory social security (O) Water supply, sewerage, waste remediation (E) Education (P) Construction (F) Human health and social work activities (Q) Wholesale and retail trade, repair of motor vehicles (G) Arts, entertainment and recreation (R) Transportation and storage (H) Other service activities (S) Accommodation and food service activities (I) Activities of households (T) Information and communication (J) Activities of extraterritorial organizations and bodies (U) Financial and insurance activities (K) Are business activities subject to licensing? Are shares of company or related person traded on stock exchange? Source of funds business income please indicate name of stock exchange borrowed funds other please indicate client representative s signature ABLV Bank, AS / Registration No. 59 / SWIFT: AIZK LV K / VEI. / /... /

6 Client Questionnaire Information on politically exposed person status (explanation available at Are you or any of your authorized representatives a politically exposed person (holds or has held a prominent public position over the last s, including head of a municipality, member of parliament, member of the council or board of a state company), a family member or close associate of a politically exposed person? Politically exposed person No. country position held Politically exposed person No. country position held Client s confirmation I hereby confirm that all the information provided in this questionnaire is true and undertake to immediately tify the bank of any change in the information. I have read ABLV Bank, AS General Terms of Business and the explanation available on and fully understand them and undertake to comply with them. Place client representative s signature, full name Moscow, Russian Federation city, country ABLV Bank, AS / Registration No. 59 / SWIFT: AIZK LV K / VEI. / /... /

7 Information About Principal Business Partners Customer information Customer legal entity name / individual customer code Incoming Payments Name of a partner, country of registration Name of the products / services / transaction type Country where products / services are supplied OOO "Elektronika i tehnika", RU TV sets Russia OOO "UKRTEHNODOM", UA laptops Ukraine TOO Planeta Elektroniki, KZ TV sets, laptops Kazakhstan Invest Trading LTD, CY loan Outgoing Payments Name of a partner, country of registration Name of the products / services / transaction type Country where products / services are bought Siemens GMBH, DE households appliences Germany China Electronics LTD, HG TV sets, laptops and their components China Translogistic LLP, UK purchase of logistics services Russia Confirmation Customer s representative / customer signature ABLV Bank, AS / Registration No. 59 / SWIFT: AIZK LV K / VEI. / /... /

8 Beneficiary Application Client company name for legal entities or for individuals client code Client s beneficiary information Beneficiary of birth Personal number for Latvian clients only Identification document series, number, date and place of issue.., Fruzensky district Department of Internal Affairs, Moscow Contact information petrov.o@gmail.com telephone Is this person the only beneficiary? % specify participation interest Information on beneficiary s tax residency according to FATCA and OECD CRS (explanation available on Is the beneficiary a U.S. person? If the answer is, please submit the form W-9 to the bank. Is the beneficiary owning at least 5% of shares a tax resident of a country included in the OECD CRS list of participating jurisdictions? If, please specify the tax residency address or permanent residential address. If the beneficiary is a tax resident in more than one country, please provide the "Declaration of Additional Tax Residencies". Address country city street, house No., flat No., zip code taxpayer identification number Information on politically exposed person status (explanation available at Is the beneficiary a politically exposed person (holds or has held a prominent public position over the last s, including head of a municipality, member of parliament, member of the council or board of a state company), a family member or close associate of a politically exposed person? Politically exposed person country position held Client s confirmation I hereby confirm that all the information provided in this application is true and undertake to immediately tify the bank of any change in the information. I have read ABLV Bank, AS General Terms of Business and the explanation available on and fully understand them and undertake to comply with them. Moscow, Russian Federation Client s representative place city, country ABLV Bank, AS / Registration No. 59 / SWIFT: AIZK LV client's or client representative s signature K / VEI. / /... /

9 Tax Residency Declaration for a Legal Entity Client company name client code Information on client s tax residency according to OECD CRS (explanation available on Please specify the tax residency address or company's actual management address. If there are other tax residency addresses or the company's actual management addresses, please provide the "Declaration of Additional Tax Residencies". Address Cyprus Limassol country city Karaiskakis Street, office, 57H street, house No., office No., zip code taxpayer identification number Client is classified as (select one of the options): Active Nonfinancial Organization Governmental Entity Passive Nonfinancial Organization International Organization (Intergovernmental, Supranational Organization) Financial Institution (Custodial, Depository Institution, Investment Entity, Specified Insurance Company) Client s confirmation I hereby confirm that all the information provided in this declaration is true and undertake to immediately tify the bank of any change in the information. I have read ABLV Bank, AS General Terms of Business and the explanation available on fully understand them and undertake to comply with them. Client s representative Place client representative s signature Moscow, Russian Federation city, country ABLV Bank, AS / Registration No. 59 / SWIFT: AIZK LV K / VEI.5 / /... /

10 Confirmation of Receipt of Authentication Means Customer information Customer for individuals / company name for legal entities Customer code Information on authentication means I confirm that I have received authentication means requested by the customer, which I hereby request to activate: sealed and undamaged PIN-envelope containing User ID and password for Internetbank access No. electronic code card No. Digipass and access code to it in a sealed and undamaged PIN-envelope No. 5 I have read ABLV Bank, AS General Terms of Business, consent thereto, and agree to be bound thereby. signature and full name of the customer / customer s representative signature and full name of the Bank officer Notes by the Bank ABLV Bank, AS / Registration No. 59 / SWIFT: AIZK LV K / VEI. / /.9.. /

11 Application for Card Account Opening and Payment Card Issuing for a Legal Entity Customer information Customer Current account LV AIZK 5 P E T 7 9 Cardholder information Name, surname on payment card O L E G R O V in Latin letters (without language specific characters) Passport / ID card 99 99,.., Frunzensky district Department of Internal Affairs, Moscow; 7..9 series and No., place and date of issue, date and place of birth Residential address ul.tverskaja, 999, kv. 7, Moscow,, RF city, country Payment card and card account information Payment card type Visa Infinite Visa Platinum Visa Gold Business MasterCard Gold Business Visa Business MasterCard Business Visa Electron Maestro Cirrus RUB (Maestro and VISA Electron) GBP (Visa Infinite, Visa Platinum, Visa Gold Business and Visa Business) Security deposit (according to the Rates and Charges) amount in payment card account currency Connect to short messaging for transactions with the card Currency (choose only one) USD EUR Credit limit amount in payment card account currency Declaration I hereby apply for card account opening and payment card issuing to the specified cardholder. I am informed that the Bank is obliged to provide information to the Bank of Latvia and is entitled to receive information from the Credit Register of the Bank of Latvia in the cases specified in Regulation for the Credit Register of the Bank of Latvia ( I hereby confirm that all information provided in the Cardholder information section herein is complete, correct and true in all respects, and I have received a consent from the above data subject to provide this information to ABLV Bank, AS, for processing. I hereby commit to immediately inform ABLV Bank, AS, of all changes in the stated information. I have read ABLV Bank, AS, General Terms of Business and rates and charges, consent thereto, and agree to be bound thereby. signature, full name of the customer s representative, seal authorization code Place of signature Moscow, Russian Federation city, state Signed before me, the identity of signer verified. ABLV Bank, AS / Registration No. 59 / SWIFT: AIZK LV Agreement Nr.999 signature, position and full name of the Bank s representative K / VEI. / / /

12 Cardholder Application Cardholder information Name, surname Password I V A N O V A combination of letters and/or figures that will be used for cardholder recognition Passport / ID card 99 99,.., Frunzensky district Department of Internal Affairs, Moscow; 7..9 series and No., place and date of issue, date and place of birth I hereby agree to be a cardholder of payment cards linked to accounts of the following customer: Customer name for legal entities / for individuals customer code Declaration I have read ABLV Bank, AS, General Terms of Business and rates and charges, consent thereto, and agree to be bound thereby. I hereby confirm that I am additionally informed about the data processing procedure stipulated in sections А5 and А7 of the ABLV Bank, AS, General Terms of Business, and agree to be bound thereby. cardholder s signature, full name Place of signature Moscow, Russian Federation city, state Signed before me, the identity of signer verified. ABLV Bank, AS / Registration No. 59 / SWIFT: AIZK LV Agreement Nr.999 signature, position and full name of the Bank s representative K / VEI. / Versija: / Spēkā : 5... /