DECLARATIONS. □ I declare that I have received, acquainted myself with and unconditionally accept the General Terms and Conditions for the providing of payment services to legal entities of Raiffeisenbank (Bulgaria) EAD, an integral part of this Agreement-Application. □ I declare that I have acquainted myself with and unconditionally accept the General Conditions for using Raiffeisen ONLINE. □ I declare that I have acquainted myself with and unconditionally accept the Instruction for Using of hardware device - Token □ I declare that I have acquainted myself with and unconditionally accept the Instruction for Confirmation of payments with SMS codes in Raiffeisen ONLINE □ I declare that I have acquainted myself with and unconditionally accept the General Conditions for using the Raiffeisen E-Bank Statements service. □ I declare that I have acquainted myself with and unconditionally accept the General Conditions for using Xxxx International. □ I declare that I have received, acquainted myself with and unconditionally accept the General Business Conditions of Raiffeisenbank (Bulgaria) EAD. □ I declare that I have received, acquainted myself with and unconditionally accept the Fees and Commissions Tariff for legal entities of Raiffeisenbank (Bulgaria) EAD. □ I declare that I have received, acquainted myself with and unconditionally accept the current Interest Rates Bulletin for Legal entities of Raiffeisenbank (Bulgaria) EAD. □ I declare that by signing this Agreement, I confirm the truth and accuracy of all the information I have provided, and I allow the Bank to check it at any time, and I undertake, if any relevant change occurs, to inform the Bank immediately. □ I declare that I agree to provide the Bank with the necessary information and documents, related to Law on the Measures against Money Laundering (LMML) and the Rules for the Application of the LMML, and the applicable Bulgarian legislation - upon request by the Bank, related to the implementation of a concrete operation. □ I declare that I am responsible for all actions undertaken on my behalf or by persons I have authorized after access to the Raiffeisen ONLINE service has been granted. □ I declare that I am responsible for all actions undertaken on my behalf or by persons I have authorized after access to the Xxxx International service has been granted. □ I declare that I shall undertake to archive the documents generated via the Raiffeisen E-Bank Statements service on my own information carrier for a period of 18 months after their generation. Date ………………………………………….. ............................................................................................................../name and signature of the person/s/ authorized by the company / IX. FOR USE BY BANK OFFICIALS official’s Initials in Midas date time signature Account opened by / item II / Account checked by / item II / Agreement-Application received by /items II , III, IV and V/ Agreement-Application checked and approved by /items III, IV and V / Agreement/Application scanned by User name and password for Raiffeisen e-Bank Statements have been provided by User name and password for Raiffeisen Online have been provided by User name and password for a hardware TOKEN device have been provided by IT Department /items III and V/: Approved by: Confirmed by: ИК 09.01.01 /Annex 7/ (the information is filled in by an employee of RBBG) account number (IBAN) B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5
Appears in 1 contract
Samples: Agreement
DECLARATIONS. □ Accuracy of information Subscription Agreement, Issuing Document and Articles of Association I certify that all the information provided in this document and in the declaration of beneficial owner is accurate and complete and undertake to immediately notify Banque de Patrimoines Privés if any of the information provided in this document changes (in particular if you have stated that you are an institutional investor and do not qualify as such anymore, change of name, contact, status, structure, ultimate economic beneficiaries…) and submit a new form within 30 days. I declare that I have receivedread, acquainted myself with agreed and unconditionally accept understood the General Terms and Conditions for the providing of payment services to legal entities of Raiffeisenbank (Bulgaria) EAD, an integral part contents of this Agreement-Applicationsubscription form and that I have had the opportunity prior to completing this form to request and read the Issuing Document and Articles of Association of the Company. □ I understand that the subscription for Shares is made subject to the terms of such documents and the terms and conditions of this form (including the Beneficial Owner Capacity U.S. Distribution Transfer Restrictions Origin of funds Fax or other electronic transmission TAX Compliance application notes). I hereby confirm that the investment is made on the applicant’s own behalf; I hereby confirm that the investment is made in my name but on behalf of my clients and that I have identified and verified the identity of underlying clients and their ultimate economic beneficiaries as well as the origin of the money invested. None of such clients and ultimate economic beneficiaries is named on list of prohibited country, territories, entities and individuals maintained by the OFAC, the EU or my financial supervisory authority. I am the ultimate economic beneficiary of the Shares invested; or I am not the ultimate economic beneficiary and I have provided the additional declaration to identify the ultimate economic beneficiaries I declare that I have acquainted myself full legal capacity to subscribe in, hold and/or deal with and unconditionally accept the General Conditions Shares. I acknowledge that the Company is not registered under the U.S. Securities Act of 1933 or other laws governing the U.S. Securities industry. I agree that the Shares cannot be sold or transferred to or for using Raiffeisen ONLINEthe account of any US Person or in the USA or in or for the account of any person in any other jurisdiction that would be restricted or prohibited to acquire Shares. □ I declare that I have acquainted myself with and unconditionally accept the Instruction for Using of hardware device - Token □ I declare that I have acquainted myself with and unconditionally accept the Instruction for Confirmation of payments with SMS codes in Raiffeisen ONLINE □ I declare that I have acquainted myself with and unconditionally accept the General Conditions for using the Raiffeisen E-Bank Statements service. □ I declare that I have acquainted myself with and unconditionally accept the General Conditions for using Xxxx International. □ I declare that I have received, acquainted myself with and unconditionally accept the General Business Conditions of Raiffeisenbank (Bulgaria) EAD. □ I declare that I have received, acquainted myself with and unconditionally accept the Fees and Commissions Tariff for legal entities of Raiffeisenbank (Bulgaria) EAD. □ I declare that I have received, acquainted myself with and unconditionally accept the current Interest Rates Bulletin for Legal entities of Raiffeisenbank (Bulgaria) EAD. □ I declare that by signing this Agreement, I confirm that the truth monies invested do not originate directly or indirectly from illegal or criminal activities and accuracy of all the information I have provided, more generally do not contravene to applicable anti-‐money laundering laws and I allow the Bank to check it at any time, and I undertake, if any relevant change occurs, to inform the Bank immediatelyregulations. □ I declare that I agree that the Company and its agents (including Banque de Patrimoines Privés) is authorized to provide the Bank with the necessary information accept and documents, related to Law on the Measures against Money Laundering (LMML) execute any future instructions received by fax and/or electronic instruction without subsequent written confirmation and the Rules for the Application until written notice of the LMMLcontrary, the applicant assuming all risks, e.g. those arising from an error in communication or comprehension as well as those arising from fraud and release the applicable Bulgarian legislation - upon request by the Bank, related to the implementation of a concrete operation. □ I declare Company from any liability in that I am responsible for all actions undertaken on my behalf or by persons I have authorized after access to the Raiffeisen ONLINE service has been granted. □ I declare that I am responsible for all actions undertaken on my behalf or by persons I have authorized after access to the Xxxx International service has been granted. □ I declare that I shall undertake to archive the documents generated via the Raiffeisen E-Bank Statements service on my own information carrier for a period of 18 months after their generation. Date ………………………………………….. ............................................................................................................../name and signature of the person/s/ authorized by the company / IX. FOR USE BY BANK OFFICIALS official’s Initials in Midas date time signature Account opened by / item II / Account checked by / item II / Agreement-Application received by /items II , III, IV and V/ Agreement-Application checked and approved by /items III, IV and V / Agreement/Application scanned by User name and password for Raiffeisen e-Bank Statements have been provided by User name and password for Raiffeisen Online have been provided by User name and password for a hardware TOKEN device have been provided by IT Department /items III and V/: Approved by: Confirmed by: ИК 09.01.01 /Annex 7/ (the information is filled in by an employee of RBBG) account number (IBAN) B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5respect.
Appears in 1 contract
Samples: Subscription Agreement
DECLARATIONS. □ Accuracy of information I certify that all the information provided in this document and in the declaration of beneficial owner is accurate and complete and undertake to immediately notify Centaur if any of the information provided in this document changes (in particular if you have stated that you are an institutional investor and do not qualify as such anymore, change of name, contact, status, structure, ultimate economic beneficiaries…) and submit a new form within 30 days. I declare that I have receivedread, acquainted myself with agreed and unconditionally accept understood the General Terms and Conditions for the providing of payment services to legal entities of Raiffeisenbank (Bulgaria) EAD, an integral part contents of this Agreement-Applicationsubscription form and that I have had the opportunity prior to completing this form to request and read the Issuing Document and Articles of Association of the Company. □ I understand that the subscription for Shares is made subject to the terms of such documents and the terms and conditions of this form (including the application notes). I hereby confirm that the investment is made on the applicant’s own behalf; I hereby confirm that the investment is made in my name but on behalf of my clients and that I have identified and verified the identity of underlying clients and their ultimate economic beneficiaries as well as the origin of the money invested. None of such clients and ultimate economic beneficiaries is named on list of prohibited country, territories, entities and individuals maintained by the OFAC, the EU, United Nations and HM Treasury Sanctions or my financial supervisory authority. I am the ultimate economic beneficiary of the Shares invested; or I am not the ultimate economic beneficiary and I have provided the additional declaration to identify the ultimate economic beneficiaries I declare that I have acquainted myself full legal capacity to subscribe in, hold and/or deal with and unconditionally accept the General Conditions Shares. I acknowledge that the Company is not registered under the U.S. Securities Act of 1933 or other laws governing the U.S. Securities industry. I agree that the Shares cannot be sold or transferred to or for using Raiffeisen ONLINEthe account of any US Person or in the USA or in or for the account of any person in any other jurisdiction that would be restricted or prohibited to acquire Shares. □ I declare that I have acquainted myself with and unconditionally accept the Instruction for Using of hardware device - Token □ I declare that I have acquainted myself with and unconditionally accept the Instruction for Confirmation of payments with SMS codes in Raiffeisen ONLINE □ I declare that I have acquainted myself with and unconditionally accept the General Conditions for using the Raiffeisen E-Bank Statements service. □ I declare that I have acquainted myself with and unconditionally accept the General Conditions for using Xxxx International. □ I declare that I have received, acquainted myself with and unconditionally accept the General Business Conditions of Raiffeisenbank (Bulgaria) EAD. □ I declare that I have received, acquainted myself with and unconditionally accept the Fees and Commissions Tariff for legal entities of Raiffeisenbank (Bulgaria) EAD. □ I declare that I have received, acquainted myself with and unconditionally accept the current Interest Rates Bulletin for Legal entities of Raiffeisenbank (Bulgaria) EAD. □ I declare that by signing this Agreement, I confirm that the truth monies invested do not originate directly or indirectly from illegal or criminal activities and accuracy of all the information I have provided, more generally do not contravene to applicable anti-money laundering laws and I allow the Bank to check it at any time, and I undertake, if any relevant change occurs, to inform the Bank immediatelyregulations. □ I declare that I agree that the Company and its agents (including Centaur) is authorized to provide the Bank with the necessary information accept and documents, related to Law on the Measures against Money Laundering (LMML) execute any future instructions received by fax and/or electronic instruction without subsequent written confirmation and the Rules for the Application until written notice of the LMMLcontrary, the applicant assuming all risks, e.g. those arising from an error in communication or comprehension as well as those arising from fraud and release the applicable Bulgarian legislation - upon request by the Bank, related to the implementation of a concrete operation. □ I declare Company from any liability in that I am responsible for all actions undertaken on my behalf or by persons I have authorized after access to the Raiffeisen ONLINE service has been granted. □ I declare that I am responsible for all actions undertaken on my behalf or by persons I have authorized after access to the Xxxx International service has been granted. □ I declare that I shall undertake to archive the documents generated via the Raiffeisen E-Bank Statements service on my own information carrier for a period of 18 months after their generation. Date ………………………………………….. ............................................................................................................../name and signature of the person/s/ authorized by the company / IX. FOR USE BY BANK OFFICIALS official’s Initials in Midas date time signature Account opened by / item II / Account checked by / item II / Agreement-Application received by /items II , III, IV and V/ Agreement-Application checked and approved by /items III, IV and V / Agreement/Application scanned by User name and password for Raiffeisen e-Bank Statements have been provided by User name and password for Raiffeisen Online have been provided by User name and password for a hardware TOKEN device have been provided by IT Department /items III and V/: Approved by: Confirmed by: ИК 09.01.01 /Annex 7/ (the information is filled in by an employee of RBBG) account number (IBAN) B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5respect.
Appears in 1 contract
Samples: Subscription Agreement
DECLARATIONS. □ Accuracy of information I certify that all the information provided in this document and in the declaration of beneficial owner is accurate and complete and undertake to immediately notify Banque de Patrimoines Privés if any of the information provided in this document changes (in particular if you have stated that you are an institutional investor and do not qualify as such anymore, change of name, contact, status, structure, ultimate economic beneficiaries…) and submit a new agreement within 30 days. Subscription Agreement, Offering Memorandum and Limited Partnership Agreement I declare that I have receivedread, acquainted myself with agreed and unconditionally accept understood the General Terms and Conditions for the providing of payment services to legal entities of Raiffeisenbank (Bulgaria) EAD, an integral part contents of this Agreement-ApplicationSubscription Agreement and that I have had the opportunity prior to completing this agreement to request and read the Offering Memorandum and Limited Partnership Agreement of the Partnership. □ I understand that the subscription for Units is made subject to the terms of such documents and the terms and conditions of this agreement (including the application notes). Beneficial Owner I hereby confirm that the investment is made on the applicant’s own behalf; I hereby confirm that the investment is made in my name but on behalf of my clients and that I have identified and verified the identity of underlying clients and their ultimate economic beneficiaries as well as the origin of the money invested. None of such clients and ultimate economic beneficiaries is named on list of prohibited country, territories, entities and individuals maintained by the OFAC, the EU or my financial supervisory authority. I am the ultimate economic beneficiary of the Units invested; or I am not the ultimate economic beneficiary and I have provided the additional declaration to identify the ultimate economic beneficiaries Capacity I declare that I have acquainted myself full legal capacity to subscribe in, hold and/or deal with and unconditionally accept the General Conditions for using Raiffeisen ONLINEUnits. □ Non U.S. Person I hereby declare that Units are not acquired directly or indirectly or on behalf of a US Person as defined in the Offering Memorandum nor a corporation controlled by, or a majority of whose shares are held by, US Persons or by or on behalf of any person in any other jurisdiction that would be restricted or prohibited to acquire Units. I have acquainted myself with and unconditionally accept acknowledge that the Instruction Partnership is not registered under the U.S. Securities Act of 1933 or other laws governing the U.S. Securities industry. Transfer Restrictions I agree that the Units cannot be sold or transferred to or for Using the account of hardware device - Token □ I declare any US Person or in the USA or in or for the account of any person in any other jurisdiction that I have acquainted myself with and unconditionally accept the Instruction for Confirmation would be restricted or prohibited to acquire Units. Origin of payments with SMS codes in Raiffeisen ONLINE □ I declare that I have acquainted myself with and unconditionally accept the General Conditions for using the Raiffeisen E-Bank Statements service. □ I declare that I have acquainted myself with and unconditionally accept the General Conditions for using Xxxx International. □ I declare that I have received, acquainted myself with and unconditionally accept the General Business Conditions of Raiffeisenbank (Bulgaria) EAD. □ I declare that I have received, acquainted myself with and unconditionally accept the Fees and Commissions Tariff for legal entities of Raiffeisenbank (Bulgaria) EAD. □ I declare that I have received, acquainted myself with and unconditionally accept the current Interest Rates Bulletin for Legal entities of Raiffeisenbank (Bulgaria) EAD. □ I declare that by signing this Agreement, funds I confirm that the truth monies invested do not originate directly or indirectly from illegal or criminal activities and accuracy of all the information I have provided, more generally do not contravene to applicable anti-money laundering laws and I allow the Bank to check it at any time, and I undertake, if any relevant change occurs, to inform the Bank immediatelyregulations. □ I declare that Fax or other electronic transmission I agree that the Partnership and its agents (including Banque de Patrimoines Privés) is authorized to provide accept and execute any future instructions received by fax and/or electronic instruction without subsequent written confirmation and until written notice of the Bank with contrary, the necessary information applicant assuming all risks, e.g. those arising from an error in communication or comprehension as well as those arising from fraud and documents, release the Partnership from any liability in that respect. TAX Compliance I/We confirm that I/we did declare all revenues to the competent tax authorities and that the source of funds is not related to Law on tax evasion in any other jurisdiction. Eligible Investor I confirm to fulfill the Measures against Money Laundering (LMML) criteria to qualify as an “eligible” investor as per the definition in the Offering Memorandum and the Rules for the Application of the LMML, and the applicable Bulgarian legislation - upon request by the Bank, related to the implementation of a concrete operation. □ I declare that I am responsible for all actions undertaken on my behalf or by persons I have authorized after access to the Raiffeisen ONLINE service has been granted. □ I declare that I am responsible for all actions undertaken on my behalf or by persons I have authorized after access to the Xxxx International service has been granted. □ I declare that I shall undertake to archive the documents generated via the Raiffeisen E-Bank Statements service on my own information carrier for a period of 18 months after their generation. Date ………………………………………….. ............................................................................................................../name and signature of the person/s/ authorized by the company / IX. FOR USE BY BANK OFFICIALS official’s Initials in Midas date time signature Account opened by / item II / Account checked by / item II / Agreement-Application received by /items II , III, IV and V/ Agreement-Application checked and approved by /items III, IV and V / Agreement/Application scanned by User name and password for Raiffeisen e-Bank Statements have been provided by User name and password for Raiffeisen Online have been provided by User name and password for a hardware TOKEN device have been provided by IT Department /items III and V/: Approved by: Confirmed by: ИК 09.01.01 /Annex 7/ (the information is filled in by an employee of RBBG) account number (IBAN) B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5LPA.
Appears in 1 contract
Samples: Subscription Agreement
DECLARATIONS. □ Accuracy of information Subscription Agreement, Issuing Document and Articles of Association I certify that all the information provided in this document and in the declaration of beneficial owner is accurate and complete and undertake to immediately notify Banque de Patrimoines Privés if any of the information provided in this document changes (in particular if you have stated that you are an institutional investor and do not qualify as such anymore, change of name, contact, status, structure, ultimate economic beneficiaries…) and submit a new form within 30 days. I declare that I have receivedread, acquainted myself with agreed and unconditionally accept understood the General Terms and Conditions for the providing of payment services to legal entities of Raiffeisenbank (Bulgaria) EAD, an integral part contents of this Agreement-Applicationsubscription form and that I have had the opportunity prior to completing this form to request and read the Issuing Document and Articles of Association of the Company. □ I understand that the subscription for Shares is made subject to the terms of such documents and the terms and conditions of this form (including the application notes). Beneficial Owner Capacity U.S. Distribution Transfer Restrictions Origin of funds Fax or other electronic transmission TAX Compliance I hereby confirm that the investment is made on the applicant’s own behalf; I hereby confirm that the investment is made in my name but on behalf of my clients and that I have identified and verified the identity of underlying clients and their ultimate economic beneficiaries as well as the origin of the money invested. None of such clients and ultimate economic beneficiaries is named on list of prohibited country, territories, entities and individuals maintained by the OFAC, the EU or my financial supervisory authority. I am the ultimate economic beneficiary of the Shares invested; or I am not the ultimate economic beneficiary and I have provided the additional declaration to identify the ultimate economic beneficiaries I declare that I have acquainted myself full legal capacity to subscribe in, hold and/or deal with and unconditionally accept the General Conditions Shares. I acknowledge that the Company is not registered under the U.S. Securities Act of 1933 or other laws governing the U.S. Securities industry. I agree that the Shares cannot be sold or transferred to or for using Raiffeisen ONLINEthe account of any US Person or in the USA or in or for the account of any person in any other jurisdiction that would be restricted or prohibited to acquire Shares. □ I declare that I have acquainted myself with and unconditionally accept the Instruction for Using of hardware device - Token □ I declare that I have acquainted myself with and unconditionally accept the Instruction for Confirmation of payments with SMS codes in Raiffeisen ONLINE □ I declare that I have acquainted myself with and unconditionally accept the General Conditions for using the Raiffeisen E-Bank Statements service. □ I declare that I have acquainted myself with and unconditionally accept the General Conditions for using Xxxx International. □ I declare that I have received, acquainted myself with and unconditionally accept the General Business Conditions of Raiffeisenbank (Bulgaria) EAD. □ I declare that I have received, acquainted myself with and unconditionally accept the Fees and Commissions Tariff for legal entities of Raiffeisenbank (Bulgaria) EAD. □ I declare that I have received, acquainted myself with and unconditionally accept the current Interest Rates Bulletin for Legal entities of Raiffeisenbank (Bulgaria) EAD. □ I declare that by signing this Agreement, I confirm that the truth monies invested do not originate directly or indirectly from illegal or criminal activities and accuracy of all the information I have provided, more generally do not contravene to applicable anti-money laundering laws and I allow the Bank to check it at any time, and I undertake, if any relevant change occurs, to inform the Bank immediatelyregulations. □ I declare that I agree that the Company and its agents (including Banque de Patrimoines Privés) is authorized to provide the Bank with the necessary information accept and documents, related to Law on the Measures against Money Laundering (LMML) execute any future instructions received by fax and/or electronic instruction without subsequent written confirmation and the Rules for the Application until written notice of the LMMLcontrary, the applicant assuming all risks, e.g. those arising from an error in communication or comprehension as well as those arising from fraud and release the applicable Bulgarian legislation - upon request by the Bank, related to the implementation of a concrete operation. □ I declare Company from any liability in that I am responsible for all actions undertaken on my behalf or by persons I have authorized after access to the Raiffeisen ONLINE service has been granted. □ I declare that I am responsible for all actions undertaken on my behalf or by persons I have authorized after access to the Xxxx International service has been granted. □ I declare that I shall undertake to archive the documents generated via the Raiffeisen E-Bank Statements service on my own information carrier for a period of 18 months after their generation. Date ………………………………………….. ............................................................................................................../name and signature of the person/s/ authorized by the company / IX. FOR USE BY BANK OFFICIALS official’s Initials in Midas date time signature Account opened by / item II / Account checked by / item II / Agreement-Application received by /items II , III, IV and V/ Agreement-Application checked and approved by /items III, IV and V / Agreement/Application scanned by User name and password for Raiffeisen e-Bank Statements have been provided by User name and password for Raiffeisen Online have been provided by User name and password for a hardware TOKEN device have been provided by IT Department /items III and V/: Approved by: Confirmed by: ИК 09.01.01 /Annex 7/ (the information is filled in by an employee of RBBG) account number (IBAN) B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5respect.
Appears in 1 contract
Samples: Subscription Agreement
DECLARATIONS. □ Accuracy of information Subscription Agreement, Issuing Document and Articles of Association I certify that all the information provided in this document and in the declaration of beneficial owner is accurate and complete and undertake to immediately notify Banque de Patrimoines Privés if any of the information provided in this document changes (in particular if you have stated that you are an institutional investor and do not qualify as such anymore, change of name, contact, status, structure, ultimate economic beneficiaries…) and submit a new form within 30 days. I declare that I have receivedread, acquainted myself with agreed and unconditionally accept understood the General Terms and Conditions for the providing of payment services to legal entities of Raiffeisenbank (Bulgaria) EAD, an integral part contents of this Agreement-Applicationsubscription form and that I have had the opportunity prior to completing this form to request and read the Issuing Document and Articles of Association of the Company. □ I understand that the subscription for Shares is made subject to the terms of such documents and the terms and conditions of this form (including the application notes). Beneficial Owner I hereby confirm that the investment is made on the applicant’s own behalf; I hereby confirm that the investment is made in my name but on behalf of my clients and that I have identified and verified the identity of underlying clients and Capacity U.S. Distribution Transfer Restrictions Origin of funds Fax or other electronic transmission TAX Compliance their ultimate economic beneficiaries as well as the origin of the money invested. None of such clients and ultimate economic beneficiaries is named on list of prohibited country, territories, entities and individuals maintained by the OFAC, the EU or my financial supervisory authority. I am the ultimate economic beneficiary of the Shares invested; or I am not the ultimate economic beneficiary and I have provided the additional declaration to identify the ultimate economic beneficiaries I declare that I have acquainted myself full legal capacity to subscribe in, hold and/or deal with and unconditionally accept the General Conditions Shares. I acknowledge that the Company is not registered under the U.S. Securities Act of 1933 or other laws governing the U.S. Securities industry. I agree that the Shares cannot be sold or transferred to or for using Raiffeisen ONLINEthe account of any US Person or in the USA or in or for the account of any person in any other jurisdiction that would be restricted or prohibited to acquire Shares. □ I declare that I have acquainted myself with and unconditionally accept the Instruction for Using of hardware device - Token □ I declare that I have acquainted myself with and unconditionally accept the Instruction for Confirmation of payments with SMS codes in Raiffeisen ONLINE □ I declare that I have acquainted myself with and unconditionally accept the General Conditions for using the Raiffeisen E-Bank Statements service. □ I declare that I have acquainted myself with and unconditionally accept the General Conditions for using Xxxx International. □ I declare that I have received, acquainted myself with and unconditionally accept the General Business Conditions of Raiffeisenbank (Bulgaria) EAD. □ I declare that I have received, acquainted myself with and unconditionally accept the Fees and Commissions Tariff for legal entities of Raiffeisenbank (Bulgaria) EAD. □ I declare that I have received, acquainted myself with and unconditionally accept the current Interest Rates Bulletin for Legal entities of Raiffeisenbank (Bulgaria) EAD. □ I declare that by signing this Agreement, I confirm that the truth monies invested do not originate directly or indirectly from illegal or criminal activities and accuracy of all the information I have provided, more generally do not contravene to applicable anti- money laundering laws and I allow the Bank to check it at any time, and I undertake, if any relevant change occurs, to inform the Bank immediatelyregulations. □ I declare that I agree that the Company and its agents (including Banque de Patrimoines Privés) is authorized to provide the Bank with the necessary information accept and documents, related to Law on the Measures against Money Laundering (LMML) execute any future instructions received by fax and/or electronic instruction without subsequent written confirmation and the Rules for the Application until written notice of the LMMLcontrary, the applicant assuming all risks, e.g. those arising from an error in communication or comprehension as well as those arising from fraud and release the applicable Bulgarian legislation - upon request by the Bank, related to the implementation of a concrete operation. □ I declare Company from any liability in that I am responsible for all actions undertaken on my behalf or by persons I have authorized after access to the Raiffeisen ONLINE service has been granted. □ I declare that I am responsible for all actions undertaken on my behalf or by persons I have authorized after access to the Xxxx International service has been granted. □ I declare that I shall undertake to archive the documents generated via the Raiffeisen E-Bank Statements service on my own information carrier for a period of 18 months after their generation. Date ………………………………………….. ............................................................................................................../name and signature of the person/s/ authorized by the company / IX. FOR USE BY BANK OFFICIALS official’s Initials in Midas date time signature Account opened by / item II / Account checked by / item II / Agreement-Application received by /items II , III, IV and V/ Agreement-Application checked and approved by /items III, IV and V / Agreement/Application scanned by User name and password for Raiffeisen e-Bank Statements have been provided by User name and password for Raiffeisen Online have been provided by User name and password for a hardware TOKEN device have been provided by IT Department /items III and V/: Approved by: Confirmed by: ИК 09.01.01 /Annex 7/ (the information is filled in by an employee of RBBG) account number (IBAN) B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5respect.
Appears in 1 contract
Samples: Subscription Agreement
DECLARATIONS. □ Accuracy of information Subscription Agreement, Issuing Document and Articles of Association I certify that all the information provided in this document and in the declaration of beneficial owner is accurate and complete and undertake to immediately notify Banque de Patrimoines Privés if any of the information provided in this document changes (in particular if you have stated that you are an institutional investor and do not qualify as such anymore, change of name, contact, status, structure, ultimate economic beneficiaries…) and submit a new form within 30 days. I declare that I have receivedread, acquainted myself with agreed and unconditionally accept understood the General Terms and Conditions for the providing of payment services to legal entities of Raiffeisenbank (Bulgaria) EAD, an integral part contents of this Agreement-Applicationsubscription form and that I have had the opportunity prior to completing this form to request and read the Issuing Document and Articles of Association of the Company. □ I understand that the subscription for Shares is made subject to the terms of such documents and the terms and conditions of this form (including the Beneficial Owner Capacity U.S. Distribution Transfer Restrictions Origin of funds Fax or other electronic transmission TAX Compliance application notes). I hereby confirm that the investment is made on the applicant’s own behalf; I hereby confirm that the investment is made in my name but on behalf of my clients and that I have identified and verified the identity of underlying clients and their ultimate economic beneficiaries as well as the origin of the money invested. None of such clients and ultimate economic beneficiaries is named on list of prohibited country, territories, entities and individuals maintained by the OFAC, the EU or my financial supervisory authority. I am the ultimate economic beneficiary of the Shares invested; or I am not the ultimate economic beneficiary and I have provided the additional declaration to identify the ultimate economic beneficiaries I declare that I have acquainted myself full legal capacity to subscribe in, hold and/or deal with and unconditionally accept the General Conditions Shares. I acknowledge that the Company is not registered under the U.S. Securities Act of 1933 or other laws governing the U.S. Securities industry. I agree that the Shares cannot be sold or transferred to or for using Raiffeisen ONLINEthe account of any US Person or in the USA or in or for the account of any person in any other jurisdiction that would be restricted or prohibited to acquire Shares. □ I declare that I have acquainted myself with and unconditionally accept the Instruction for Using of hardware device - Token □ I declare that I have acquainted myself with and unconditionally accept the Instruction for Confirmation of payments with SMS codes in Raiffeisen ONLINE □ I declare that I have acquainted myself with and unconditionally accept the General Conditions for using the Raiffeisen E-Bank Statements service. □ I declare that I have acquainted myself with and unconditionally accept the General Conditions for using Xxxx International. □ I declare that I have received, acquainted myself with and unconditionally accept the General Business Conditions of Raiffeisenbank (Bulgaria) EAD. □ I declare that I have received, acquainted myself with and unconditionally accept the Fees and Commissions Tariff for legal entities of Raiffeisenbank (Bulgaria) EAD. □ I declare that I have received, acquainted myself with and unconditionally accept the current Interest Rates Bulletin for Legal entities of Raiffeisenbank (Bulgaria) EAD. □ I declare that by signing this Agreement, I confirm that the truth monies invested do not originate directly or indirectly from illegal or criminal activities and accuracy of all the information I have provided, more generally do not contravene to applicable anti-money laundering laws and I allow the Bank to check it at any time, and I undertake, if any relevant change occurs, to inform the Bank immediatelyregulations. □ I declare that I agree that the Company and its agents (including Banque de Patrimoines Privés) is authorized to provide the Bank with the necessary information accept and documents, related to Law on the Measures against Money Laundering (LMML) execute any future instructions received by fax and/or electronic instruction without subsequent written confirmation and the Rules for the Application until written notice of the LMMLcontrary, the applicant assuming all risks, e.g. those arising from an error in communication or comprehension as well as those arising from fraud and release the applicable Bulgarian legislation - upon request by the Bank, related to the implementation of a concrete operation. □ I declare Company from any liability in that I am responsible for all actions undertaken on my behalf or by persons I have authorized after access to the Raiffeisen ONLINE service has been granted. □ I declare that I am responsible for all actions undertaken on my behalf or by persons I have authorized after access to the Xxxx International service has been granted. □ I declare that I shall undertake to archive the documents generated via the Raiffeisen E-Bank Statements service on my own information carrier for a period of 18 months after their generation. Date ………………………………………….. ............................................................................................................../name and signature of the person/s/ authorized by the company / IX. FOR USE BY BANK OFFICIALS official’s Initials in Midas date time signature Account opened by / item II / Account checked by / item II / Agreement-Application received by /items II , III, IV and V/ Agreement-Application checked and approved by /items III, IV and V / Agreement/Application scanned by User name and password for Raiffeisen e-Bank Statements have been provided by User name and password for Raiffeisen Online have been provided by User name and password for a hardware TOKEN device have been provided by IT Department /items III and V/: Approved by: Confirmed by: ИК 09.01.01 /Annex 7/ (the information is filled in by an employee of RBBG) account number (IBAN) B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5respect.
Appears in 1 contract
Samples: Subscription Agreement
DECLARATIONS. □ Accuracy of information Subscription Agreement, Issuing Document and Articles of Association Beneficial Owner Capacity U.S. Distribution Transfer Restrictions I certify that all the information provided in this document and in the declaration of beneficial owner is accurate and complete and undertake to immediately notify Banque de Patrimoines Privés if any of the information provided in this document changes (in particular if you have stated that you are an institutional investor and do not qualify as such anymore, change of name, contact, status, structure, ultimate economic beneficiaries…) and submit a new form within 30 days. I declare that I have receivedread, acquainted myself with agreed and unconditionally accept understood the General Terms and Conditions for the providing of payment services to legal entities of Raiffeisenbank (Bulgaria) EAD, an integral part contents of this Agreement-Applicationsubscription form and that I have had the opportunity prior to completing this form to request and read the Issuing Document and Articles of Association of the Company. □ I understand that the subscription for Shares is made subject to the terms of such documents and the terms and conditions of this form (including the application notes). I hereby confirm that the investment is made on the applicant’s own behalf; I hereby confirm that the investment is made in my name but on behalf of my clients and that I have identified and verified the identity of underlying clients and their ultimate economic beneficiaries as well as the origin of the money invested. None of such clients and ultimate economic beneficiaries is named on list of prohibited country, territories, entities and individuals maintained by the OFAC, the EU or my financial supervisory authority. I am the ultimate economic beneficiary of the Shares invested; or I am not the ultimate economic beneficiary and I have provided the additional declaration to identify the ultimate economic beneficiaries I declare that I have acquainted myself full legal capacity to subscribe in, hold and/or deal with and unconditionally accept the General Conditions Shares. I acknowledge that the Company is not registered under the U.S. Securities Act of 1933 or other laws governing the U.S. Securities industry. I agree that the Shares cannot be sold or transferred to or for using Raiffeisen ONLINEthe account of any US Person or in the USA or in or for the account of any person in any other jurisdiction that would be restricted or prohibited to acquire Shares. □ I declare that I have acquainted myself with and unconditionally accept the Instruction for Using Origin of hardware device - Token □ I declare that I have acquainted myself with and unconditionally accept the Instruction for Confirmation of payments with SMS codes in Raiffeisen ONLINE □ I declare that I have acquainted myself with and unconditionally accept the General Conditions for using the Raiffeisen E-Bank Statements service. □ I declare that I have acquainted myself with and unconditionally accept the General Conditions for using Xxxx International. □ I declare that I have received, acquainted myself with and unconditionally accept the General Business Conditions of Raiffeisenbank (Bulgaria) EAD. □ I declare that I have received, acquainted myself with and unconditionally accept the Fees and Commissions Tariff for legal entities of Raiffeisenbank (Bulgaria) EAD. □ I declare that I have received, acquainted myself with and unconditionally accept the current Interest Rates Bulletin for Legal entities of Raiffeisenbank (Bulgaria) EAD. □ I declare that by signing this Agreement, funds Fax or other electronic transmission TAX Compliance KID I confirm that the truth monies invested do not originate directly or indirectly from illegal or criminal activities and accuracy of all the information I have provided, more generally do not contravene to applicable anti-‐money laundering laws and I allow the Bank to check it at any time, and I undertake, if any relevant change occurs, to inform the Bank immediatelyregulations. □ I declare that I agree that the Company and its agents (including Banque de Patrimoines Privés) is authorized to provide the Bank with the necessary information accept and documents, related to Law on the Measures against Money Laundering (LMML) execute any future instructions received by fax and/or electronic instruction without subsequent written confirmation and the Rules for the Application until written notice of the LMMLcontrary, the applicant assuming all risks, e.g. those arising from an error in communication or comprehension as well as those arising from fraud and release the applicable Bulgarian legislation - upon request by the Bank, related to the implementation of a concrete operation. □ I declare Company from any liability in that I am responsible for all actions undertaken on my behalf or by persons I have authorized after access to the Raiffeisen ONLINE service has been granted. □ I declare that I am responsible for all actions undertaken on my behalf or by persons I have authorized after access to the Xxxx International service has been granted. □ I declare that I shall undertake to archive the documents generated via the Raiffeisen E-Bank Statements service on my own information carrier for a period of 18 months after their generation. Date ………………………………………….. ............................................................................................................../name and signature of the person/s/ authorized by the company / IX. FOR USE BY BANK OFFICIALS official’s Initials in Midas date time signature Account opened by / item II / Account checked by / item II / Agreement-Application received by /items II , III, IV and V/ Agreement-Application checked and approved by /items III, IV and V / Agreement/Application scanned by User name and password for Raiffeisen e-Bank Statements have been provided by User name and password for Raiffeisen Online have been provided by User name and password for a hardware TOKEN device have been provided by IT Department /items III and V/: Approved by: Confirmed by: ИК 09.01.01 /Annex 7/ (the information is filled in by an employee of RBBG) account number (IBAN) B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5respect.
Appears in 1 contract
Samples: Subscription Agreement
DECLARATIONS. □ Accuracy of information Subscription Agreement, Issuing Document and Articles of Association Beneficial Owner Capacity U.S. Distribution Transfer Restrictions I certify that all the information provided in this document and in the declaration of beneficial owner is accurate and complete and undertake to immediately notify Banque de Patrimoines Privés if any of the information provided in this document changes (in particular if you have stated that you are an institutional investor and do not qualify as such anymore, change of name, contact, status, structure, ultimate economic beneficiaries…) and submit a new form within 30 days. I declare that I have receivedread, acquainted myself with agreed and unconditionally accept understood the General Terms and Conditions for the providing of payment services to legal entities of Raiffeisenbank (Bulgaria) EAD, an integral part contents of this Agreement-Applicationsubscription form and that I have had the opportunity prior to completing this form to request and read the Issuing Document and Articles of Association of the Company. □ I understand that the subscription for Shares is made subject to the terms of such documents and the terms and conditions of this form (including the application notes). I hereby confirm that the investment is made on the applicant’s own behalf; I hereby confirm that the investment is made in my name but on behalf of my clients and that I have identified and verified the identity of underlying clients and their ultimate economic beneficiaries as well as the origin of the money invested. None of such clients and ultimate economic beneficiaries is named on list of prohibited country, territories, entities and individuals maintained by the OFAC, the EU or my financial supervisory authority. I am the ultimate economic beneficiary of the Shares invested; or I am not the ultimate economic beneficiary and I have provided the additional declaration to identify the ultimate economic beneficiaries I declare that I have acquainted myself full legal capacity to subscribe in, hold and/or deal with and unconditionally accept the General Conditions Shares. I acknowledge that the Company is not registered under the U.S. Securities Act of 1933 or other laws governing the U.S. Securities industry. I agree that the Shares cannot be sold or transferred to or for using Raiffeisen ONLINEthe account of any US Person or in the USA or in or for the account of any person in any other jurisdiction that would be restricted or prohibited to acquire Shares. □ I declare that I have acquainted myself with and unconditionally accept the Instruction for Using Origin of hardware device - Token □ I declare that I have acquainted myself with and unconditionally accept the Instruction for Confirmation of payments with SMS codes in Raiffeisen ONLINE □ I declare that I have acquainted myself with and unconditionally accept the General Conditions for using the Raiffeisen E-Bank Statements service. □ I declare that I have acquainted myself with and unconditionally accept the General Conditions for using Xxxx International. □ I declare that I have received, acquainted myself with and unconditionally accept the General Business Conditions of Raiffeisenbank (Bulgaria) EAD. □ I declare that I have received, acquainted myself with and unconditionally accept the Fees and Commissions Tariff for legal entities of Raiffeisenbank (Bulgaria) EAD. □ I declare that I have received, acquainted myself with and unconditionally accept the current Interest Rates Bulletin for Legal entities of Raiffeisenbank (Bulgaria) EAD. □ I declare that by signing this Agreement, funds Fax or other electronic transmission TAX Compliance KID I confirm that the truth monies invested do not originate directly or indirectly from illegal or criminal activities and accuracy of all the information I have provided, more generally do not contravene to applicable anti-money laundering laws and I allow the Bank to check it at any time, and I undertake, if any relevant change occurs, to inform the Bank immediatelyregulations. □ I declare that I agree that the Company and its agents (including Banque de Patrimoines Privés) is authorized to provide the Bank with the necessary information accept and documents, related to Law on the Measures against Money Laundering (LMML) execute any future instructions received by fax and/or electronic instruction without subsequent written confirmation and the Rules for the Application until written notice of the LMMLcontrary, the applicant assuming all risks, e.g. those arising from an error in communication or comprehension as well as those arising from fraud and release the applicable Bulgarian legislation - upon request by the Bank, related to the implementation of a concrete operation. □ I declare Company from any liability in that I am responsible for all actions undertaken on my behalf or by persons I have authorized after access to the Raiffeisen ONLINE service has been granted. □ I declare that I am responsible for all actions undertaken on my behalf or by persons I have authorized after access to the Xxxx International service has been granted. □ I declare that I shall undertake to archive the documents generated via the Raiffeisen E-Bank Statements service on my own information carrier for a period of 18 months after their generation. Date ………………………………………….. ............................................................................................................../name and signature of the person/s/ authorized by the company / IX. FOR USE BY BANK OFFICIALS official’s Initials in Midas date time signature Account opened by / item II / Account checked by / item II / Agreement-Application received by /items II , III, IV and V/ Agreement-Application checked and approved by /items III, IV and V / Agreement/Application scanned by User name and password for Raiffeisen e-Bank Statements have been provided by User name and password for Raiffeisen Online have been provided by User name and password for a hardware TOKEN device have been provided by IT Department /items III and V/: Approved by: Confirmed by: ИК 09.01.01 /Annex 7/ (the information is filled in by an employee of RBBG) account number (IBAN) B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5respect.
Appears in 1 contract
Samples: Subscription Agreement
DECLARATIONS. □ Accuracy of information Subscription Agreement, Issuing Document and Limited Partnership Agreement Beneficial Owner Capacity Non U.S. Person I certify that all the information provided in this document and in the declaration of beneficial owner is accurate and complete and undertake to immediately notify Banque de Patrimoines Privés if any of the information provided in this document changes (in particular if you have stated that you are an institutional investor and do not qualify as such anymore, change of name, contact, status, structure, ultimate economic beneficiaries…) and submit a new agreement within 30 days. I declare that I have receivedread, acquainted myself with agreed and unconditionally accept understood the General Terms and Conditions for the providing of payment services to legal entities of Raiffeisenbank (Bulgaria) EAD, an integral part contents of this Agreement-Applicationsubscription agreement and that I have had the opportunity prior to completing this form to request and read the Issuing Document and Limited Partnership Agreement of the Partnership. □ I understand that the subscription for Units is made subject to the terms of such documents and the terms and conditions of this agreement (including the application notes). I hereby confirm that the investment is made on the applicant’s own behalf; I hereby confirm that the investment is made in my name but on behalf of my clients and that I have identified and verified the identity of underlying clients and their ultimate economic beneficiaries as well as the origin of the money invested. None of such clients and ultimate economic beneficiaries is named on list of prohibited country, territories, entities and individuals maintained by the OFAC, the EU or my financial supervisory authority. I am the ultimate economic beneficiary of the Units invested; or I am not the ultimate economic beneficiary and I have provided the additional declaration to identify the ultimate economic beneficiaries I declare that I have acquainted myself full legal capacity to subscribe in, hold and/or deal with and unconditionally accept the General Conditions for using Raiffeisen ONLINEUnits. □ I hereby declare that Units are not acquired directly or indirectly or on behalf of a US Person as defined in the Issuing Document nor a corporation controlled by, or a majority of whose units are held by, US Persons or by or on behalf of any person in any other jurisdiction that would be restricted or prohibited to acquire Units. I have acquainted myself with and unconditionally accept acknowledge that the Instruction Partnership is not registered under the U.S. Securities Act of 1933 or other laws governing the U.S. Securities industry. Transfer Restrictions Origin of funds Fax or other electronic transmission TAX Compliance KID Eligible Investor I agree that the Units cannot be sold or transferred to or for Using the account of hardware device - Token □ I declare any US Person or in the USA or in or for the account of any person in any other jurisdiction that I have acquainted myself with and unconditionally accept the Instruction for Confirmation of payments with SMS codes in Raiffeisen ONLINE □ I declare that I have acquainted myself with and unconditionally accept the General Conditions for using the Raiffeisen E-Bank Statements servicewould be restricted or prohibited to acquire Units. □ I declare that I have acquainted myself with and unconditionally accept the General Conditions for using Xxxx International. □ I declare that I have received, acquainted myself with and unconditionally accept the General Business Conditions of Raiffeisenbank (Bulgaria) EAD. □ I declare that I have received, acquainted myself with and unconditionally accept the Fees and Commissions Tariff for legal entities of Raiffeisenbank (Bulgaria) EAD. □ I declare that I have received, acquainted myself with and unconditionally accept the current Interest Rates Bulletin for Legal entities of Raiffeisenbank (Bulgaria) EAD. □ I declare that by signing this Agreement, I confirm that the truth monies invested do not originate directly or indirectly from illegal or criminal activities and accuracy of all the information I have provided, more generally do not contravene to applicable anti-money laundering laws and I allow the Bank to check it at any time, and I undertake, if any relevant change occurs, to inform the Bank immediatelyregulations. □ I declare that I agree that the Partnership and its agents (including Banque de Patrimoines Privés) is authorized to provide the Bank with the necessary information accept and documents, related to Law on the Measures against Money Laundering (LMML) execute any future instructions received by fax and/or electronic instruction without subsequent written confirmation and the Rules for the Application until written notice of the LMMLcontrary, the applicant assuming all risks, e.g. those arising from an error in communication or comprehension as well as those arising from fraud and release the applicable Bulgarian legislation - upon request by the Bank, related to the implementation of a concrete operation. □ I declare Partnership from any liability in that I am responsible for all actions undertaken on my behalf or by persons I have authorized after access to the Raiffeisen ONLINE service has been granted. □ I declare that I am responsible for all actions undertaken on my behalf or by persons I have authorized after access to the Xxxx International service has been granted. □ I declare that I shall undertake to archive the documents generated via the Raiffeisen E-Bank Statements service on my own information carrier for a period of 18 months after their generation. Date ………………………………………….. ............................................................................................................../name and signature of the person/s/ authorized by the company / IX. FOR USE BY BANK OFFICIALS official’s Initials in Midas date time signature Account opened by / item II / Account checked by / item II / Agreement-Application received by /items II , III, IV and V/ Agreement-Application checked and approved by /items III, IV and V / Agreement/Application scanned by User name and password for Raiffeisen e-Bank Statements have been provided by User name and password for Raiffeisen Online have been provided by User name and password for a hardware TOKEN device have been provided by IT Department /items III and V/: Approved by: Confirmed by: ИК 09.01.01 /Annex 7/ (the information is filled in by an employee of RBBG) account number (IBAN) B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5respect.
Appears in 1 contract
Samples: blockassetmanagement.com
DECLARATIONS. □ Accuracy of information Subscription Agreement, Issuing Document and Articles of Association I certify that all the information provided in this document and in the declaration of beneficial owner is accurate and complete and undertake to immediately notify Banque de Patrimoines Privés if any of the information provided in this document changes (in particular if you have stated that you are an institutional investor and do not qualify as such anymore, change of name, contact, status, structure, ultimate economic beneficiaries…) and submit a new form within 30 days. I declare that I have receivedread, acquainted myself with agreed and unconditionally accept understood the General Terms and Conditions for the providing of payment services to legal entities of Raiffeisenbank (Bulgaria) EAD, an integral part contents of this Agreement-Applicationsubscription form and that I have had the opportunity prior to completing this form to request and read the Issuing Document and Articles of Association of the Company. □ I understand that the subscription for Shares is made subject to the terms of such documents and the terms and conditions of this form (including the application notes). Beneficial Owner Capacity U.S. Distribution Transfer Restrictions Origin of funds Fax or other electronic transmission TAX Compliance KID I hereby confirm that the investment is made on the applicant’s own behalf; I hereby confirm that the investment is made in my name but on behalf of my clients and that I have identified and verified the identity of underlying clients and their ultimate economic beneficiaries as well as the origin of the money invested. None of such clients and ultimate economic beneficiaries is named on list of prohibited country, territories, entities and individuals maintained by the OFAC, the EU or my financial supervisory authority. I am the ultimate economic beneficiary of the Shares invested; or I am not the ultimate economic beneficiary and I have provided the additional declaration to identify the ultimate economic beneficiaries I declare that I have acquainted myself full legal capacity to subscribe in, hold and/or deal with and unconditionally accept the General Conditions Shares. I acknowledge that the Company is not registered under the U.S. Securities Act of 1933 or other laws governing the U.S. Securities industry. I agree that the Shares cannot be sold or transferred to or for using Raiffeisen ONLINEthe account of any US Person or in the USA or in or for the account of any person in any other jurisdiction that would be restricted or prohibited to acquire Shares. □ I declare that I have acquainted myself with and unconditionally accept the Instruction for Using of hardware device - Token □ I declare that I have acquainted myself with and unconditionally accept the Instruction for Confirmation of payments with SMS codes in Raiffeisen ONLINE □ I declare that I have acquainted myself with and unconditionally accept the General Conditions for using the Raiffeisen E-Bank Statements service. □ I declare that I have acquainted myself with and unconditionally accept the General Conditions for using Xxxx International. □ I declare that I have received, acquainted myself with and unconditionally accept the General Business Conditions of Raiffeisenbank (Bulgaria) EAD. □ I declare that I have received, acquainted myself with and unconditionally accept the Fees and Commissions Tariff for legal entities of Raiffeisenbank (Bulgaria) EAD. □ I declare that I have received, acquainted myself with and unconditionally accept the current Interest Rates Bulletin for Legal entities of Raiffeisenbank (Bulgaria) EAD. □ I declare that by signing this Agreement, I confirm that the truth monies invested do not originate directly or indirectly from illegal or criminal activities and accuracy of all the information I have provided, more generally do not contravene to applicable anti- money laundering laws and I allow the Bank to check it at any time, and I undertake, if any relevant change occurs, to inform the Bank immediatelyregulations. □ I declare that I agree that the Company and its agents (including Banque de Patrimoines Privés) is authorized to provide the Bank with the necessary information accept and documents, related to Law on the Measures against Money Laundering (LMML) execute any future instructions received by fax and/or electronic instruction without subsequent written confirmation and the Rules for the Application until written notice of the LMMLcontrary, the applicant assuming all risks, e.g. those arising from an error in communication or comprehension as well as those arising from fraud and release the applicable Bulgarian legislation - upon request by the Bank, related to the implementation of a concrete operation. □ I declare Company from any liability in that I am responsible for all actions undertaken on my behalf or by persons I have authorized after access to the Raiffeisen ONLINE service has been granted. □ I declare that I am responsible for all actions undertaken on my behalf or by persons I have authorized after access to the Xxxx International service has been granted. □ I declare that I shall undertake to archive the documents generated via the Raiffeisen E-Bank Statements service on my own information carrier for a period of 18 months after their generation. Date ………………………………………….. ............................................................................................................../name and signature of the person/s/ authorized by the company / IX. FOR USE BY BANK OFFICIALS official’s Initials in Midas date time signature Account opened by / item II / Account checked by / item II / Agreement-Application received by /items II , III, IV and V/ Agreement-Application checked and approved by /items III, IV and V / Agreement/Application scanned by User name and password for Raiffeisen e-Bank Statements have been provided by User name and password for Raiffeisen Online have been provided by User name and password for a hardware TOKEN device have been provided by IT Department /items III and V/: Approved by: Confirmed by: ИК 09.01.01 /Annex 7/ (the information is filled in by an employee of RBBG) account number (IBAN) B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5respect.
Appears in 1 contract
Samples: Subscription Agreement
DECLARATIONS. □ Accuracy of information Subscription Agreement, Issuing Document and Limited Partnership Agreement Beneficial Owner Capacity Non U.S. Person Transfer Restrictions Origin of funds Fax or other electronic transmission I certify that all the information provided in this document and in the declaration of beneficial owner is accurate and complete and undertake to immediately notify Banque de Patrimoines Privés if any of the information provided in this document changes (in particular if you have stated that you are an institutional investor and do not qualify as such anymore, change of name, contact, status, structure, ultimate economic beneficiaries…) and submit a new agreement within 30 days. I declare that I have receivedread, acquainted myself with agreed and unconditionally accept understood the General Terms and Conditions for the providing of payment services to legal entities of Raiffeisenbank (Bulgaria) EAD, an integral part contents of this Agreement-Applicationsubscription agreement and that I have had the opportunity prior to completing this form to request and read the Issuing Document and Limited Partnership Agreement of the Partnership. □ I understand that the subscription for Units is made subject to the terms of such documents and the terms and conditions of this agreement (including the application notes). I hereby confirm that the investment is made on the applicant’s own behalf; I hereby confirm that the investment is made in my name but on behalf of my clients and that I have identified and verified the identity of underlying clients and their ultimate economic beneficiaries as well as the origin of the money invested. None of such clients and ultimate economic beneficiaries is named on list of prohibited country, territories, entities and individuals maintained by the OFAC, the EU or my financial supervisory authority. I am the ultimate economic beneficiary of the Units invested; or I am not the ultimate economic beneficiary and I have provided the additional declaration to identify the ultimate economic beneficiaries I declare that I have acquainted myself full legal capacity to subscribe in, hold and/or deal with and unconditionally accept the General Conditions for using Raiffeisen ONLINEUnits. □ I hereby declare that Units are not acquired directly or indirectly or on behalf of a US Person as defined in the Issuing Document nor a corporation controlled by, or a majority of whose Units are held by, US Persons or by or on behalf of any person in any other jurisdiction that would be restricted or prohibited to acquire Units. I have acquainted myself with and unconditionally accept acknowledge that the Instruction Partnership is not registered under the U.S. Securities Act of 1933 or other laws governing the U.S. Securities industry. I agree that the Units cannot be sold or transferred to or for Using the account of hardware device - Token □ I declare any US Person or in the USA or in or for the account of any person in any other jurisdiction that I have acquainted myself with and unconditionally accept the Instruction for Confirmation of payments with SMS codes in Raiffeisen ONLINE □ I declare that I have acquainted myself with and unconditionally accept the General Conditions for using the Raiffeisen E-Bank Statements servicewould be restricted or prohibited to acquire Units. □ I declare that I have acquainted myself with and unconditionally accept the General Conditions for using Xxxx International. □ I declare that I have received, acquainted myself with and unconditionally accept the General Business Conditions of Raiffeisenbank (Bulgaria) EAD. □ I declare that I have received, acquainted myself with and unconditionally accept the Fees and Commissions Tariff for legal entities of Raiffeisenbank (Bulgaria) EAD. □ I declare that I have received, acquainted myself with and unconditionally accept the current Interest Rates Bulletin for Legal entities of Raiffeisenbank (Bulgaria) EAD. □ I declare that by signing this Agreement, I confirm that the truth monies invested do not originate directly or indirectly from illegal or criminal activities and accuracy of all the information I have provided, more generally do not contravene to applicable anti-money laundering laws and I allow the Bank to check it at any time, and I undertake, if any relevant change occurs, to inform the Bank immediatelyregulations. □ I declare that I agree that the Partnership and its agents (including Banque de Patrimoines Privés) is authorized to provide accept and execute any future instructions received by fax and/or electronic instruction without subsequent written confirmation and until written notice of the Bank with contrary, the necessary information applicant assuming all risks, e.g. those arising from an error in communication or comprehension as well as those arising from fraud and documents, release the Partnership from any liability in that respect. TAX Compliance Eligible Investor I/We confirm that I/we did declare all revenues to the competent tax authorities and that the source of funds is not related to Law on tax evasion in any other jurisdiction. I confirm to fulfill the Measures against Money Laundering (LMML) criteria to qualify as an “eligible” investor as per the definition in the Issuing Document and the Rules for the Application of the LMML, and the applicable Bulgarian legislation - upon request by the Bank, related to the implementation of a concrete operation. □ I declare that I am responsible for all actions undertaken on my behalf or by persons I have authorized after access to the Raiffeisen ONLINE service has been granted. □ I declare that I am responsible for all actions undertaken on my behalf or by persons I have authorized after access to the Xxxx International service has been granted. □ I declare that I shall undertake to archive the documents generated via the Raiffeisen E-Bank Statements service on my own information carrier for a period of 18 months after their generation. Date ………………………………………….. ............................................................................................................../name and signature of the person/s/ authorized by the company / IX. FOR USE BY BANK OFFICIALS official’s Initials in Midas date time signature Account opened by / item II / Account checked by / item II / Limited Partnership Agreement-Application received by /items II , III, IV and V/ Agreement-Application checked and approved by /items III, IV and V / Agreement/Application scanned by User name and password for Raiffeisen e-Bank Statements have been provided by User name and password for Raiffeisen Online have been provided by User name and password for a hardware TOKEN device have been provided by IT Department /items III and V/: Approved by: Confirmed by: ИК 09.01.01 /Annex 7/ (the information is filled in by an employee of RBBG) account number (IBAN) B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5.
Appears in 1 contract
Samples: blockassetmanagement.com
DECLARATIONS. □ Accuracy of information I certify that all the information provided in this document and in the declaration of beneficial owner is accurate and complete and undertake to immediately notify Banque de Patrimoines Privés if any of the information provided in this document changes (in particular if you have stated that you are an institutional investor and do not qualify as such anymore, change of name, contact, status, structure, ultimate economic beneficiaries…) and submit a new agreement within 30 days. Subscription Agreement, Offering Memorandum and Limited Partnership Agreement I declare that I have receivedread, acquainted myself with agreed and unconditionally accept understood the General Terms and Conditions for the providing of payment services to legal entities of Raiffeisenbank (Bulgaria) EAD, an integral part contents of this Agreement-ApplicationSubscription Agreement and that I have had the opportunity prior to completing this agreement to request and read the Offering Memorandum and Limited Partnership Agreement of the Partnership. □ I understand that the subscription for Units is made subject to the terms of such documents and the terms and conditions of this agreement (including the application notes). Beneficial Owner I hereby confirm that the investment is made on the applicant’s own behalf; I hereby confirm that the investment is made in my name but on behalf of my clients and that I have identified and verified the identity of underlying clients and their ultimate economic beneficiaries as well as the origin of the money invested. None of such clients and ultimate economic beneficiaries is named on list of prohibited country, territories, entities and individuals maintained by the OFAC, the EU or my financial supervisory authority. I am the ultimate economic beneficiary of the Units invested; or I am not the ultimate economic beneficiary and I have provided the additional declaration to identify the ultimate economic beneficiaries Capacity I declare that I have acquainted myself full legal capacity to subscribe in, hold and/or deal with and unconditionally accept the General Conditions for using Raiffeisen ONLINEUnits. □ Non U.S. Person I hereby declare that Units are not acquired directly or indirectly or on behalf of a US Person as defined in the Offering Memorandum nor a corporation controlled by, or a majority of whose shares are held by, US Persons or by or on behalf of any person in any other jurisdiction that would be restricted or prohibited to acquire Units. I have acquainted myself with and unconditionally accept acknowledge that the Instruction Partnership is not registered under the U.S. Securities Act of 1933 or other laws governing the U.S. Securities industry. Transfer Restrictions I agree that the Units cannot be sold or transferred to or for Using the account of hardware device - Token □ I declare any US Person or in the USA or in or for the account of any person in any other jurisdiction that I have acquainted myself with and unconditionally accept the Instruction for Confirmation would be restricted or prohibited to acquire Units. Origin of payments with SMS codes in Raiffeisen ONLINE □ I declare that I have acquainted myself with and unconditionally accept the General Conditions for using the Raiffeisen E-Bank Statements service. □ I declare that I have acquainted myself with and unconditionally accept the General Conditions for using Xxxx International. □ I declare that I have received, acquainted myself with and unconditionally accept the General Business Conditions of Raiffeisenbank (Bulgaria) EAD. □ I declare that I have received, acquainted myself with and unconditionally accept the Fees and Commissions Tariff for legal entities of Raiffeisenbank (Bulgaria) EAD. □ I declare that I have received, acquainted myself with and unconditionally accept the current Interest Rates Bulletin for Legal entities of Raiffeisenbank (Bulgaria) EAD. □ I declare that by signing this Agreement, funds I confirm that the truth monies invested do not originate directly or indirectly from illegal or criminal activities and accuracy of all the information I have provided, more generally do not contravene to applicable anti-money laundering laws and I allow the Bank to check it at any time, and I undertake, if any relevant change occurs, to inform the Bank immediatelyregulations. □ I declare that Fax or other electronic transmission I agree that the Partnership and its agents (including Banque de Patrimoines Privés) is authorized to provide accept and execute any future instructions received by fax and/or electronic instruction without subsequent written confirmation and until written notice of the Bank with contrary, the necessary information applicant assuming all risks, e.g. those arising from an error in communication or comprehension as well as those arising from fraud and documents, release the Partnership from any liability in that respect. TAX Compliance I/We confirm that I/we did declare all revenues to the competent tax authorities and that the source of funds is not related to Law on tax evasion in any other jurisdiction. Eligible Investor I confirm to fulfill the Measures against Money Laundering (LMML) criteria to qualify as an “eligible” investor as per the definition in the Offering Memorandum and the Rules for LPA. KID I do declare to adhere to the Application status of professional investor according to the European Regulation N°1286/2014 of the LMML, and the applicable Bulgarian legislation - upon request by the Bank, related to the implementation of a concrete operation. □ I declare that I am responsible for all actions undertaken on my behalf or by persons I have authorized after access to the Raiffeisen ONLINE service has been granted. □ I declare that I am responsible for all actions undertaken on my behalf or by persons I have authorized after access to the Xxxx International service has been granted. □ I declare that I shall undertake to archive the documents generated via the Raiffeisen E-Bank Statements service on my own information carrier for a period of 18 months after their generation. Date ………………………………………….. ............................................................................................................../name and signature European Parliament of the person/s/ authorized by Council of 26 November 2014 on key information documents (KID) for packaged retail and insurance-based investment products (PRIIPs), published on 9 December 2014 in the company / IX. FOR USE BY BANK OFFICIALS official’s Initials in Midas date time signature Account opened by / item II / Account checked by / item II / Agreement-Application received by /items II , III, IV and V/ Agreement-Application checked and approved by /items III, IV and V / Agreement/Application scanned by User name and password for Raiffeisen e-Bank Statements have been provided by User name and password for Raiffeisen Online have been provided by User name and password for a hardware TOKEN device have been provided by IT Department /items III and V/: Approved by: Confirmed by: ИК 09.01.01 /Annex 7/ (Official Journal of the information is filled in by an employee of RBBG) account number (IBAN) B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5European Union.
Appears in 1 contract
Samples: Subscription Agreement
DECLARATIONS. □ Accuracy of information Subscription Agreement, Issuing Document and Articles of Association Beneficial Owner I certify that all the information provided in this document and in the declaration of beneficial owner is accurate and complete and undertake to immediately notify Banque de Patrimoines Privés if any of the information provided in this document changes (in particular if you have stated that you are an institutional investor and do not qualify as such anymore, change of name, contact, status, structure, ultimate economic beneficiaries…) and submit a new form within 30 days. I declare that I have receivedread, acquainted myself with agreed and unconditionally accept understood the General Terms and Conditions for the providing of payment services to legal entities of Raiffeisenbank (Bulgaria) EAD, an integral part contents of this Agreement-Applicationsubscription form and that I have had the opportunity prior to completing this form to request and read the Issuing Document and Articles of Association of the Company. □ I understand that the subscription for Shares is made subject to the terms of such documents and the terms and conditions of this form (including the application notes). I hereby confirm that the investment is made on the applicant’s own behalf; I hereby confirm that the investment is made in my name but on behalf of my clients and that I have identified and verified the identity of underlying clients and their ultimate economic beneficiaries as well as the origin of the money invested. Capacity U.S. Distribution Transfer Restrictions Origin of funds Fax or other electronic transmission TAX Compliance None of such clients and ultimate economic beneficiaries is named on list of prohibited country, territories, entities and individuals maintained by the OFAC, the EU or my financial supervisory authority. I am the ultimate economic beneficiary of the Shares invested; or I am not the ultimate economic beneficiary and I have provided the additional declaration to identify the ultimate economic beneficiaries I declare that I have acquainted myself full legal capacity to subscribe in, hold and/or deal with and unconditionally accept the General Conditions Shares. I acknowledge that the Company is not registered under the U.S. Securities Act of 1933 or other laws governing the U.S. Securities industry. I agree that the Shares cannot be sold or transferred to or for using Raiffeisen ONLINEthe account of any US Person or in the USA or in or for the account of any person in any other jurisdiction that would be restricted or prohibited to acquire Shares. □ I declare that I have acquainted myself with and unconditionally accept the Instruction for Using of hardware device - Token □ I declare that I have acquainted myself with and unconditionally accept the Instruction for Confirmation of payments with SMS codes in Raiffeisen ONLINE □ I declare that I have acquainted myself with and unconditionally accept the General Conditions for using the Raiffeisen E-Bank Statements service. □ I declare that I have acquainted myself with and unconditionally accept the General Conditions for using Xxxx International. □ I declare that I have received, acquainted myself with and unconditionally accept the General Business Conditions of Raiffeisenbank (Bulgaria) EAD. □ I declare that I have received, acquainted myself with and unconditionally accept the Fees and Commissions Tariff for legal entities of Raiffeisenbank (Bulgaria) EAD. □ I declare that I have received, acquainted myself with and unconditionally accept the current Interest Rates Bulletin for Legal entities of Raiffeisenbank (Bulgaria) EAD. □ I declare that by signing this Agreement, I confirm that the truth monies invested do not originate directly or indirectly from illegal or criminal activities and accuracy of all the information I have provided, more generally do not contravene to applicable anti-‐money laundering laws and I allow the Bank to check it at any time, and I undertake, if any relevant change occurs, to inform the Bank immediatelyregulations. □ I declare that I agree that the Company and its agents (including Banque de Patrimoines Privés) is authorized to provide the Bank with the necessary information accept and documents, related to Law on the Measures against Money Laundering (LMML) execute any future instructions received by fax and/or electronic instruction without subsequent written confirmation and the Rules for the Application until written notice of the LMMLcontrary, the applicant assuming all risks, e.g. those arising from an error in communication or comprehension as well as those arising from fraud and release the applicable Bulgarian legislation - upon request by the Bank, related to the implementation of a concrete operation. □ I declare Company from any liability in that I am responsible for all actions undertaken on my behalf or by persons I have authorized after access to the Raiffeisen ONLINE service has been granted. □ I declare that I am responsible for all actions undertaken on my behalf or by persons I have authorized after access to the Xxxx International service has been granted. □ I declare that I shall undertake to archive the documents generated via the Raiffeisen E-Bank Statements service on my own information carrier for a period of 18 months after their generation. Date ………………………………………….. ............................................................................................................../name and signature of the person/s/ authorized by the company / IX. FOR USE BY BANK OFFICIALS official’s Initials in Midas date time signature Account opened by / item II / Account checked by / item II / Agreement-Application received by /items II , III, IV and V/ Agreement-Application checked and approved by /items III, IV and V / Agreement/Application scanned by User name and password for Raiffeisen e-Bank Statements have been provided by User name and password for Raiffeisen Online have been provided by User name and password for a hardware TOKEN device have been provided by IT Department /items III and V/: Approved by: Confirmed by: ИК 09.01.01 /Annex 7/ (the information is filled in by an employee of RBBG) account number (IBAN) B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5 B G R Z B B 9 1 5 5respect.
Appears in 1 contract
Samples: Subscription Agreement