Contact Information

Business Name
Contact Title
*Contact Name
*Contact Surname
*Contact E-mail
*Contact E-mail Confirmed
*Telephone
Mobile Telephone
Alternative/Business Telephone
Best Time to Call
Facsimile
*Address
Address
*City
*State/Province
*Postal/Zip Code
*Country
Shipping Information (if different from above)
Name
Address
Address
City
State/Province
Postal/Zip Code
Country
Telephone

Personal Information

Full Legal Name (as it appears on ID)


Date of Birth
(dd/mm/yy)

Place of Birth


Citizenship


Passport or Driver’s License No


Date of Issue


Country of Issue


Country of Residence


Expiry Date
(dd/mm/yy)

Current Residential Address (P.O. Box not acceptable)

Address1

Address2

City

Postal/Zip Code

Country


Occupation

Employer


Position


Business Telephone (if any)


Alternative Contact (optional)

iName

Surname

Address1

Address2

City

Postal/Zip Code

Country

Phone

Email

Title/Position with Company


Passport or Driver’s License No



Additional Authorized Signer 2


Full Legal Name (as it appears on ID)

Title/Position with Company


Passport or Driver's License No.

*Check here if you will need to Add More Authorized Signers

Authorized Signatures Required for Instructions with Bank
Any One Any Two All
Other, please specify

Declaration of Source of Funds

Nature and Detailed Description of Beneficial Owner’s Business


Purpose of the New Account


Description of the Nature of Transactions Planned to be Executed under New Account


Expected Average Monthly Balance
(amount)
(currency)


What banking services and products do you require today and will require in the future? (check all that apply)

Payments in LVL deposits trade finance
(letters of credit, cash collection)

Payments in hard currencies lending individual safe deposit
boxes

Payments in soft currencies payment cards project analysis, advisory services

Hard currencies conversion cash servicing trust, brokerage
services

Soft currencies conversion other (please indicate)


How do you plan to manage your account? (check all that apply)

Through the Internet
Through fax
Through the Bank’s branches by Bank Express telephone banking

References from Other Banks or Business Partners (if any)

(Please list below, 3-5 benefits you would like your Corporation to offer)
1.
2.
3.
4.
5.

Inquiry

Which Search Engine did you use to find our site?

Which Keyword(s) did you use?