Registered office address Please note. The ultimate beneficial

Please note. The ultimate beneficial owner, must fill in the Client Information sheet.
Îáðàòèòå âíèìàíèå. Îñíîâíîé âëàäåëåö ñ÷åòà äîëæåí çàïîëíèòü ôîðìó «Èíôîðìàöèÿ î êëèåíòå»
The Client is a: 1. Corporation
Êëèåíò: 1. Êîðïîðàöèÿ
2. Partnership
2. Ïàðòíåðñòâî
Name in Full:
Íàçâàíèå êîìïàíèè:
Country of Incorporation or formation of partnership:
Ñòðàíà ôîðìèðîâàíèÿ êîðïîðàöèè èëè ïàðòíåðñòâà:
Date of Incorporation or formation of partnership:
Äàòà ôîðìèðîâàíèÿ êîðïîðàöèè èëè ïàðòíåðñòâà:
Business Registration #:
Ðåãèñòðàöèîííûé íîìåð:
Certificate of Incorporation #:
Íîìåð ñåðòèôèêàòà êîðïîðàöèè:
Registered office address
Àäðåñ ðåãèñòðàöèè êîìïàíèè
Steet:
Óëèöà:
City:
Ãîðîä:
Province:
Îáëàñòü:
House:
Äîì:
App#:
Office #:
Êâ.:
Îôèñ:
Country:
Ñòðàíà:
Zip:
Zip:
Èíäåêñ:
Èíäåêñ:
Business office address (if different from Registered Office Address)
Àäðåñ ôàêòè÷åñêîãî íàõîæäåíèÿ êîìïàíèè (åñëè îòëè÷àåòñÿ îò àäðåñà ðåãèñòðàöèè)
Steet:
Óëèöà:
City:
Ãîðîä:
Province:
Îáëàñòü:
House:
Äîì:
App#:
Office #:
Êâ.:
Îôèñ:
Country:
Ñòðàíà:
Zip:
Zip:
Èíäåêñ:
Èíäåêñ:
Contact information
Êîíòàêòíàÿ èíôîðìàöèÿ
Telephone (Day):
ÒåëåôîíÒåëåôîí (Äåíü):
Telephone (Night):
Òåëåôîí (Íî÷ü):
TelephoneFax (Day):
Ôàêñ (Äåíü):
E-mailFax (Night):
Ôàêñ (Íî÷ü):
Corporate E-mail:
Êîðïîðàòèâíûé e-mail:
Brief description of business
Êðàòêîå îïèñàíèå ðîäà äåÿòåëüíîñòè
Nature of Business:
Õàðàêòåð äåÿòåëüíîñòè:
Client Information Statement (Corporation or Partnership)
Èíôîðìàöèÿ î êëèåíòå (Êîðïîðàöèÿ èëè Ïàðòíåðñòâî)
List of main Shareholders (for Corporation)/Joint Owners or Partners (for Partnership)
Ñïèñîê îñíîâíûõ Ó÷ðåäèòåëåé (äëÿ Êîðïîðàöèè)/Ñîâëàäåëüöåâ èëè Ïàðòíåðîâ (äëÿ Ïàðòíåðñòâà)
1
Full name:
Ïîëíîå èìÿ:
Home address:
Äîìàøíèé àäðåñ:
2
Full name:
Ïîëíîå èìÿ:
Home address:
Äîìàøíèé àäðåñ:
3
Full name:
Ïîëíîå èìÿ:
Home address:
Äîìàøíèé àäðåñ:
4
Full name:
Ïîëíîå èìÿ:
Home address:
Äîìàøíèé àäðåñ:
5
Full name:
Ïîëíîå èìÿ:
Home address:
Äîìàøíèé àäðåñ:
6
Full name:
Ïîëíîå èìÿ:
Home address:
Äîìàøíèé àäðåñ:
The ultimate beneficial owner of the Account
Îñíîâíîé âëàäåëåö ñ÷åòà
The person who represents the partnership/corporation in business/financial relations with Broker. The copy of Power of Attorney must be inclosed to this document.
Ëèöî, ïðåäñòàâëÿþùåå èíòåðåñû ïàðòíåðñòâà/êîðïîðàöèè ïî äåëîâûì/ôèíàíñîâûì âîïðîñàì ñ áðîêåðîì. Êîïèÿ äîâåðåííîñòè äîëæíà áûòü ïðèëîæåíà ê ýòîìó äîêóìåíòó
Full name:
Ïîëíîå èìÿ:
Signatures (for Corporation)
Ïîäïèñàíî (äëÿ Êîðïîðàöèè)
Corporate seal:
Ïå÷àòü:
Full Name of Director duly authorized:
Ïîëíîå èìÿ Äèðåêòîðà, èìåþùåãî ïðàâî ïîäïèñè:
Signature of Director:
Ïîäïèñü äèðåêòîðà:
Date:
Äàòà:
Signatures (for Partnership)
Ïîäïèñàíî (äëÿ Ïàðòíåðñòâà)
1
Name of partner:
Èìÿ ïàðòíåðà:
Signature:
Ïîäïèñü:
Date:
Äàòà:
2
Name of partner:
Èìÿ ïàðòíåðà:
Signature:
Ïîäïèñü:
Date:
Äàòà:
3
Name of partner:
Èìÿ ïàðòíåðà:
Signature:
Ïîäïèñü:
Date:
Äàòà:
4
Name of partner:
Èìÿ ïàðòíåðà:
Signature:
Ïîäïèñü:
Date:
Äàòà:
5
Name of partner:
Èìÿ ïàðòíåðà:
Signature:
Ïîäïèñü:
Date:
Äàòà:
6
Name of partner:
Èìÿ ïàðòíåðà:
Signature:
Ïîäïèñü:
Date:
Äàòà: