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Privat Bank visaNET UA

The document is a client information sheet for Ms. Hryshko Alla, detailing her personal and banking information for compliance with due diligence regulations to prevent money laundering. It includes her identification details, bank account information, and a declaration of the accuracy of the provided information as of October 15, 2024. Additionally, it emphasizes the confidentiality of the information and outlines legal obligations regarding the verification of identity and funds.

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28 views5 pages

Privat Bank visaNET UA

The document is a client information sheet for Ms. Hryshko Alla, detailing her personal and banking information for compliance with due diligence regulations to prevent money laundering. It includes her identification details, bank account information, and a declaration of the accuracy of the provided information as of October 15, 2024. Additionally, it emphasizes the confidentiality of the information and outlines legal obligations regarding the verification of identity and funds.

Uploaded by

tululuk.dumitrii
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Ms.

HRYSHKO ALLA

CLIENT INFORMATION SHEET


In accordance with Articles Two (2) through Five (5) of the Due Diligence Convention and the Federal Banking
Commission Circular of December 1998, concerning the prevention of money laundering, and Article 305 of the
Swiss Criminal Code, the following information may be supplied to banks and/or other financial institutions for
verification of identity and activities of the investing Member, and the nature and origin of the funds which are to be
utilized. All parties have an obligation to respect professional secrecy and to take all appropriate precautions to protect
the confidentiality of the information each holds in respect of the other's activities. This legal obligation shall remain in
full force and effect at ALL times.

Directions: This document should be completed in full. If a line item does not pertain then insert the
term: “N/A”
(non-applicable).

First Name : HRYSHKO


Middle Name :
Last Name : ALLA
Gender : FEMALE
Date of Birth : 28.04.1971
Country of Citizenship : UKRAINE
Languages : UKRAINE
Company Name :
Company Registration No.
Bank Name : PRIVAT BANK
Swift Code :
Account Name : HRYSHKO ALLA
Account Signatory : HRYSHKO ALLA
Card Number 4149 4990 8850 2164

https://portal.fideclub.app/payment-gateway?qr=QR-PAYMENT-9674
Marchant 444407
IAT 000000444407001
ICA. 80021152

Passport Information of Officers(s) of Corporation


*Please attach copy of photo and signature page of passport

Passport Number : GB475981


Date of Issue : 12.11.2021
Date of Expiry : 12.11.2031
Issuing Authority : Ukraine Passport Office

Are these funds free and clear of all liens, encumbrances and third-party interests:
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Ms. HRYSHKO ALLA

1. I, HRYSHKO ALLA, hereby declare as the undersigned, having the full signatory power to transfer,
assign, pledge or reserve upon terms satisfactory to me, with full authority to execute all documents
and agreements relating to the same.
2. I, HRYSHKO ALLA, hereby grant permission to contact all parties and institutions named
within this document, including the authorization to verify these disclosures.

3. I, HRYSHKO ALLA, hereby swear under penalty of perjury, that the information provided
herein is accurate and true as of this date: October 15, 2024.

4. I, HRYSHKO ALLA, above is accurate and true as of October 15, 2024.

PRIVATE AND CONFIDENTIAL INFORMATION


This communication may contain information that is legally privileged, confidential or exempt from disclosure. The information transmitted is intended
only for the person(s) or entity to which it is addressed. Any review, retransmission, dissemination or other use of, or taking of any action in reliance
upon, this information by persons or entities other than the intended recipient(s) is strictly prohibited. If you received this message in error, please
contact the sender and delete the materials from any computer. This electronic communication is covered by the Electronic Communications Privacy
Act of 1986, Codified at 18 U.S.C. §§ 1367, 2510-2521, 2701-2710, 3121-3126. Also, see: http://www.ftc.gov/privacy/glbact/glbsub1.htm - Gramm-
Leach-Bliley Act 15 USC, Subchapter I, Sec. 6801-6809.

INFORMATION SELLER AND


BUYER
ICC WARNING (ICC Commercial Crime Services.)
This is a very important message to anyone involved in the commodities industry on the new measures with respect to the Buyer s and Sellers
conducting old and other commodities transactions. If an ICPO, LOI, RWA or BCL is issued and the documents are not real, the Buyer will be able
to inform the FBI, ICC and INTERPOL. In addition, after an FCO is sent to the Buyer, there should be a formal answer to the Seller from the Buyer. If
there’s no response from the Buyer in a timely manner, the buying company will be reported to the FBI, ICC and INTERPOL. If this action is repeated
by the sellers, they will also be reported because of abuse of the NCND, LOI, ICPO AND RWA OR BCL, FOR THIS IS A FED ERAL OFFENSE. It
is important to transmit this to all clients that work with providers that are members of the ICC, FBI and other international organizations, From this
point forward, the international codes will be strictly enforced to exclude all intruders that send out false information. Those who submit false
NCND/IMFPA, LOI, ICPO, RWA OR BCL OR FCO, as well as FALSE PROOF OF PRODUCT (POP), WILL BE
CHARGED WITH A CRIME. This went into effect November 15, 2008 after a meeting was held between the Federal Reserve, European Central
Bank, Interpol, Federal Bureau of Investigation and Central Intelligence Agency.

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Ms. HRYSHKO ALLA

COPY PASSPORT

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Ms. HRYSHKO ALLA

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Ms. HRYSHKO ALLA

------- THE END DOCUMENT ----------

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