Eurocard Corporate Limit
Transcription
Eurocard Corporate Limit
Eurocard Corporate Limit Spending limit – individual purchase. SEK The company is liable for payment – Individual invoicing Agreement No Company information Corporate ID No. Spending limit – individual purchase. SEK Cash withdrawals Yes Spending limit – 30 days. SEK 0 0 0 No 0 0 0 Full company name Invoice address Town Postcode Telephone (including area code) Card delivery address Postcode Town Company name on the card (max. 26 characters) Contact, name Telephone (including area code) Card to be sent to Invoice to be sent to The company Contact Residence The company Annual fees will be debited Contact Residence Cardholder’s invoice Name of parent company (if applicant is a subsidiary) Bank (name of the bank and contact) FOLD HERE The company Corporate ID No. of parent company Telephone (including area code) Eurocard Corporate Limit ordered for. When ordering more than one card, attach a copy of “Tillägg Eurocard Corporate Limit” P2060. Surname First name (given name) Personal ID No. Employment No./Cost centre Mobile number Address (if different from registered address) Postcode Town E-mail address (Enter this to receive our latest offers and information) Auxiliary services Yes, we wish additional travel insurance for the cardholder and have read the terms and conditions available at eurocard.se. The receiver of the application and the sender of the offer regarding insurance is the insurance provider Trygg Hansa. Signature I/We apply herewith for a Eurocard Corporate Limit and confirm that the details supplied are correct. The General Conditions and prices can be found at eurocard.se, or P 2039eng MP-id 17 130306 Date obtained from Eurocard’s customer centre. I am/We are aware that this application will be subject to a routine credit check, during which credit information may be obtained. I/ We have read and agree to comply with the conditions. This agreement will become effective on the day Eurocard approves the application. Authorised company signature Printed name Personal ID No. Printed name Personal ID No. Additional information that may influence the credit checking process, such as applications to the Swedish Companies Registration Office to make changes to the company or the company’s Board of Directors, should be supplied in a separate appendix. Send your application to Frisvar, Eurocard AB, Svarspost 2008 1118, SE-110 07 Stockholm, Sweden. The postage is pre-paid. AFN code Clearing No. 157 Eurocard AB SE-103 83 Stockholm, Sweden Tel. switchboard: +46 8 14 67 00 Tel. Customer Service: +46 8 14 67 37 eurocardkund@eurocard.se eurocard.se Bankgiro: 849-0005 Corporate ID No.: 556070-4453 Intyg om verklig huvudman/ Certificate regarding Beneficial Owner Företag/Company name Företagsnamn/Company name Organisationsnr/Corporate id no. Land för styrelsens säte (om annat än Sverige)/ Country of registered office (if other than Sweden) Kontaktperson, telefonnr (även riktnr)/ Contact, phone No. (incl. area code) Verklig huvudman/Beneficial owner Verklig huvudman är en fysisk person som ytterst kontrollerar företaget genom direkt eller indirekt ägande av eller kontroll över mer än 25 % av aktierna (kapital, andelar eller motsvarande) eller rösträtterna, eller som på annat sätt utövar kontroll över företaget. Beneficial owner is a natural person who ultimately controls the Company by direct or indirect ownership or control of more than 25% of the shares (capital, ownership and equivalent) or the voting rights, or who otherwise exercises control over the Company. Namn/Name Personnr eller födelsedatum/ Personal id No. or date of birth* Adress (inkl. land)/Address (incl. country) Ägarandel i %/ Ownership % Det finns inte någon fysisk person som äger eller har kontroll över mer än 25 %./ No natrual person owns or controls more than 25%. * If not a Swedish Personal ID No. always state date of birth. Ägar- eller kontrollstruktur/Ownership or control structure VIK Om ägandet eller kontrollen utövas genom en juridisk person redogör för ägar- eller kontrollstuktur med en skiss eller genom att bifoga ett organisationsschema. Ange den juridiska personens firma, organisationsnummer, adress (inkl. land) och ägarandel i procent. If the ownership or control is exercised via legal entities, please clarify your group structure and/or control structure with a drawing or attach an organisation chart. State the legal entities company name, Registration No., address (incl. country) and ownership in percentage. HÄR Se bifogat organisationsschema/See attached organisation chart Namn/name Organisationsnr/ Registration No. Adress (inkl. land)/Address (incl. country) Ägarandel i %/ Ownership % Underskrift av behörig firmatecknare/Authorised signatory(ies) Härmed intygas att ovanstående uppgifter är riktiga och sanningsenliga. Vi förbinder oss samtidigt att omgående meddela Diners Club Nordic AB om det skulle inträffa förändringar i dessa förhållanden. We certify and confirm that the above stated information is true and complete. We undertake to inform Diner Club Nordic AB immediately of any changes whatsoever to information given herein involving a new beneficial owner being added or a previous beneficial owner no longer being a being a beneficial owner. EC2233 150109 Datum/Date Namnteckningar/Signature(s) Namnförtydligande/Name in print Eurocard AB 103 83 Stockholm, Sweden Tel växel: +46 8 14 67 00 Tel kundservice: +46 8 14 67 37 eurocardkund@eurocard.se eurocard.se Bankgiro: 849-0005 Org.nr: 556070-4453