CLIENT APPLICATION FORM

(Every beneficial owner must complete a form)

 

The information provided herein is subject to the confidentiality

provisions of the relevant Panamanian laws

 

Trust Services, S.A. does not provide either legal or foreign tax advice and this should be obtained from professionals licensed to render such advice before making offshore commitments.

 

The application cannot be processed until the completed original of this form

and supporting documentation are received.

We reserve the right to reject an application without explanation.

 

                                                           

NAME:                                               __________________________________________

                                                           

NAME OF ANY SPOUSE:               __________________________________________

                                                           

ADDRESS:                                         __________________________________________

                                                           

                                                            __________________________________________

                                                           

TELEPHONE:                                   __________________________________________

                                                           

TELEFAX:                                          __________________________________________

                                                           

E-MAIL:                                              __________________________________________

 

 

I understand that business cannot be accepted before all preliminary paperwork has been provided and I confirm the accuracy of the information given and that all assets detailed in section 4 hereof belong to me and no one else. I acknowledge that TRUST SERVICES, S.A. (“the firm”) shall not be responsible, unless otherwise provided for by the terms of a trust or foundation, for any investment decisions made which shall be the sole responsibility of me AND IT IS FURTHER acknowledged herein that I will familiarise myself with the firm’s fee schedules and that I understand that the firm does not receive any commissions or other incentives from third parties (including brokers, bankers and other professionals) and does not offer advice or recommendations of any description whatsoever to its clients in respect of investments or banking and the choice, therefore, of investments, banks, investment professionals or any other professional service providers to be utilised, notwithstanding any suggestions made by the firm, shall be the sole decision and responsibility of me unless otherwise provided for by the terms of a trust or foundation.  I further understand that if I am the authorised signatory on a bank or other account, I must deal directly with the institution concerning all matters after the account is opened.  It is understood that I will be required to sign a Client Agreement, a copy of which appears on the website of the firm, which will be prepared by the firm for signature and without which I cannot be represented.

 

_______________________________________

Signature

 

Date: __________________________________      


 

  1. Please attach a notarised copy of the photo page of your passport and copies of all pages, including blank ones as well as a notarised copy of a similar photo ID (driver’s licence, for example).

 

  1. Please provide a utility bill (not older than 2 months) confirming your address.

 

  1. Please provide two references addressed to you personally which should be no older than 30 days.  One should be a character reference and should be provided by a professional (lawyer or accountant, for example), who has known you for at least two years.  The other should be a bank reference which states how the account has been conducted and the duration of the relationship (should be no less than 2 years).

 

  1. In the space provided, please briefly state the purpose of the offshore structure and the source of assets which will be transferred.  No assets belonging to third parties can be accepted.

 

 

PURPOSE OF OFFSHORE STRUCTURE (Please provide specific details about your intentions and objectives)

 

 

 

 

 

 

 

 

 

 

 

 

SOURCE OF ASSETS (Please provide specific details of the assets as well as any documentary evidence, such as financial statements)

 

           

 

 

 

 

 

 

 

 

 

 

 

 

 

  1. Please attach a brief résumé which details your academic and professional background.  If employed, please include where you work, with address, your position and length of service.  If retired, please include date of retirement and details of former employer with address, including length of service and position.  If you have held any official posts in either municipal, local or national government, including any related boards, committees or commissions, please provide brief details in the space provided.

 

 

 

 

 

6-       Are there any previous, pending or anticipated lawsuits where you were, are or might be a defendant, including any official investigations of which you were, are or might be the subject?  Please answer YES or NO.  If YES, please provide details.

 

 

 

 

 

 

7-       Clients can use the firm’s banking facilities without processing a bank account for which a transaction fee of 0.375% is charged in respect of all inward funds received.  A reducing fee scale applies above $1 million.  The minimum fee per transaction is $25 and the maximum fee per transaction is $5,000.  There is no fee charged for outward fund transfers.

 

Do you require a separate account? Please answer YES or NO.

 

 

 

Do you require a brokerage account?  Please answer YES or NO. 

 

 

 

 

Note:  Our minimum processing fee is $400 for either a bank or brokerage account and if necessary we will send the requirements to you in order for us to proceed.

 

 

 

 

 

 

 

 

 

 

 

NOTES

 

  1. Payment of fees can be wired as follows:

 

HSBC BANK
452 Fifth Avenue
New York, NY 10018, USA
Swift code MRMDUS33
ABA 021001088
Chip 0108
For credit to:
BANCO PANAMEÑO DE LA VIVIENDA, S.A.
Ave. La Rotonda y Boulevard Costa del Este,
Costa del Este, Panama
Swift: BPV VPAPA
Account No. 000-03619-6
Further credit to:
TRUST SERVICES, S.A.
Account No. 12-020-000124725-001
*Ref. _________________
 
 
 
                                *Please use the initials of your name

 

 

  1. A copy of our standard Client Agreement (which we will prepare) establishing the terms and conditions of our engagement can be viewed on the home page of our website www.trustservices.net

 

  1. Correspondence:   Letters should only be mailed to:  Apartado 0832-1630, WTC, Panama, Republic of Panama.  There is no street delivery of mail in Panama.

 

4.       Courier packages should only be sent to us at:  Edificio Balboa Plaza, Oficina 522, Avenida Balboa, Panama, Republic of Panama.  Tel. +507-269-2438.

 

5.       Our office hours (Monday – Friday) are:          8 a.m. – 12:30 p.m.

                                                                                     2 p.m. – 5:00 p.m.