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:
__________________________________
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)
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.
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.