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:                                               __________________________________________

 

MARITAL STATUS.                          __________________________________________

 

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.  If a passport is unavailable, a similar photo ID (driver’s licence, for example) will suffice.

 

  1. Please provide a utility bill (no 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 details the average balance maintained and how the account has been conducted.  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

 

                

 

 

 

SOURCE OF ASSETS  (Please provide any documentary evidence, such as financial statements)

 

           

 

 

 

 

 

 

 

           

 

 

 

 

 

            NOTE:  Details required for a business:

 

 

  1. In the space provided, please briefly state your academic and business background. 

 

 

 

 

 

 

 

 

  1. 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.

 

 

 

 

 

  1. 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 there is no fee charged for outward fund transfers.

 

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

 

 

If YES, a bank will need details of the approximate number of monthly deposits and withdrawals (with anticipated amounts) as well as the other requirements shown on the relevant application form.  Our minimum processing fee is $350.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NOTES

 

  1. Payment of fees can be wired as follows:

 

 

HSBC BANK
140 Broadway, 11th Floor
New York, NY 10005-1180
Swift code MRMDUS33
ABA 021001088
Chip 0108
For credit to:
BANCO PANAMEÑO DE LA VIVIENDA, S.A.
41st Street and Chile Avenue, Bella Vista
Panama
Swift: BPV VPAPA
Account No. 000-03619-6
Further credit to:
OMS Ltd.
Account No. 12-20-111332-1
Reference:  *

 

      *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, World Trade Centre, 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.