FOGOT AS
reg. nr. 10225817
APPLICATION
of new user - legal entity
1. Name ____________________________________________________
(please give a name as in accordance with Commercial Registry)
2. Registration code ____________________________________________
3. Place of location _____________________________________________
(please give a place of location or legal address)
4. Telephone _______________
5. E-mail __________________
6. WMID ____________________
7. Main business activity _________________________________________
8. Territory of activity _________________________________________
9. Sources of financing _________________________________________
10. Basic partners ________________________________________________
11. Prospective annual sum of exchanges ___________________________
12. Connected with politically imposed person2, member of his family, close colleague ____
(please put YES or NO)
Please perform for me a transaction with WebMoney in accordance with terms of CONTRACT OF RECORD (http://www.fogot.ee/exchange/en/dogovorw.html).
_______________ | _______________ | _______________ | _______________ |
date | position | signature | name and surname |
2Politically imposed persons:
1) Head of State, of Government, Minister, Deputy Minister and Assistant of Minister;
2) Member of Parliament;
3) Judge of Supreme Court, of Constitutional Court or any other higher courts, whose judgments might be appealed further only in exceptional cases;
4) Board member of state control body and board member of Central Bank;
5) Ambassador, charge d'affaires and higher military officer;
6) Member of management, supervisory and administration bodies of state commercial union.