OnLine APPLICATION - PROYTEC PANAMA CORP

The APPLICATION must be filled in all mandatory fields marked with a red asterisk.

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ELECTRONIC APPLICATION

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USER

!!! DO NOT MODIFY !!!

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PROYTEC PANAMA CORP - PROYTEC GROUP

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THE FIELDS WITH A RED ASTERISK ARE MANDATORY

Date

1. NAME and SURNAME
First
Last
ENTER THE NAME AND SURNAME PRESENT IN THE CIS/KIC

2. BUSINESS NAME
ENTER THE BUSINESS NAME PRESENT IN THE CIS/KIC

3. E-mail for Contact

In accordance with Articles 2 through 5 of the Due Diligence Convention and the Federal Banking Commission Circular of December 1998, and under the US Patriot Act of 2002, as amended in February 2003 concerning the prevention of money laundering and 305 of the Swiss Criminal Code, the following information may be supplied to Banks and/or other Financial Institutions for purposes of verification of identity and activities of the Client described below, and the nature and origin of the funds which are to be utilized. The foregoing is subject to agreement by all parties to whom this information is provided that they are obligated to respect the privacy rights of the Client and all individuals described herein, as well as the generally accepted professional standards relating to the maintenance of confidential information, and to take all appropriate precautions to protect the confidentiality of the information contained herein, This legal obligation shall remain in full force indefinitely without restriction.

ENTER THE CODE PRESENT IN THE CIS/KIC.

IF YOU DO NOT REMEMBER YOUR CIS/KYC CODE, LEAVE IT BLANK

BUSINESS DATA
BUSINESS DATA

24. Collegiate Administrative Body
YES
NO

!!! IMPORTANT !!!

If YES send the Personal Documents of all Administrators in JPG or PNG graphic format, not PDF to E-mail:

proytecbox@gmail.com

The SUBJECT of the email must be:

[NAME and SURNAME] (indicated in point 1.) - [BUSINESS NAME] (indicated in point 2.) - ADMINISTRATORS' DOCUMENTS

FINANCIAL SERVICE
FINANCIAL SERVICE

76. If Type of financial service requested is "Other" (description)

78. If Business Reason for financing/investment is "Other" (description)

79. Brief description of the purpose of the financing/investment

80. I undertake to send a descriptive REPORT as indicated in the INDEX to be followed for the drafting of the Report accompanying the Financial Plan, and to also send the FINANCIAL PLAN.
YES

The index to follow for drafting the descriptive REPORT can be downloaded here : BUSINESS PLAN

The REPORT must be sent to : proytecbox@gmail.com
The SUBJECT of the email must be:
[NAME and SURNAME] (indicated in point 1.) - [BUSINESS NAME] (indicated in point 2.) - REPORT

The FINANCIAL PLAN must be sent to : proytecbox@gmail.com
The SUBJECT of the email must be:
[NAME and SURNAME] (indicated in point 1.) - [BUSINESS NAME] (indicated in point 2.) - FINANCIAL PLAN

If the descriptive REPORT is integrated into a single Document with the FINANCIAL PLAN, constituting the BUSINESS PLAN
the SUBJECT of the email must be :
"[NAME and SURNAME] (indicated in point 1.) - [BUSINESS NAME] (indicated in point 2.) - BUSINESS PLAN

REQUEST
REQUEST

81. Currency

82. TOTAL AMOUNT FOR THE PURPOSE

83. FINANCING/INVESTMENT REQUIRED

84. DURATION OF THE FINANCING/INVESTMENT REQUIRED

85. PERIOD OF GRACE REQUIRED

APPLICANT'S FINANCIAL DATA
APPLICANT'S FINANCIAL DATA

86. Currency Gross Income

87. Gross Income Period

88. Gross Income

89. Net Income for the Period indicated

90. Banking Exposures

91. Total Banking Exposures
If there are no exposures write "0"

92. Total other Financial Commitments
Indicate the sum of Leasing, other Financing or Loans, etc.
If there are no exposures write "0"

93. Are there Mortgages, Guarantees or Pledges?

94. Total Value of Mortgages, Guarantees or Pledges
Indicate the sum of Mortgages, Guarantees or Pledges
If there are no exposures write "0"

95. I undertake to send the FINANCIAL STATEMENTS for the last 3 years and the BANKING MOVEMENT EXTRACT for the last 24 months (Not applicable to Start Up Business)
YES

The FINANCIAL STATEMENTS must be sent to :
proytecbox@gmail.com
The SUBJECT of the email must be:
[NAME and SURNAME] (indicated in point 1.) - [BUSINESS NAME] (indicated in point 2.) - FINANCIAL STATEMENTS

The BANKING MOVEMENT EXTRACT must be sent to :
proytecbox@gmail.com
The SUBJECT of the email must be:
[NAME and SURNAME] (indicated in point 1.) - [BUSINESS NAME] (indicated in point 2.) - BANKING MOVEMENT EXTRACT

96. Are there Bankruptcy requests?

97. Are there any disputes ? (If YES describe below)

98. If Disputes exist (description)

STATEMENTS
STATEMENTS

99. I, under penalty of perjury, with full corporate and individual responsibility, hereby irrevocably, confirms neither I, nor anyone else associated with my organization, company or individual investor works for any agency of any government.
YES

100. I, under penalty of perjury, with full corporate and individual responsibility, also declare that it is not involved in any government entrapment operation.
YES

101. I, under penalty of perjury, with full corporate and individual responsibility, hereby irrevocably, confirm that neither I, nor anyone else associated with my organization or company has been convicted of a crime, in any country in the World.
YES

102. I, under penalty of perjury, with full corporate and individual responsibility, also declare that, as nor my team within my organization or company are considered terrorists or on a checklist of the Department of Security of any State in the World.
YES

103. I, under penalty of perjury, with full corporate and individual responsibility, declare that:
I am not a politically exposed person

104. I, under penalty of perjury, with full corporate and individual responsibility, declare that:
I do not have a family member, and that I am not closely related to a politically exposed person

AUTHORISATIONS
AUTHORISATIONS

105. I authorize the collection, use and disclosure by PROYTEC GROUP and PROYTEC PANAMA CORP of the data and information provided with this APPLICATION to its affiliates, Credit Agencies, Reporting Agencies, Banking and Financial Institutions and associated Companies.
YES

106. I also authorize the disclosure by these parties of credit and financial information obtained from the above sources for the purpose of obtaining and using a credit information report and verifying current and ongoing creditworthiness.
YES

107. I understand and accept that PROYTEC GROUP and PROYTEC PANAMA CORP may disclose personal, business, financial and credit information submitted with this APPLICATION and in the Documents sent to future creditors and banking and financial institutions requesting credit references..
YES

108. I authorize the collection, use and disclosure of personal information by PROYTEC GROUP and PROYTEC PANAMA CORP and of the persons (natural and legal) referred to in this APPLICATION and in the Documents sent..
YES

RESPONSIBILITIES
RESPONSIBILITIES

109. I swear under penalty of perjury, with total personal responsibility, that the information provided in this document is accurate and truthful and I irrevocably confirm that I am legally authorized to sign this APPLICATION also by committing the Company.
YES

110. COMPILING AND SENDING THE QUESTIONNAIRE
I am aware that this APPLICATION is filled in directly on the PROYTEC PANAMA CORP website (https://proytecpanama.com) in the DOWNLOAD section from which you access the ONLINE APPLICATION and is automatically sent when you press the SEND button.

111. SEND THE APPLICATION
By pressing the SEND button I accept all the conditions indicated in the form which will be stored electronically and used for recognition purposes in order to be able to use one or more services offered by the PROYTEC GROUP and PROYTEC PANAMA CORP.

112. SIGNATURE
My NAME and SURNAME, which I report again at the end of this APPLICATION document, must be considered as an electronic signature made by me with the precise, firm and responsible desire to confirm everything I have declared.

REFERENCE REGULATIONS
REFERENCE REGULATIONS

113. EDT (ELECTRONIC DOCUMENT TRANSMISSIONS)
This APPLICATION is subject to the rules and regulations of the Electronic Transmission of Documents (EDT), provided that it is sent and received via the indicated E-mail addresses. In particular, signatures on documents transmitted via EDT tools are subject to EDT (Electronic Transmissions of Documents) and will be considered valid and applicable with respect to any provision of this APPLICATION.

114. ELECTRONIC SIGNATURE
Incorporate U.S. Public Law 106-229, ‘‘Electronic Signatures in Global and National Commerce Act’’ or such other applicable law conforming to the UNCITRAL Model Law on Electronic Signatures (2001).

115. ELECTRONIC DOCUMENTS
Electronic Commerce Agreement (ECE/TRADE/257, Geneva, May 2000) adopted by the United Nations Centre for Trade Facilitation and Electronic Business (UN/CEFACT).

116. DATA PROTECTION
EDT documents shall be subject to General Data Protection Regulation (GDPR/UE/2016/679), as applicable.

117. ORIGINAL COPY OF DOCUMENTS
3. Either Party may request hard copy of any document that has been previously transmitted by electronic means provided however, that any such request shall in no manner delay the parties from performing their respective obligations and duties under EDT instruments.

ELECTRONIC SIGNATURE (Name and Surname)
First
Last

Email

DATA (USER)
!!! DO NOT MODIFY !!!

Contact via

Indicate the Manager or Agent or Partner Company or Customer
IF "Contact via" IS "Website" WRITE "-"

It is advisable to be accompanied, advised and supported by a Director, a Manager or an Agent of PROYTEC PANAMA Corp.

Requests from the PROYTEC PANAMA Corp. network take precedence, even if all requests are parsed successfully.

END APPLICATION

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