investor information summary

6
Str. Gr. Ureche nr. 1 -3, B1. W INVESTOR DATE : Monday, Marc FROM : S.C. PANGIRA TO : Compliance O THROUGH : SIR DR IR FE In accordance with Articles two Federal Banking Commission money laundering, and Article may be supplied to banks and/o identity and activities of the Pri utilized. All parties have an ob precautions to protect the con others’ activities. This legal obl 1. Principal a) Represented By b) Nationality c) Passport Number d) Date Of Issue e) Date Of Expiration f) Date Of Birth g) SSN/Identity No. h) Place Of Birth i) Contact Address Clients Initials __ W. Maracineanu – mezanin IASI Romania Euro Email :[email protected] R INFORMATION SUMMARY ch 23, 2015 AN BUDI SERVICE S.R.L Officer – NRL Platform EROZ o (2) through five (5) of the Due Diligence Con Circular of December 1998, concerning the 305 of the Swiss Criminal Code, the follow or other financial institutions for the purpose o incipal, and the nature and origin of the fund bligation for professional discretion and to take nfidentiality of the information each holds in ligation shall remain in full force and effect at a : S.C. PANGIRAN BUDI SERVICE S.R : SIR DR IR FEROZ : MALAYSIAN : A25895236 : 21 JANUARY 2012 : 23 JUNE 2017 : 08 NOV 1974 : 741108-01-7575 : JOHORE BHARU : JALAN GURNEY 2 ________ opean Union Page 1 Y nvention and the he prevention of wing information of verification of ds that are to be e all appropriate n respect of the all times. R.L

Upload: musa-sir-dr-ir-feroz

Post on 07-Aug-2015

40 views

Category:

Documents


1 download

TRANSCRIPT

Page 1: INVESTOR INFORMATION SUMMARY

Str. Gr. Ureche nr. 1 -3, B1. W. Maracineanu

INVESTOR INFORMATION SUMMARY

DATE : Monday, March 23, 2015FROM : S.C. PANGIRAN BUDI SERVICE S.R.LTO : Compliance Officer THROUGH : SIR DR IR FEROZ

In accordance with Articles two (2) through five (5) of the Due Diligence Convention and the Federal Banking Commission Circular of December 1998, concerning the prevention of money laundering, and Article 305 of the Swiss Criminamay be supplied to banks and/or other financial institutions for the purpose of verification of identity and activities of the Principal, and the nature and origin of the funds that are to be utilized. All parties have an obligation for professional discretion and to take all appropriate precautions to protect the confidentiality of the information each holds in respect of the others’ activities. This legal obligation shall remain in full force and effect at all times.

1. Principal

a) Represented By

b) Nationality

c) Passport Number

d) Date Of Issue

e) Date Of Expiration

f) Date Of Birth

g) SSN/Identity No.

h) Place Of Birth

i) Contact Address

Clients Initials __

3, B1. W. Maracineanu – mezanin IASI Romania European Union

Email :[email protected]

INVESTOR INFORMATION SUMMARY

Monday, March 23, 2015 S.C. PANGIRAN BUDI SERVICE S.R.L Compliance Officer – NRL Platform SIR DR IR FEROZ

In accordance with Articles two (2) through five (5) of the Due Diligence Convention and the Federal Banking Commission Circular of December 1998, concerning the prevention of money laundering, and Article 305 of the Swiss Criminal Code, the following information may be supplied to banks and/or other financial institutions for the purpose of verification of identity and activities of the Principal, and the nature and origin of the funds that are to be

obligation for professional discretion and to take all appropriate precautions to protect the confidentiality of the information each holds in respect of the others’ activities. This legal obligation shall remain in full force and effect at all times.

:

S.C. PANGIRAN BUDI SERVICE S.R.L

: SIR DR IR FEROZ

Nationality : MALAYSIAN

: A25895236

: 21 JANUARY 2012

: 23 JUNE 2017

: 08 NOV 1974

: 741108-01-7575

: JOHORE BHARU

: JALAN GURNEY 2

________

IASI Romania European Union

Page 1

INVESTOR INFORMATION SUMMARY

In accordance with Articles two (2) through five (5) of the Due Diligence Convention and the Federal Banking Commission Circular of December 1998, concerning the prevention of

l Code, the following information may be supplied to banks and/or other financial institutions for the purpose of verification of identity and activities of the Principal, and the nature and origin of the funds that are to be

obligation for professional discretion and to take all appropriate precautions to protect the confidentiality of the information each holds in respect of the others’ activities. This legal obligation shall remain in full force and effect at all times.

S.C. PANGIRAN BUDI SERVICE S.R.L

Page 2: INVESTOR INFORMATION SUMMARY

Str. Gr. Ureche nr. 1 -3, B1. W. Maracineanu

j) Contact Telephone No.

k) Facsimile No.

l) Cell No.

m) Occupation

n) Business Name

o) Business Address

p) Contact Telephone No.

q) Facsimile No.

r) Cell No.

2.

Address For Mail

3.

Address For Courier

4.

BD Issuing Bank Name

a) Address

b) Account Number

c) Account Name

d) Bank Officer 1 Name

e) Bank Officer 1 Pin Code

f) Bank Officer 2 Name

g) Bank Officer 2 Pin Code

h) Telephone

i) Telefax

j) SWIFT CODE

Clients Initials __

3, B1. W. Maracineanu – mezanin IASI Romania European Union

Email :[email protected]

: +60177430448

: TBA

: +60177430448

: BUSINESS OWNER

: S.C. PANGIRAN BUDI SERVICE S.R.L

: +60355118268

: +60177430448

: +60355108268

: +60177430448

: 1-08-02 WORLDWIDE @7,JALAN LAZUARDI 7/29.SEKSYEN 7,40000,SHAH ALAM,SELANGOR,MALAYSIA

: SAME AS ABOVE

: NATWEST,NEW YORK

: AS ATTACHED

: AS ATTACHED

: AS ATTACHED

: AS ATTACHED

: AS ATTACHED

: AS ATTACHED

: AS ATTACHED

: TBA

: TBA

:

________

IASI Romania European Union

Page 2

S.C. PANGIRAN BUDI SERVICE S.R.L

02 WORLDWIDE @7,JALAN LAZUARDI 7/29. SEKSYEN 7,40000,SHAH ALAM,SELANGOR,MALAYSIA

Page 3: INVESTOR INFORMATION SUMMARY

Str. Gr. Ureche nr. 1 -3, B1. W. Maracineanu

k) Face Value BANK DRAFT

5. Affirmation: I hereby swear under the full penalty of perjury, that the information provided herein is both true and accurate. I am in control signatory authority on the aforementioned bank account and have full authority to execute all contracts and agreements relating to pleading the assets for a loan. The funds are in full compliance with the antiFinancial Action Task Force (FATF) 6/01.

Signed and Sealed this Monday, March 23, 2015

______________________________________Name : SIR DR IR FEROZTitle : CHAIRMANPassport No. : A25895236Country of Issue : MALAYSIA

Clients Initials __

3, B1. W. Maracineanu – mezanin IASI Romania European Union

Email :[email protected]

BANK DRAFT : USD 190 MILLION (1 PCS) USD 190 MILLION (1 PCS) USD 250 MILLION (1 PCS)

I hereby swear under the full penalty of perjury, that the information provided herein is both true and accurate. I am in control of the assets stated above, and have signatory authority on the aforementioned bank account and have full authority to execute all contracts and agreements relating to pleading the assets for a loan. The funds are in full compliance with the anti-money laundering policies set forth by the Financial Action Task Force (FATF) 6/01.

Monday, March 23, 2015

______________________________________

SIR DR IR FEROZ CHAIRMAN A25895236

________

IASI Romania European Union

Page 3

I hereby swear under the full penalty of perjury, that the information provided herein of the assets stated above, and have

signatory authority on the aforementioned bank account and have full authority to execute all contracts and agreements relating to pleading the assets for a loan. The

ndering policies set forth by the

Page 4: INVESTOR INFORMATION SUMMARY

Str. Gr. Ureche nr. 1 -3, B1. W. Maracineanu

Clients Initials __

3, B1. W. Maracineanu – mezanin IASI Romania European Union

Email :[email protected]

________

IASI Romania European Union

Page 4

Page 5: INVESTOR INFORMATION SUMMARY

Str. Gr. Ureche nr. 1 -3, B1. W. Maracineanu

Clients Initials __

3, B1. W. Maracineanu – mezanin IASI Romania European Union

Email :[email protected]

________

IASI Romania European Union

Page 5

Page 6: INVESTOR INFORMATION SUMMARY

Str. Gr. Ureche nr. 1 -3, B1. W. Maracineanu

Clients Initials __

3, B1. W. Maracineanu – mezanin IASI Romania European Union

Email :[email protected]

________

IASI Romania European Union

Page 6