Application for Escrow Account by J81qx7

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									Application for Escrow Account
Transaction Parties Information


Party to the transaction
                             name, surname or company name

Personal data
                             identity No. / passport data for non residents of LR or company registration No.

Transaction participant            Buyer                             Seller                          Other

Authorized
representative
                             name, surname

Personal data
                             identity No. / passport data for non residents of LR

Contact information
                             phone numbers, e-mail address




Party to the transaction
                             name, surname or company name

Personal data
                             identity No. / passport data for non residents of LR or company registration No.

Transaction participant            Buyer                             Seller                          Other

Authorized
representative
                             name, surname

Personal data
                             identity No. / passport data for non residents of LR

Contact information
                             phone numbers, e-mail address




Party to the transaction
                             name, surname or company name

Personal data
                             identity No. / passport data for non residents of LR or company registration No.

Transaction participant            Buyer                             Seller                          Other

Authorized
representative
                             name, surname

Personal data
                             identity No. / passport data for non residents of LR

Contact information
                             phone numbers, e-mail address




Date
                             day          month          year                                  signature, full name, seal




ABLV Bank, AS / Registration No. 50003149401 / SWIFT: AIZK LV 22                                                            K4 / VEI.279 / Versija: 02 / Spēkā no: 23.03.2012.   1/2
Application for Escrow Account



Transaction Information


Subject of the
transaction



Amount and currency
of the transaction
                                  amount in figures and words


Term of crediting the
transaction amount to
the escrow account                day          month         year

Documents appended
to the application




Special provisions




Documents to be                         Buyer                           Seller                           Other option
submitted by

Term of submitting
documents
                                  day          month         year

Fee for reviewing the                   Buyer                           Seller                           Buyer and Seller in equal parts                                      Other option
application is to be
covered by

Fee for making escrow                   Buyer                           Seller                           Buyer and Seller in equal parts                                      Other option
account agreement is
to be covered by

Fee for transferring1 the               Buyer                           Seller                           Other option
transaction amount
from the escrow
account is to be
covered by


Confirmation


I have read the ABLV Bank, AS, General Business Terms and Conditions, consent thereto, and agree to be bound thereby.


Date
                                  day          month         year                                   signature, full name, seal



To be Completed by the Bank



Escrow account No.                LV                 AIZK


Date
                                  day          month         year                                   bank officer’s signature, full name




1
    If no specific order on desired type of payment is received from the customer, the payment will be made as a standard one.

ABLV Bank, AS / Registration No. 50003149401 / SWIFT: AIZK LV 22                                                                          K4 / VEI.279 / Versija: 02 / Spēkā no: 23.03.2012.   2/2

								
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