(This form is provided as a sample for informational purposes only. Your application will be entered online
through the link provided for such purpose. You shall fill out below data on Borrower’s Full Letterhead; initial,
sign and seal each page respectively.)
APPLICATION TO BORROW BANK INSTRUMENTS
(MTN, BONDS, EUROPAPERS, COMMERCIAL PAPERS, CD OR TREASURY BILLS)
TO THE LENDER. C/O: A. I. C. T., INC. – …............................................:
DATE
:
BORROWER’S COMPANY INFORMATION
COMPANY NAME
:
ADDRESS
:
CITY/COUNTRY
:
AUTHORIZED SIGNATORY
FIRST & LAST NAME
PASSPORT NUMBER
ISSUING COUNTRY
E MAIL
:
:
:
:
(This must be the e-mail address of the authorized signatory and it is required in order to receive the contract.)
BORROWER’S DESIGNATED BANK
BANK NAME
:
BRANCH
:
ADDRESS
:
TELEPHONE
:
SWIFT CODE
:
BANK OFFICER
:
HOLDER OF ACCOUNT
:
NUMBER OF ACCOUNT
:
(If the receiving bank and the paying bank are different, please indicate both bankcoordinates.)
BANK NAME
:
BRANCH
:
ADDRESS
:
TELEPHONE
:
SWIFT CODE
:
BANK OFFICER
:
HOLDER OF ACCOUNT
:
NUMBER OF ACCOUNT
:
BANK INSTRUMENT REQUESTED
TYPE
:
ISSUING BANK
:
CURRENCY
:
AMOUNT
:
ISIN CODE
:
PRICE / FEES
:
E-mail: [email protected] ● UK: +44 203 514 7176 ● TR: +90 555 963 0899 ● Initials _________
London – UK •
New Jersey – USA •
Zurich – Switzerland •
Istanbul – Turkey •
Seoul – Korea (South ) •
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OPTION
(please cross and select option requested)
WE CONFIRM THAT THIS APPLICATION IS:
□ TO RECEIVE THE INSTRUMENT BY
□ TO RECEIVE THE PROOF OF FUNDS (POF)
SWIFT MT760 TO MY DESIGNATED BANK
INSTEAD OF THE INSTRUMENT
(for more information please see POF procedure)
□ WITH PRE-ADVICE - MT799
□ WITHOUT PRE-ADVICE - MT799
WE ARE READY TO DEPOSIT IN A DESIGNATED ACCOUNT THE BANK EXPENSES DUE TO PERMIT
TO COVER THE CALL OPTION EXPENSES TO RESERVE THE BANK INSTRUMENT; AMOUNTING
TO:
FOR INSTRUMENTS WITH A FACE VALUE OF:
 UP TO 499 MILLION; THE COST IS
 FROM 500 MILLION TO 999 MILLION; THE COST IS
 FROM 1BILLION ONWARD; THE COST IS
€20,000.00
€25,000.00
€30,000.00
FURTHERMORE WE ARE READY TO COVER THE EXPENSES AGAINST INVOICE TO ORGANISE
THE DELIVERY OF THE PRE ADVISE, IN AN AMOUNT OF €85,000.00.
(This money will be refunded after successfully closing the transaction by the Lender or can be deducted at the
moment of the payment of the services fees)
(Please attach a) copy of passport from the authorized signatory and b) brief summary of the financial project.)
EVERY REQUEST FOR OUR LEASING SERVICE MUST BE ACCOMPANIED BY A BRIEF
DESCRIPTION, ON COMPANY LETTERHEAD, OF PROJECT OR PURPOSE FOR WHICH THE BANK
INSTRUMENT IS BEING LEASED.
CONFIRMED AND APPROVED BY THE BORROWER:
(COMPANY NAME)
_______________________________________________
PRINTED NAME
:
TITLE
:
DATE
:
E-mail: [email protected] ● UK: +44 203 514 7176 ● TR: +90 555 963 0899 ● Initials _________
London – UK •
New Jersey – USA •
Zurich – Switzerland •
Istanbul – Turkey •
Seoul – Korea (South ) •
Page 2/10
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CLIENT’S INFORMATION SHEET
FACE VALUE AMOUNT REQUESTED
:
€/$ XXX,000,000. (XXXX MILLION EURO/ USD)
TYPE OF INSTRUMENT REQUESTED
LEASING FEES PAYMENT TERMS
:
:
BG / BOND / MTN / CD /
T-BILLS
1) CONDITIONAL IRREVOCABLE CORPORATE
PAY ORDER endorsed by borrower’s bank as per
draft at page 5.; or
□
□
□
□
□
2) BANK BACKED PROMISSORY NOTES
(which Expiring date will be negotiated between the
Parties) with the aval a/o endorsement of an
acceptable bank as per form at page 6.; or
3) Conditional SWIFT MT103 or MT700 MODE OF
LEASE : SWIFT TRANSFER OF THE INSTRUMENT
BY MT760
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
BORROWER FULL NAME
TITLE
NATIONALITY
PASSPORT NUMBER
ISSUED COUNTRY
ISSUE DATE
EXPIRATION DATE
COMPANY NAME
OFFICE ADDRESS
:
:
:
:
:
:
:
:
:
MOBILE PHONE
:
BUSINESS TELEPHONE
:
BUSINESS FAX
:
E-MAIL ADDRESS
:
LEGAL ADVISOR NAME
:
LEGAL FIRM E-MAIL ADDRESS
:
LEGAL FIRM PHONE NUMBER
:
YES
MY BANK IS LISTED IN THE INTERNATIONAL BANKERS ALMANAC
:
(IF NO, YOU MUST PREPARE A CLOSING BANK, WITH ALL DETAILS RECEIVED FROM YOUR
BANKER SENT TO THE PROVIDER)
YES
ALL MY CLOSING BANK OFFICERS AWARE OF THIS TRANSACTION
:
CONFIRMED AND APPROVED BY THE BORROWER:
(COMPANY NAME)
_______________________________________________
PRINTED NAME
:
TITLE
:
DATE
:
E-mail: [email protected] ● UK: +44 203 514 7176 ● TR: +90 555 963 0899 ● Initials _________
London – UK •
New Jersey – USA •
Zurich – Switzerland •
Istanbul – Turkey •
Seoul – Korea (South ) •
Page 3/10
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COPY OF PASSPORT FROM THE AUTHORISED SIGNATORY
(scanned color copy of passport will be enclosed)
CONFIRMED AND APPROVED BY THE BORROWER:
(COMPANY NAME)
_______________________________________________
PRINTED NAME
:
TITLE
:
DATE
:
E-mail: [email protected] ● UK: +44 203 514 7176 ● TR: +90 555 963 0899 ● Initials _________
London – UK •
New Jersey – USA •
Zurich – Switzerland •
Istanbul – Turkey •
Seoul – Korea (South ) •
Page 4/10
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Sample
BRIEF SUMMARY OF THE FINANCIAL PROJECT
We; X Y Z COMPANY; are applying to borrow a €/$ XXX,000,000 (XXXXX MILLION EUROS/U.S.
DOLLARS) (-tranche of the-) Bank Guarantee, ISIN Code XX0123456789 issued by XXX BANK. (With
Face Value of €/$ XXX,000,000)
With this transaction we target to enhance our credibility towards our business partners in xxxxxxx of xx
xxxxxxxxx on ………………………….. These locations are very prominent prime residential locations in the
country and will render very profitable results at speedy completion of such projects. More detailed project
information can be reviewed at our website www.xxxxxxx.com or provided upon request.
CONFIRMED AND APPROVED BY THE BORROWER:
(COMPANY NAME)
_______________________________________________
PRINTED NAME
:
TITLE
:
DATE
:
E-mail: [email protected] ● UK: +44 203 514 7176 ● TR: +90 555 963 0899 ● Initials _________
London – UK •
New Jersey – USA •
Zurich – Switzerland •
Istanbul – Turkey •
Seoul – Korea (South ) •
Page 5/10
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Sample / Draft
NON-CIRCUMVENTION, NON-DISCLOSURE & WORKING AGREEMENT
IRREVOCABLE MASTER FEE PROTECTION AGREEMENT
LENDER
BORROWER
CONSULTANT
PAYMASTER
TRANSACTION CODE
ISIN CODE
:
:
:
:
:
:
XXXXXXXX INVESTMENTS LIMITED
........................................................................................
WXXXXX-XXX
XX0123456789
RE: GLOBAL MASTER SECURITIES LENDING & BORROWING AGREEMENT
Nr: WXXXXX-XXX DATED Xxxxx XX, 20XX
1 OF 2: NON-CIRCUMVENTION, NON-DISCLOSURE & WORKING AGREEMENT (NCNDA)
WHEREAS, the Undersigned wish to enter into this Agreement to define certain parameters of the future
legal obligations, are bound by duty of Confidentiality with respect to their sources and contacts. This duty
is in accordance with the International Chamber of Commerce regulations in regards to NonCircumvention – Non-Disclosure; latest applicable version at the date of execution of this agreement.
…… xxx…... (Draft / Sample; will be completed with all applicable clauses.)
2 OF 2: IRREVOCABLE MASTER FEE PROTECTION AGREEMENT (IMFPA)
This “IRREVOCABLE MASTER FEE PROTECTION AGREEMENT (IMFPA)”; attached to and made an
integral part of above referred “GLOBAL MASTER SECURITIES LENDING & BORROWING
AGREEMENT” with Transaction Code “WXXXXX-XXX” dated Xxxxxxx XX, 201X; is lawfully
executed between “(COMPANY NAME)” As The BORROWER of subject Agreement; and
“ASSOCIATED INTERMEDIARIES & CONSULTANTS TEAM, INC.” As the PAYMASTER for all the
commissions due and payable to any and all INTERMEDIARIES and CONSULTANTS; who were
involved in assisting the BORROWER and facilitating subject financial transaction. Payment of the
total amount of commissions is the sole responsibility of the BORROWER.
(The payment for this irrevocable fee protection agreement are to be secured by the borrower during the course
of the transaction in the same manner as by the payment of leasing/service fees will be secured; through
acceptable bank endorsement only)
TRANSACTION
FACE AMOUNT
:
:
LEASE PRICE
COMMISSIONS & FEES
BORROWER’S SIDE
:
:
:
LEASING OF BANK GUARANTEE
€/$ XXX,000,000 (XXXX MILLION EUROS/U.S. DOLLARS)
+ Rolls & Extensions.
XX.XX% OF FACE VALUE
2.00% OF FACE VALUE TOTAL
2.00% OF THE FACE VALUE OF €/$ XXX,000,000 (XXXX
MILLION EUROS/U.S. DOLLARS) OF SUBJECT BANK
INSTRUMENT.
E-mail: [email protected] ● UK: +44 203 514 7176 ● TR: +90 555 963 0899 ● Initials _________
London – UK •
New Jersey – USA •
Zurich – Switzerland •
Istanbul – Turkey •
Seoul – Korea (South ) •
Page 6/10
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The total amount of €/$ XXX,000.00 (XXXX XXXXXX THOUSAND EUROS/U.S. DOLLARS) for the
commissions and fees for all the intermediaries involved should be settled in CASH or to be transferred
into Beneficiary’s Account as PAYMASTER for all the Intermediaries and Consultants; to be disbursed in
accordance with orders and at sole discretion of PAYMASTER; in accordance with Sub Agent or Sub Fee
agreements in file. Proof and detail shall be provided upon necessity and judicial demand.
The undersigned, with full corporate responsibility, under penalty of perjury, issue this “IRREVOCABLE
MASTER FEE PROTECTION AGREEMENT” of the same Currency with subject Bank Instrument to be
paid as listed below, for intermediaries and consultants, of the total face value of each and every
transaction described above, including all rolls and extensions thereof.
This Irrevocable Fee Protection Agreement shall be valid and binding upon lawful execution of above
referred “Global Master Securities Lending & Borrowing Agreement” between the BORROWER and the
LENDER. Said fee to be paid to the order of the groups’ Paymaster as follows:
The payment of €5,000.00 (FIVE THOUSAND EUROS) covering the initial administrative expenses of
intermediaries for subject transaction; is to be wired as per the wiring instructions provided with the
invoice; to bank account of ASSOCIATED INTERMEDIARIES & CONSULTANTS TEAM, INC.;
contemporaneously with the BORROWER wiring the payment of call option fees due at the time of signing
the above referred “Global Master Securities Lending & Borrowing Agreement” with LENDER. This portion
of the consulting fee denotes the legal consideration of this “Irrevocable Master Fee Protection Agreement”
and is the payment for the work performed up to such point in subject transaction; having processed the
application of BORROWER and having the BORROWER accepted by the LENDER and consequently
issued subject Agreement (G.M.S.L.B.A.). This money will be refunded after successfully closing the
transaction or deducted from the Intermediary Fees total amount.
The balance of commissions payments shall be made to the PAYMASTER; as per his written instructions;
upon completion of each and every tranche with rolls and extensions; without protest, delay or deductions.
PAYMASTER
:
BANKING DETAILS
BANK NAME
BANK BRANCH
BANK ADDRESS
:
:
:
:
ACCOUNT NAME
CURRENCY
ACCOUNT NUMBER
SWIFT CODE
ACCOUNT REP.
TEL
FAX
MOBILE
E-MAIL
:
:
:
:
:
:
:
:
:
…..............................................................
XXXXXXXXXXX BANK
XXXXX
XXX XXX
XXXXXXXXXXX
..................................................................
EUR/USD
XXXXXXXX
XXXXXXXX
XXXXXXXXXXXXX
+XX XXX XXX XXXX Ext: XXX
+XX XXX XXX XXXX
+XX XXX XXX XXXX
[email protected]
E-mail: [email protected] ● UK: +44 203 514 7176 ● TR: +90 555 963 0899 ● Initials _________
London – UK •
New Jersey – USA •
Zurich – Switzerland •
Istanbul – Turkey •
Seoul – Korea (South ) •
Page 7/10
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PARTIAL INVALIDITY The illegality, invalidity and non-enforceable provision of this document under the
laws of any jurisdiction shall not affect its legality, validity or enforceability under the law of any other
jurisdiction or provision.
ARBITRATION All parties agree to refer any disputes between the parties arising out of or in connection
with this agreement including any questions regarding its existence, validity or termination to arbitration
rules of the international arbitration centre (I.A.C). The appointed arbitrator shall hold the proceedings in
any country chosen by the parties and the rules of the IAC shall apply.
This document is accepted and signed by parties named below as signatories representing the lawful
authorization of each to bind the company to the terms and conditions of this agreement on this XX th day of
Xxxxxxx 201X.
BORROWER:
(COMPANY NAME)
PAYMASTER:
(COMPANY NAME)
________________________________
PRINTED NAME, Title
___________________________________
PRINTED NAME, Title
EDT ( Electronic document transmissions )
EDT (Electronic document transmissions) shall be deemed valid and enforceable in respect of
any provisions of this Contract. As applicable, this agreement shall be:
 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) and
 ELECTRONIC COMMERCE AGREEMENT (ECE/TRADE/257, Geneva, May 2000)
adopted by the United Nations Centre for Trade Facilitation and Electronic
Business (UN/CEFACT).
 EDT documents shall be subject to European Community Directive No. 95/46/EEC,
as applicable. 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.
E-mail: [email protected] ● UK: +44 203 514 7176 ● TR: +90 555 963 0899 ● Initials _________
London – UK •
New Jersey – USA •
Zurich – Switzerland •
Istanbul – Turkey •
Seoul – Korea (South ) •
Page 8/10
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PASSPORT COPIES OF PARTIES
THE BORROWER
(scanned color copy of passport will be enclosed)
THE PAYMASTER
(scanned color copy of passport will be enclosed)
THE CONSULTANTS
(scanned color copy of passport will be enclosed)
E-mail: [email protected] ● UK: +44 203 514 7176 ● TR: +90 555 963 0899 ● Initials _________
London – UK •
New Jersey – USA •
Zurich – Switzerland •
Istanbul – Turkey •
Seoul – Korea (South ) •
Page 9/10
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LEGAL NOTICE
DISCLAIMER: The facilities detailed in this communication are not subject to the provisions
of the United Kingdom Financial Services Act 1986 or any amendment thereto ("the act").
The facilities are specifically exempted from the act by way of note 5 to clause 13b of part I
of the act. We are not registered as a financial adviser under the act and we do not offer any
form of investment advice nor provide nor sell any form of investment or security as defined
within the act. The announcement on these pages does not constitute an offer or an
invitation to purchase any securities. Our financial service is provided strictly against
payment of an attorney’s funding/arrangement fee. We do not enter into any joint venture or
participate in your business. The release of the fee is not conditional upon the success or
otherwise of the investment strategy to be employed by the applicant.
NO OFFER: This material contains exclusively information. Nothing received from Our
Financial Institution now and in the future should be construed as an offer solicitation or
recommendation to buy or sell any investment or to engage in any other transaction. This
information and any received from Our Financial Institution in the future does not constitute
an offer, solicitation or recommendation to buy or to sell any securities for investment, nor
an offer, solicitation or recommendation of any other kind. The information is given solely for
educational - and informational purposes, requested by you (the party to whom the
information is transmitted), exclusively for the personal use of the recipient.
NO WARRANTY: All information and opinion contained on the site is provided without any
warranty of any kind, either express or implied, to the fullest extent permissible pursuant to
applicable law. All information and opinion is provided to assist prospective investors in
making their own decisions without any guarantees as to accuracy, reliability or
completeness. The information provided now and received from Our Financial Institution in
the future does not contain investment-, legal-, accounting-, tax- or other advice or opinion
and should not be relied upon for any specific investment or other purposes. A competent
professional should always be consulted before utilizing any information existing now and
received from Our Financial Institution in the future.
We are NOT, nor do we claim to be, a Licensed United States Securities Dealer,
Broker or U. S. Investment Adviser. You must keep the information strictly confidential
and you are not allowed to make the information available to others without written consent
from Our Financial Institution.
WE ARE CONSULTANTS WORKING WITH THE AUTHORIZED REPRESENTATIVES OF THE
LENDER AND PROVIDER COMPANIES. ALL THE DEALS MUST BE MANAGED AND CHECKED
FROM OUR SIDE; SO WE ACT COMPLETELY ON BEHALF OF THE REPRESENTATIVES OF THE
LENDER AND PROVIDER COMPANIES IN FORCE OF APPROPRIATE BOARD RESOLUTIONS;
WHO WILL DECIDE ABOUT THE DUE DILIGENCE AND ABOUT THE ACCEPTANCE OF THE
CLIENT / BUYER.
The above-mentioned details are for information purposes only and not to be considered a
Solicitation of Funds or to Sell Securities or other commodities. We reserve the right to
accept or reject all form of Documentation incomplete or unprofessional email
communication.
WARNING: We, “A. I. C. T.”, Take honesty, ethics and fair dealing in financing very seriously.
Fraudulent transactions, deceptive or illegal activity will be immediately reported to the
proper authorities, “National and International”.
E-mail: [email protected] ● UK: +44 203 514 7176 ● TR: +90 555 963 0899 ● Initials _________
London – UK •
New Jersey – USA •
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Istanbul – Turkey •
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Page 10/10
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