Applicants Must Complete ALL Sections of the Form in Order for the Application to Be Processed

Nationwide Toll Free 1-877-998-7539 Fax: 281-754-4941

Email:

Client Intake Form

Applicants must complete ALL sections of the form in order for the application to be processed. This Intake Form will become part of your contract. Our time is as valuable as yours, so please, only serious applications from individuals who know what they need and have the funds to pay for the requested service. Email to or fax to 281-754-4941 Attn: Proof of Funds Dept.

CLIENT INFORMATION

Principal Name
Nationality
Drivers' License or Passport #
Expiration Date
Date Of Birth
Permanent Address
Primary Phone Number
Secondary Phone Number
Fax Number
E-mail Address

CLIENT BANK INFORMATION

Name of Bank
Branch
Bank Address
Telephone & Fax
Account Number
S.W.I.F.T. Code
Bank Officer #1
Bank Officer #2
Account Name
Account Signatory
Funds Set Aside To Pay Fee’s
Are Funds Liquid, Free & Clear? / YES NO

CLIENT COMPANY INFORMATION

Name of Company
Type of Business Conducted
Business Address
Registered Office
Telephone & Fax Number
Do You Have Any Outstanding Judgments, Law Suits or Tax Liens?
Place of Incorporation
Date of Incorporation
Corporation Registration Number
Legal Advisor & Company Name
Employer Tax ID Number - EIN
Principal Structure of Business / Corporation Partnership Individual LLC

SERVICE REQUESTED

What Kind of Service Do You Need? / POF Blocked Account Bank Instrument
Sizeof Instruments Needed
Do You Have 2.50% of This Amount?
If “NO” Then How Much Do You Have?
Type of Instrument [If Applicable] / BG CD SBLC/BG
Desired Leasing Term
Desired Closing Date
Do You Require Monetization / Yes No
Recourse or Non-recourse loan
Desired Bank
Type of Account Confirmation Required / By Phone Statement MT799 MT760

REFERRING BROKER [IF APPLICABLE]

The following persons are recognized as our Referring Agent(s):

Referring Broker Name
Referring Broker Email & Phone #
Referring Broker Name
Referring Agent Email & Phone #

USE OF ACCOUNT

Provide a detailed description of how you will be using the account/instrument – be as detailed as possible. Applications will be turned down if the description is only 1 -2 sentences. Provide ALL necessary information including required ‘text’, payment and delivery methods:

US PATRIOT ACT CERTIFICATION

All information requested is in accordance with International Money Laundering Regulations and the US Patriot Act

In compliance with the Uniting and strengthening America by Providing Appropriate Tools Required to Intercept and Obstruct Terrorism (US Patriot Actof 2001) and other counter-terrorism laws. Client hereby certifies under penalty of perjury the following:

1. That all monies tendered or to be deposited in escrow by or on behalf of Client are from a source that is in compliance with all applicable United States of America anti-terrorist financing and asset control laws, statutes and executive orders, and
2. That all monies received by or on behalf of Client will be used by Client strictly in compliance with all applicable United States of America anti-terrorist and asset control laws, statutes and executive orders.

ACCURACY OF INFORMATION

I personally represent and warrant, under penalty of perjury, that the information provided is accurate and complete. Further, I warrant that I have the legal authority to sign on behalf of my self and/or my company. I agree to notify the leasing provider if the information which has been supplied changes in any manner.

______

Signature

Name of Authorized Signatory
Title
Date

ADDITIONAL DOCUMENTATION REQUIRED

Please attach the following documents when submitting your application:

•Companies: Corporate applicants must provide a Certificate of Incorporation and Corporate Resolution, along with proper identification documents.

•Individuals: Individual applicants must supply two documents which show identification (Color Copy of Passport, State ID, Utility Bill, Etc.)

•Authorized Persons: Associated or authorized applicants must provide two forms of identification to prove their residence and identity.

•Proof Of Funds: all applications must provide a statement showing the funds available for payment of bank fees. All broker fees are paid following the successful deliver of the instrument or monetization if the Monetizer is referred by our group. .

•Executive Summary of Business Plan

•History of Management Group

•Private Placement Non-Solicitation Statement

•Payment of Service Fees:Applications must be submitted with a bank statement showing the ability to pay the amount equal to the leasing fee unless payment will be by ICPO or MT700 following delivery. If payment will be by ICPO. 24 hoursfollowing delivery of the instrument, applicant must verify how many days bank needs to pay the service fee upon delivery. (normal is 1-7) No proof is required when requesting monetization services.

•Verbiage:Applicants must clearly define the verbiage needed for their transaction if there are special conditions. Please provide receiving bank’s requested MT760 verbiage if delivery is to your bank.

•Delivery of SBLC/BG to unknown Monetizer. Applicant must provide the delivery and fee payment procedures of the Monetizer if not utilizing a Monetizer referred by our group.

BANK COORDINATES FOR DELIVERY OF INSTRUMENT ( If Applicable):

BENEFICIARY NAME:
PASSPORT #:
TELEPHONE + FAX#:
EMAIL:
BANK NAME:
BANK ADDRESS:
ACCOUNT NAME:
ACCOUNT NUMBER:
SWIFT CODE:
ABA - ROUTING #:
BANK OFFICER:
BANK OFFICER PHONE / FAX #:

Proof of Funds Service

A proof of funds is a document prepared by a financial institution that affirms that an individual or business entity has the funds on hand to enter into a given financial transaction. A document of this type is sometimes prepared at the request of a seller who is considering an offer from a buyer. The seller requests the proof through the buyer, who in turn authorizes his or her bank or other institution to provide data that confirms the ability to honor the terms of the transaction.

Ease of Qualification

These are true cash collateral accounts. The Proof of Funds is valid for the 90-day period stated and may be extended for one year or more.

• No background check
• No credit report
• No credit scores
• No Business plan
• No Executive summary
• No LTV ratio
• No real estate appraisal

Types of Proof of Funds

• Top 50 Bank Proof of Funds Letter
• Top 50 Bank Blocked / Reserved Funds Letter
• Top 50 Bank Comfort Letter
• Top 50 Bank Swift MT760 (Cash Accounts / BG's / SBLC's)
• Top 50 Bank Swift MT799

NOTE: Our Minimum Proof of Funds amount is USD $10,000,000.00 (Ten Million United States Dollars) for Letters and USD $50,000,000.000 (Fifty Million United States Dollars) for MT760's.

Pricing for Proof of Funds

Proof of Funds Pricing.logon on to

Requirements

This is a "funds first" transaction. Because of the considerable costs involved in providing Proof of Funds we cannot initiate the process of creating an account for you without seeing the fee upfront in escrow. We will not accept a delay of payment until your other transaction closes.

The fee is paid into a third-party escrow account so you are protected. You remain in control of the funds until verification is completed.

We use a neutral third-party escrow company as the escrow agent. Fees need to be deposited into an escrow account prior to bank account creation. Once you receive the verified bank account letter, you then authorize the release of the fees held in escrow. This ensures that all parties perform as agreed.

Set-up time to after a fully executed package is received and funds are in escrow is 3-5 days.

Step by step process

1. Complete Submission Checklist Items and Form (see below).
2. A contract is then sent back along with escrow instructions.
3. Once the fee is wired into escrow we will have the bank account set-up.
4. Within 48-72 hours your POF account will be ready to be verified.
5. POF Letter is sent directly to Escrow from Issuing Bank or an MT799 is sent via Swift to Receiving Bank and an MT799 transmission receipt (export copy) is sent to escrow directly from Issuing Bank.

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All information submitted will be handled with strict confidentiality