E-Banking USER REGISTRATION

/ ACCOUNT N°:

FORM F2

E-Banking USER REGISTRATION

(one form per person)

This document supplements the document denominated “FORM F: INSTRUCTIONS TO THE BANK” of Banque Heritage (Uruguay) S.A. (the “Bank”) to authorize the persons indicated hereinbelow to operate through E-banking.

1. User Information

Full Name:
I.C.:
Use existing User:
Create new User

If the User is not the holder /authorized legal representative /attorney of the Account, please fill in the following:

Date and Place of birth:
Domicile:
Telephone number:
Profession, Trade or Main Activity:

If User’s income represents a source of income of the account, please indicate:

Amount of income:
Civil Status *:

(*)If married, please indicate the following spouse’s data:

Full Name:
Spouse’s Identity Document No:

2. Authorizations

The User shall be authorized to carry out transactions in all present and future subaccounts, except as otherwise indicated herein below:

To operate only in Sub-account (s) / Currency (s):

It is hereby expressly provided that, in the case of US Dollar accounts, they shall include both Dollar notes and Dollar transfers.

This authorization will enable the User to make queries in all present or future products, except as otherwise provided hereunder:

Not to authorize queries on additional products (debts, comex, investments, others.)

3. Sending of Password

We hereby request you send the Password to following e-mail address:

We accept and agree that the e-mail used for sending the Password may be unsecure and that, therefore, third parties may have Access thereto. Consequently, we release the Bank from any liability for the potential access that such persons may have to such information, and for the use of it made thereby, even if it is to our prejudice and without our consent.

4. Authorizations and form of action

User is authorized to (until otherwise indicated by us in writing) perform the following through E-banking:

Mark the corresponding authorization and form of action: / AUTHORIZATION(1): Simple (S)
Double (D)
Triple (T) / USER (2: Entering User (I) Authorizing User (A)
Inquiries / S
Check book request / S
Transfers between own accounts / S / D / T / I / A
Purchase and Sale of Currency / S / D / T / I / A
Purchase and Sale of Securities / S / D / T / I / A
Delivery versus payment / S / D / T / I / A
Receipt versus payment and delivery free of payment / S / D / T / I / A
Bills of Exchange in favour of originator / S / D / T / I / A
Reload of prepaid card / S / D / T / I / A
Payment of Services / S / D / T / I / A
(*) Transfers to third parties within the Bank / S / D / T / I / A
(*) Transfers to local banks / S / D / T / I / A
(*) Transfers to foreign banks / S / D / T / I / A
(*) Delivery free of payment / S / D / T / I / A
(*) Withdrawals by cash desk / S / D / T / I / A
(*)Bills of Exchange in favour of third parties / S / D / T / I / A
(*) Request for sundry debits (payment of cards and others) / S / D / T / I / A
(*) Request for sundry debits (payment of cards and others) / S / D / T / I / A
(*) Payment of wages (mark to hide details from User) / S / D / T / I / A
(*)Payment to Suppliers / S / D / T / I / A

(*)These transactions shall be carried out by using a security device (Token) EXCEPT FOR:

- Transfers to accounts in Banque Heritage or in Local Banks up to an amount of USD 1,000 (One Thousand or its equivalent)

- Instructions given by Entering User

(1) AUTHORIZATION: Indicate type of authorization:

S: Simple Authorization: transactions made by a single person.

D: Double Authorization: an entering user + an authorizing user participate in the transactions.

T: Triple Authorization: an entering user + two authorizing users participate in the transactions.

(2) USER: for the case of Double or Triple Authorizations, indicate if:

I: The User is the entering user in the transaction (no Token is required to operate)

A: The User is the authoring user in the transaction. The Authorizing User may operate as the Entering User as well.

Payments with cap amounts

If User is the Authorizing User of Transfers to third parties, batches of Payment of Wages and batches of Payment to Suppliers, please indicate whether he/she may authorize such transactions:

Without cap amounts.
Up to USD / (US Dollars / )

Or its equivalent in other currency.

5. Payment of Services

User is (unless otherwise provided by us to you in writing) authorized to make the following payments on our behalf in respect of any such account or sub-account.

Payment of DGI
Payment of BPS
Payment of DUA
Payment of other services

In relation to the payment of services, we agree to maintain sufficient funds in the accounts and/or subaccounts indicated above. Consequently, we understand and accept that if the funds available are not sufficient to debit the service invoices indicated hereunder the Bank shall not issue the payment orders received. It is hereby expressly agreed that the Bank shall make no partial payments of invoices.

The Bank shall have 48 banking hours from reception of the instruction to comply with the order. It is therefore our sole liability to issue the payment orders duly in advance of the invoices due date.

As Bank makes the payments on our behalf, we hereby release the Bank from any liabilities to any third parties in general and to any Companies in particular, and accept any liabilities arising from the payments made by the Bank based on instructions and/or information provided by us and the Company.

We shall pay all fees, price, costs, taxes, charges and other amounts related to the services requested hereunder as are indicated in the Pricing List.

6. Delivery of Token (if applicable)

We request you that the token be delivered to us in the following manner, and under our sole responsibility:

Withdrawal at the Bank in the name of:
I.C.:
Sending by mail to the care of:
Domicile.:
I.C.:

This authorization shall, in the case of E-banking, prevail specifically over any other authorization or instruction granted by us prior to the signing of these presents, and may only be substituted by a new Form F2 or a revocation, which shall be valid to the Bank within 48 hours following acknowledgement of receipt thereof by the Bank.

Place and Date:

Signature: ______

Name:

F1,12,14. F F2 Page 1 of 3 Ago - 2016