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    Client Information Sheet: MRS Maria Christina Lydia Bergland

    Uploaded by

    Yash Emrith
    This document contains confidential client information for Maria Christina Lydia Bergland. It includes her personal details like passport information, date of birth, and contact details for her bank and credit card. She affirms that the information provided is true and accurate, and that she has full control and authority over the assets and accounts listed. The document is signed and dated by Bergland and contains copies of her passport and credit cards.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Client Information Sheet: MRS Maria Christina Lydia Bergland

    Uploaded by

    Yash Emrith
    378 views5 pages
    This document contains confidential client information for Maria Christina Lydia Bergland. It includes her personal details like passport information, date of birth, and contact details for her bank and credit card. She affirms that the information provided is true and accurate, and that she has full control and authority over the assets and accounts listed. The document is signed and dated by Bergland and contains copies of her passport and credit cards.

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    This document contains confidential client information for Maria Christina Lydia Bergland. It includes her personal details like passport information, date of birth, and contact details for her bank and credit card. She affirms that the information provided is true and accurate, and that she has full control and authority over the assets and accounts listed. The document is signed and dated by Bergland and contains copies of her passport and credit cards.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    378 views5 pages

    Client Information Sheet: MRS Maria Christina Lydia Bergland

    Uploaded by

    Yash Emrith
    This document contains confidential client information for Maria Christina Lydia Bergland. It includes her personal details like passport information, date of birth, and contact details for her bank and credit card. She affirms that the information provided is true and accurate, and that she has full control and authority over the assets and accounts listed. The document is signed and dated by Bergland and contains copies of her passport and credit cards.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 5

    CLIENT INFORMATION SHEET

    MRS MARIA CHRISTINA LYDIA BERGLAND


    THIS CIS IS CONFIDENTIAL, FAILURE TO COMPLY IS CAUSE FOR AUTOMATIC CANCELATION
    all information given in this CIS is accurate and true.

    Página 1 de 5
    CLIENT INFORMATIO SUMMARY
    In accordance with Articles 2 (two) through to 5 (five) 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 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.

    GENERAL INFORMATION HOLDER AND CARD INFORMATION

    CARD HOLDER MARIA CHRISTINA LYDIA BERGLAND


    PASSPORT NO PE4533079
    PLACE OF ISSUE FINLAND
    DATE OF ISSUE 26.11.2016
    DATE OF EXPIRY 26.11.2021
    DATE OF BIRTH 12.11.1987
    CARD ISSUING BANK BARCLAYS BANK DELAWERE
    CARD NUMBER 4397 0781 6268 0374
    CARD EXPIRY DATE 01/22
    CARD TYPE VISA
    CARD CVV ***
    CARD CODE ****
    Affirmation:
    I, MARIA CHRISTINA LYDIA BERGLAND 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.

    Date: May 23, 2021


    Signature

    ……………………………….
    MRS MARIA CHRISTINA LYDIA BERGLAND
    Passport No.: PE4533079
    Issued By: FINLAND
    Date of Issue: 26.11.2016
    Date of Expiry: 26.11.2021

    Página 2 de 5
    PASSPORT COPY OF THE HOLDER

    Date: May 23, 2021


    Signature

    ……………………………….
    MRS MARIA CHRISTINA LYDIA BERGLAND
    Passport No.: PE4533079
    Issued By: FINLAND
    Date of Issue: 26.11.2016
    Date of Expiry: 26.11.2021

    Página 3 de 5
    FRONT AND BACK CARD PAGE

    Date: May 23, 2021


    Signature

    ……………………………….
    MRS MARIA CHRISTINA LYDIA BERGLAND
    Passport No.: PE4533079
    Issued By: FINLAND
    Date of Issue: 26.11.2016
    Date of Expiry: 26.11.2021

    Página 4 de 5
    Certification:
    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 accounts as 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 funds for Investment & Asset Management, the investment-grade bond.
    All assets/funds engaged in this transaction were obtained with funds derived from non-criminal
    origin and are good cleared funds. The origins of funds/assets are in full compliance with the anti-
    money laundering policies set forth by the Financial Action Task Force (FATF) 6/01.

    I, MARIA CHRISTINA LYDIA BERGLAND hereby swear under penalty of perjury, that the
    information provided herein is accurate and true as of this date.

    Date: May 23, 2021


    Signature

    ……………………………….
    MRS MARIA CHRISTINA LYDIA BERGLAND
    Passport No.: PE4533079
    Issued By: FINLAND
    Date of Issue: 26.11.2016
    Date of Expiry: 26.11.2021

    Página 5 de 5

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