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Corporate Details
Business name
*
:
Process start date
*
:
Name of the PUMA Energy business representative who established the contact
*
:
Fiscal Address
*
:
Street address
*
:
State
*
:
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Town / City
*
:
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Country Of Registration
*
:
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Postal Code:
Company registration number:
Country
*
:
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Registration Date (MM/YYYY):
Contact Number:
Contact address:
Mobile Number:
Contact person :
Company rol:
Fax number:
Web Site:
Email
*
:
Re-enter e-mail address
*
:
Company Name (Other Language):
Seleccione el Idioma
Company Name (Other Language):
Counterparty Status:
Select Counterpart State
Other:
¿Listed on the stock market?:
YES
NO
Stock Exchange:
Counterparty Type:
Physical Trader
Service Provider
Ship Owner
Shipping Agent
Ship Broker
Oil Broker
Swap Broker
Futures Broker
Inspector
Customer type:
Select client type
Physical person
Legal person
Foreign legal person
* Select client type
¿Do you think your transactions with our company exceed U$S 250.000?:
YES
NO
Directors Name:
Referred by:
Bank information
Principal Bankers(Bank Name)
*
:
Swift
*
:
Bank Branch Address Details:
Bank Country
*
:
Seleccione el pais
Bank account name
*
:
Bank account currency
*
:
Bank account
*
:
Name of Bank Account Manager & Contact Details:
Intermediary/Correspondent Bank Name:
Intermediary/Correspondent Bank Swift:
Additional Information
Additional Comment, if any:
Necessary documentation
Statute copy:
* If it does not contain details about current shareholder/partner percentage or if you do not have such information on another document, then you must choose one of the following options:
Independently emitted document
Notary document
Shareholder names document
External auditor signed document
Customs administration copy:
Declaration of Conformity:
Summary of Current Changes Act copy:
Bank reference letter:
Energy Secretariat Inscription letter:
AFIP inscription receipt:
Gross income tax inscription receipt:
CMS05:
Proof of valid exemptions or exclusions:
Withholding agent:
Last audited financial statements with a closing date less than six months:
DNI copy:
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