Hist. Box KYC 2015-Individual
Hist. Box KYC 2015-Individual
Hist. Box KYC 2015-Individual
STRICTLY CONFIDENTIAL
Name:
Address:
Home Phone:
Mobile:
E-mail:
Signature: ________________________
This is not intended to be, and must not be construed to be, a solicitation of Boxes
By reading beyond this point, you acknowledge that this is a private communication of
privileged confidential information for you only, and you agree to keep it confidential and
protect it from disclosure, except as required for the transaction referred to herein. DO
NOT UNDER ANY CIRUMSTANCE SEND THIS OUTLINE, OR ANY INFORMATION
CONCERNING THIS BUSINESS, TO ANYONE! You have requested specific information
outlined below. This material and document regarding the above referenced transaction
are provided solely to serve your interests and purposes, and are not for distribution. By
receiving this information sheet you hereby agree to keep all information received from us
strictly confidential, and will not disclose it to any third party.
The following information may change at any time without notice.
ORIGIN AND HISTORY OF ASSETS: The information provided in this form must be
accurate and verifiable. The information on this form is the confirmation to the
Redemption of your legal custodian holding of the Boxes
CLIENT INFORMATION SHEET: This information must be filled in, in its entirety (two
pages), and the information contained must be accurate and verifiable.
COPY OF PASSPORT: A clean, clear color copy of the Clients passport must be
provided, enlarged to 8.5 x 11. This is best achieved by making a laser copy of the
original passport enlarged 129%. A colorscan will do as well (accepted formats: JPEG,
TIFF, PDF, DOC).
PORTFOLIO/SERIAL/ PASS-CO/SCRIPOPASS/PERITO
NUMBERS MUST BE CLEAR AND READABLE
GLOBAL CEASE AND DESIST ORDER: This is to C&D all previous KYCs issued and or
have been hijacked or presented without the authorization of the legal holder/custodian of
the boxes. This is a legal document.
PHOTOGRAPHS OF THE BOND(S) clear front and back images must be included
within this package where at all possible, as well as the SKR and authentication
documents.
PROOF OF LIFE: POL must show HEAD SHOTS: Clear Photo of Boxes submitted with
current newspaper (date circled in RED). Clear unobstructed HEAD SHOTS of Owner with
all Four Corners of the FRONT OF BOX (FULL VIEW UNOBSTRCTED). To the left of the
FRONT of the BOX, all four corners exposed of the MATCHING Authentication Document,
Full View, the coupons (clear view of all coupons) determine the value of the bond(s). The
BACK OF BOX, full view with the current newspaper (date circled in red) with Head shot
and PASSPORT to the left OF BOX (no fingers or hands in the pictures. FLAT
PICTURES-- Lay PASSPORT flat to the left of the BACK OF BOX on top of current
newspaper (date circled in red), full view all coupons exposed (NO OBSTRUTIONS)
(such hand & fingers). Flat PICTURES--are the same PICTURES AS THE HEAD SHOTS
MINUS THE HEAD. Most critical, all Documents submitted in the KYC PKG have to be
the same date as the Newspaper DATE USED IN THE Head Shots. The data on the
boxes and authentication reports have to be legible, and the passport of the Owner open
at the information page. SKRs: If bonds are in Safe Custody of a bank, attorney or
Security house, then the SKR must be included in the Photo in lieu of the bonds. (the SKR
has to have full description of all boxes and authentication reports. BOXES: The
submission of Boxes require Headshots of each box submitted in the outlined procedures
stated above in the POLs section. These procedures are required for all Boxes submitted.
Each Box must have individual POLs front and back along with the authentication
documents, newspaper, passport & head shots
PROOF OF CUSTODIAL BOX HOLDER: You must prove you are custodian and provide
a pictures of all four sides as well as top and bottom of the each boxes submitted in series
(If submitting more than 10 boxes of one type (eg Farmer, Liberty,Petchili, Lung Tsing U
Hai Railway Bond, etc) in one submission,you must provide an unlocked Excel
Spreadsheet in addition to what is being submitted in the KYC Package of each type). The
proof of Custodian can be in the form of an SKR from a secure depository following SKR
procedures stated above. A list showing all box serial numbers and corresponding
authentication document numbers is also required.
SAFE KEEPING RECEIPTS: A copy of these must be included showing all pages that
make up the document issued by the Security facility. To have a valid SKR, must be a
recognized security facility. The SKR receipt must be displayed with a Head Shot, Current
Newspaper and full description of the box number and authentication number following the
instructions stated.
I, Leonides C. Bautista, have read the above requirements, and by signing below accept
full responsibility for all the information stated in this application to be true to the best of my
knowledge and belief.
__________________________________________
Directions: This document must be completed in full. If a line item does not pertain then
insert the term: N/A (non-applicable).
Client Information:
First Name :
Last Name :
Gender :
Date of Birth :
Social Security Number :
Country of Citizenship :
Passport Number :
Date of Issue :
Date of Expiry :
Issuing Authority :
Bank Information
Bank Name : T.B.A
Street Address : T.B.A
City : T.B.A
State : T.B.A
Country : T.B.A
Postal Code : T.B.A
Account Name : T.B.A
Account Number : T.B.A (May be left T.B.A. and disclosed at closing)
IBAN Number : T.B.A
SWIFT Code : T.B.A
Account Signatory (1) : T.B.A
Account Signatory (2) : T.B.A
Bank Officer # 1 Name : T.B.A
Bank Officer # 2 Name : T.B.A
Telephone Number : T.B.A
Fax Number : T.B.A
Origin of Boxes: Multi Year History and I am the Custodian Box Holder.
I, xxxxxxxxx, hereby swear under penalty of perjury, that I am the Custodian Box Holder of
these Boxes The information provided herein is accurate and true as of this date:
Date:
Client Code:
Dear Sir,
I hereby declare that I am fully aware of the information received from you is in direct
response to my request, and is not in any way considered or intended to be a solicitation
of any sort and is proposed for our general knowledge only. I hereby affirm under penalty
of perjury that you have not solicited me in any way. I understand that the contemplated
transaction is strictly one of a private transaction, and does not in any way rely upon, or
related to, the United States Securities Act of 1933, as amended or related regulations,
and does not involve the sale of securities.
That affiant makes this affidavit knowing that the recipients will rely on the contents hereof,
and hereby agrees to indemnify and hold-harmless all recipients and all other parties,
including intermediaries, against any and all claims resulting from any applicant
misrepresentation of a material fact or any loss of asset value or any act (legal or not) of a
bank or other financial institution, governing authority or agency, the Federal Reserve or
an official or other insider of any such entity. Further, I hereby declare we are not licensed
brokers or Government employees, and understand that neither are you or your
organization. We mutually agree that this private transaction is exempt from the Securities
Act, and not intended for the general public, and all materials are for private use only.
Any unauthorized disclosure of all transaction(s) parties to, or other material fact of, such
transaction(s) shall subject the violator to criminal prosecution.
IN AS MUCH, as any document passed through the hands, or electronic equipment of any
person, Broker, Intermediary or Entity not signatory to this / these transaction(s), or
authorized by said
Signatories, and any material fact provided to any person, Broker, Intermediary, or Entity
not signatory to any transaction, allowed herein, or as required by applicable law, will
immediately VOID the transaction and subject the violator to criminal prosecution.
By signing this document, I, the undersigned, take full responsibility and hereby indemnify
and hold harmless the redeemer, as well as, where applicable, his respective officers,
directors, partners, shareholders, associates, affiliates and employees against any and all
improprieties, misrepresentations or omissions arising out of my completion of this
document.
I, the undersigned, further undertake to guarantee that all facts and information, written
and/or verbal, which has been rendered regarding these boxes are accurate, correct and
true, and can be relied upon completely, fully and totally by all parties involved.
_____________________________________
Passport number:
Country of Issue:
Date:
I warrant and attest these asset(s) are not involved, submitted for or involved in any other
transaction and are free of liens, are not encumbered and that there is no third party
interest or JV Agreements with any party connected to this asset.
Upon request, we can provide or issue any Cease and Desist to prior groups through
whom I have attempted to redeem my boxes if applicable.
I hereby authorize you on our behalf to communicate with authorized parties to bring the
transaction to a completion. I further understand and am fully aware that this transaction
will be registered with the necessary authorities including a Redeemer and or Trade Entity
and their bank and the submitted private and confidential paperwork will be forwarded to
the proper authorities for the sole purpose of establishing the necessary dossier for the
due diligence and clearance required for this transaction.
This exclusivity is granted and effective for a thirty-one (31) business days from date
signed and will remain in effect until cancelled by me in writing.
Signed this
_____________________________________________
SIGNATURE OF THE CUSTODIAN BOX HOLDER/AUTHORIZED SIGNATORY
Date:
Dear Sir,
I, , bearing China Passport No.:, of address I, the undersigned, hereby confirm under
penalty of perjury, my full commitment and agreement to redeem these boxes, subject to
negotiations.
The price is to be approved by the Custodian Box Holder upon engagement. Because this
transaction is extremely large, it is important that all aspects are discussed between the
Custodian Box Holder and Redeemer only (not mandates) for security and privacy
purposes.
Signed this
_____________________________________________
SIGNATURE OF THE CUSTODIAN BOX HOLDER/AUTHORIZED SIGNATORY
History of Assets:
Assets have been in safekeeping at ____________________________ for the past minimum
of _____ (_) years.
Note: If the subject Assets were not in safekeeping for a minimum of Three (3) years,
applicant must state below the previous location of where the Assets were held on
deposit:
Previous Location of Assets:
Bank/Institution Name :
Address :
City :
Country :
Account Holders Name :
Account Number :
Safety Deposit Box Receipt
Provide all details on the previous Custodian Box Holder of the Boxes if acquired from a
previous Custodian Box Holder:
___________________________
Passport Number :
Date of Issue :
Date of Expiry :
Country of Issuance :
Email Address: :
In signing below, we attest that the Custodian Box Holder is the registered Custodian Box
Holder of the Asset described above and that the Custodian Box Holder signed above on
his/her own free will.
___________________________
Name of Witness :
Passport Number :
Date of Issue :
Date of Expiry :
Country of Issuance :
Email Address: :
___________________________
Name of Witness :
Passport Number :
Date of Issue :
Date of Expiry :
Country of Issuance :
Email Address: :
Date:
I, xxxxx, bearing China Passport No.: xxxxxxxx, located at hereby affirm, attest and certify,
under penalty of perjury, that the boxes described below:
BOX TYPE, AUTHENTICATION Location of
DENOMINATION BOX NUMBER Details Bonds
(EG Farmer 250 k Pass Co, Perito,
Farmer 500K Scripofilia or expertise Country,
Farmer 1M, Farmer Type and Certificate depository,
2M) Number SKR number
1
2
3
4
5
held at [institution name and address] are authentic, valid and available for immediate
redemption.
These boxes were lawfully acquired through commercial enterprise of non-criminal origin
being free and are clear of any and all liens and encumbrances and I am authorized to
offer them for Redemption.
I also affirm, attest and certify that the proceeds derived from any use of the funds shall be
utilized in a legal manner for either commercial, personal or charitable purposes at my
election.
I further acknowledge that the Redeemer, with its Directors, as well as their respective
officers, directors, partners, shareholders, associates, affiliates, employees, partners and
assigns, has no direct knowledge that the Custodial Box Holder is legal or valid at this time
and Redeemer is relying upon the representations and warranties of the undersigned.
I further affirm, attest and certify that I am not affiliated, associated or employed, either
directly or indirectly, with any governmental agency, either officially or unofficially, or under
duress. I further affirm, attest and certify that my actions, either directly or indirectly, with
respect to the redemption of these boxes are not a part of any governmental investigation,
covert or otherwise.
WHEREAS; The President of the United States of America did sign H. R. 3723 on October
11, 1996 thus protecting all transactions conducted in currency of the United States of
America by allowing Corporations the right to declare their Contracts, Clients, Internal
Procedures, Information, and the transactions in which they engage, to be classified as
Corporate, or Trade Secrets fully protected under the Economic and Industrial Espionage
Laws of the United States of America and the International Economic Community.
Any unauthorized disclosure of all transaction(s) parties to, or other material fact of, such
transaction(s) shall subject the violator to criminal prosecution.
IN AS MUCH, as any document passed through the hands, or electronic equipment of any
person, Broker, Intermediary or Entity not signatory to this / these transaction(s), or
authorized by said signatories, and any material fact provided to any person, Broker,
Intermediary, Professional Consultant or Entity not signatory to any transaction, allowed
herein, or as required by applicable law, will immediately VOID the transaction and subject
the violator to criminal prosecution.
By signing this document, the undersigned takes full responsibility and hereby indemnifies
and holds harmless Redeemer, as well as, where applicable, his respective officers,
directors, partners, shareholders, associates, affiliates and employees against any and all
improprieties or misrepresentations or omissions arising out of my completion of this
document.
The undersigned further undertakes to guarantee that all facts and information, written
and/or verbal, which has been rendered regarding these Boxes, are accurate, correct and
true, and can be relied upon completely, fully and totally by xxxxxxxxxx
I hereby swear under penalty of perjury, that the information provided herein is accurate
and true.
___________________________________
CUSTODIAN BOX HOLDER /SIGNATORY
NAME:
PASSPORT No.
PASSPORT COUNTRY OF ISSUE:
Issue Date:
Expires:
Date:
Dear Sir,
I furthermore hereby warrant and represent that, in the event that I have previously
submitted our Box Package to any other source for application for the redemption of the
Boxes, for the procurement of the aforementioned and herein desired sale, that we
subsequently have issued the required Cease and Desist Order to that other source,
canceling all activities thereto.
Facsimile documents, when properly endorsed are hereby declared as originals, and
originals may be obtained upon request.
Signed this
_________________________________
Date:
Dear Sir,
Notification of our Official Global Cease and Desist to all Parties and all the
unknown people and companies that are working on my/our file, on the redemption
of our Boxes as further described below:
Transaction Code: ____________________ and any code that has been used
without our knowledge.
As of today the Redeemer and his mandates, ALL other parties working with above boxes
are hereby instructed to immediately cease and desist any and all further efforts to place
or use in any manner, the above described assets in any connection with a Redemption,
or Investment transaction, or any other transactions which any other associated party
(ies), or any associates (Internationally) may have considered or have proposed.
All copies and originals of all our papers, documents, statements, and other pertinent
information, submitted to any individuals or companies with the intention of entering in to a
Private Investment Program are hereby declared Null and Void for the following:
This cancellation is effective immediately as of the date of this letter. Accordingly, all
parties hereby instructed to Cease and Desist from any further action with the intention to
cause redemption of Private Placement on our Instruments or any other document in
support of our application. Demand is further made that all Parties other than the above
referenced, Corporate Directors and/or Signatories must immediately destroy any and all
copies of any documents that have been provided in connection with the above described
Instruments/Boxes.
All parties further served notice that in the event we become aware that any of you and
any of your associates, group or entity, have, after the issuance of this international
Cease and Desist Instruction attempted to continue in the subject matter, then we reserve
the right to seek and obtain, in addition to any legal remedy or claim for damages,
injunctive relief to restrain the unauthorized distribution of our confidential documents, as
unlicensed distribution of our confidential documents, as unlicensed negotiation of the
investment envisaged in this instruction.
Initials________ For Compliance Processing 21 of 33
GLOBAL CEASE AND DESIST ORDER EFFECTIVE IMMEDIATELY
(continued)
Finally, demand is made that this Global Cease and Desist is to be forwarded to any
persons or entity (ies) to whom any documents or other pertinent information regarding
this account may have been obtained: That any such person comply with this order, the
demands, and directions contained herein, and that each and every one of them forward
this Cease and Desist to any persons or entity (ies), to whom they may have given or
received any information regarding this account. Appropriate action will be taken in the
event of failure to comply with this demand to International Cease and Desist.
A facsimile, email, scanned copy of this document with scanned signature shall have the
same force and effect as the original.
___________________________________
CUSTODIAN BOX HOLDER /SIGNATORY
NAME:
PASSPORT No
PASSPORT COUNTRY OF ISSUE:
Issue Date:
Expires:
Date:
We, (Name of Law firm), represented by the attorney whose name is subscribed to this
Certificate and who is licensed, and registered in the (Name of Jurisdiction)........., and
domiciled at.........................(Street Address of law firm and/or attorney) hereby confirm
with full legal accountability and responsibility we certify that......(Name of Custodian Box
Holder ).xxxxx, holder and bearer of currently valid China ), Passport Number xxxxxx,
are the legal custodian box holder/ and holder of the following financial instrument or
Boxes:
Please be advised that while we are able to confirm the legal authority of the Custodian
box holder and custodian of the herein described boxes based on our information and
belief, we are not able to verify the authenticity of the instrument itself. Therefore, please
be advised that neither we nor .....(xxxxxx/Custodian Box Holder)......., hold any
insurance for these boxes.
We confirm that the above described boxes are currently in custodial safekeeping
with................
........(Name and Street Address of Depository/Bank).............. as evidenced by the
attached Safekeeping Receipt Number................... or are housed in Safe Deposit Box
# ..........., at............(Name and Street Address of location)......................
The above described boxes are available at any time, upon a request to xxxxxx
instructions.
Signature:_______________________________
Name of Attorney Certifying the Bonds
License Number:
Issuing Authority:
Expiry Date:
WHEREAS, the Undersigned wish to enter into this Agreement to define certain
parameters of the future legal obligations, are bound by a duty of Confidentiality with
respect to their sources and contacts. This duty is in accordance with the International
Chamber of Commerce Convention (I.C.C. 500) Paris, France.
WHEREAS, the Undersigned desire to enter a working business relationship to the mutual
and common benefit of the parties hereto, including their affiliates, subsidiaries,
stockholders, partners, co-ventures, trading partners, and other associated organizations
(herein after referred to as Affiliates).
The parties will maintain complete confidentiality regarding each others business sources
and/or their Affiliates and will disclose such business sources only to named parties
pursuant to the express written permission of this party who made available the source;
and
That they will not in any of the transactions the parties are desirous of entering into and
do, to the best of their abilities assure that the transaction codes established will not be
affected and
That they will not disclose names, addresses, email address, telephone and facsimile or
telex numbers to any contacts by either party to third parties and that they each recognize
such contracts as the exclusive property of the respective parties and that they will not
enter into any direct negotiations or transactions with such contracts revealed by the other
party and
That they further undertake not to enter into business transaction with banks,
investors, sources of funds or other bodies, the names of which have been provided
by one of the parties to this agreement, unless written permission has been
obtained from the other party (is) to do so. For the sake of this agreement, it does
not matter whether information obtained from a natural or a legal person. The
parties also undertake not to make use of a third party to circumvent this clause.
That in the event of circumvention of this Agreement by either party, directly or indirectly,
the circumvented party shall be entitled to a legal monetary penalty equal to maximum
service it should realize from such a transaction plus any and all expenses, including but
not limited to all legal costs and expenses incurred to recover the lost revenue. All
consideration,
Initials________ For Compliance Processing 25 of 33
NON-CIRCUMVENTION / NON-DISCLOSURE
INTERNATIONAL CHAMBER OF COMMERCE (I.C.C.)
(continued)
This agreement is valid for any and all transactions between the parties herein and shall
be governed by the enforceable law in Australian Courts, Canadian Courts, USA Courts,
English Courts, German Courts, French Courts, Singapore Courts, Hong Kong (SAR) or
under Swiss Laws in Zurich.
For any disputes, the arbitration laws of the ICC in London, United Kingdom, or Paris,
France shall apply.
The signing parties hereby accept such selected jurisdictions as the exclusive venue. The
duration of the Agreement shall perpetuate for five (5) years from the date hereof and will
supersede any and all other documents dated and issued later and cannot be cancelled by
issuance of any Global Cease and Desist Orders or any other documents intended to void,
cancel or supersede this document. All Consultants of Record who are listed on the
Genealogy Form or Genealogy List and are involved with the initial submission of the Box
Holder/Custodians documents will be covered by this NCND and cannot be eliminated
from getting paid by subsequent updates or re-submissions of other documents to the
Buyer.
________________________________
CUSTODIAN BOX HOLDER /SIGNATORY
NAME:
PASSPORT No.
PASSPORT COUNTRY OF ISSUE:
Issue Date:
Expires:
____________________________
CUSTODIAN BOX HOLDER /SIGNATORY
NAME:
PASSPORT No.
PASSPORT COUNTRY OF ISSUE:
Issue Date:
Expires:
2. If available picture of the actual Box/Bond front and picture of actual Boxes/Bonds
back (with seller passport, newspaper header (NOT OLDER THAN 3 DAYS FROM
SUBMISSION DATE)
3. If boxes are in a Secure Storage Facility; photo of seller with SKR(s), newspaper
header and passport is acceptable.
Box images must be clear and readable and show the bond number clearly