Personal data of persons making transactions

Personal data of persons making transactions

Personal data of persons making transactions / statements of will
in the name of the Account Holder
I. Account Holder's Data
Account Holder’s Name
Address for correspondence
Date of commencement of
operation by Account Holder
-
-
day - month
-
year
Account number
II. Personal data of persons authorized to make transactions / statements of will in the name of the Account Holder
Full Name
Nationality
Country
Town and Zip Code
Street, street No. or apt. No.
PESEL No. or date of birth1
Type of document
Series and number of document
Full Name
Nationality
Country
Town and Zip Code
Street, street No. or apt. No.
PESEL No. or date of birth1
Type of document
Series and number of document
Full Name
Nationality
Country
Town and Zip Code
Street, street No. or apt. No.
PESEL No. or date of birth1
Type of document
Series and number of document
1
PESEL No. (Polish Resident Identification Number) refers only to residents, date of birth for non residents
At the same time, we declare we take all responsibility for the correctness and completeness of above details and that we will remedy any damage incurred
by Bank Handlowy w Warszawie S.A. in connection with untrue or incomplete details provided above.
The Ordinance of the Minister of Finance of September 21, 2001 (Journal of Laws 01.113.1210 as amended)
Account Holder’s Signature
Date, stamp
Signature(s) of authorized persons consistent with the Account Holder's representation / power of attorney
The form should be sent at the following address:
Zespół Obsługi Dokumentacji Rachunków Korporacyjnych
Ul. Goleszowska 6, Bud. I p. 5
01-260 Warszawa