ANEXA Nr. si data/ ANNEX no. and date: Prezenta inlocuieste Anexa nr.

This annex replaces annex no. Sucursala/ Branch: CUI: Data/ Date: Operator de date cu caracter personal nr./ Personal data operator no.: 1547 din data: from date: Nr.Reg.Com:

ANEXA - SPECIMEN DE SEMNATURI - PERSOANE JURIDICE

ANNEX - SIGNATURE SPECIMEN - LEGAL ENTITIES Denumire Titular de cont/ Account holder name: CUI/CIF: Reprezentanti legali/ Authorised signatures Nume si prenume/ Name and surname:
Reprezentant 1
Tip* Limitari/ Limitations:** Type I A B Tip* Limitari/ Limitations:** Type I A B Tip* Limitari/Limitations:** Type I A B Tip* Limitari/ Limitations:** Type I A B Suma/ Amount:** Specimen semnatura Signature specimen Suma/ Amount:** Specimen semnatura Signature specimen Suma/Amount:** Specimen semnatura Signature specimen Suma/ Amount:** Specimen semnatura Signature specimen

Cod client/Client code:

Functia/ Position Tip act identitate/ID type: Serie si nr./Series and no: CNP: Nume si prenume/ Name and surname:

Reprezentant 2 Reprezentant 3 Reprezentant 4

Functia/ Position Tip act identitate/ID type: Serie si nr./Series and no: CNP: Nume si prenume/ Name and surname: Functia/ Position Tip act identitate/ ID type: Serie si nr./Series and no: CNP: Nume si prenume/ Name and surname: Functia/ Position Tip act identitate/ ID type: Serie si nr./Series and no: CNP:

Imputerniciti/ Empowered Nume si prenume/ Name and surname:

Imputernicit 1
Tip* Type Limitari/ Limitations:** Suma/ Amount:** Specimen semnatura/ Signature specimen

Functia/ Position Tip act identitate/ ID type: Serie si nr./Series and no: CNP: Nume si prenume/ Name and surname:

I A B Tip* Limitari/ Limitations:** Type I A B Tip* Limitari/ Limitations:** Type I A B Suma/ Amount:** Specimen semnatura Signature specimen Suma/ Amount:** Specimen semnatura/ Signature specimen

Imputernicit 2 Imputernicit 3

Functia/ Position Act identitate/ ID type: Serie si nr./Series and no: CNP: Nume si prenume/ Name and surname: Functia/ Position Tip act identitate/ID type: Serie si nr./Series and no: CNP:

*Se va marca "I" pentru semnatura individuala, "A" pentru prima semnatura si respectiv "B" pentru a doua semnatura/ To be marked "I" for individual signature, "A" for first signature and "B" for second signature. ** Se va completa de catre client cu tipul limitarii (limitare la operatiuni, sume, alte limitari agreate cu Banca)/ To be filled in by the client with the type of limitation (operations, amount,
EMPORIKI BANK ROMANIA S.A. Str. Berzei 19, Sector 1, Bucuresti, Romania. + 40 21 310.3955, + 40 21 315.9783; + 40 21 310.3991 bank@emporiki.ro; http://www.emporiki.ro

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Capital Social:196.089.737,27 RON Cod unic de inregistrare: 8490099 Reg. Comertului Nr. J40/3797/1996 Registrul Bancar Nr. RB-PJR-40-033/1999

Declaratii/ Declarations

In lipsa unor specificari exprese, se va intelege ca persoanele din lista de mai sus vor avea dreptul de a semna individual. In cazul in care se stipuleaza in mod expres ca semnaturile sunt complementare, se va intelege ca oricare doua persoane din prezenta lista pot semna impreuna. Clientul confirma ca persoanele imputernicite identificate mai sus au luat cunostinta si sunt de acord ca relatiile de afaceri cu banca sunt supuse Conditiilor Generale de Afaceri ale Bancii, cu toate modificarile si adaugirile ulterioare. Certificam prin prezenta ca informatiile din acest formular sunt corecte si ca semnaturile ce se regasesc in lista de mai sus au fost verificate in baza documentelor de identitate mentionate. Declaram ca am luat la cunostinta de prevederile Legii 677/2001 privind prelucrarea datelor cu caracter personal si libera circulatie a acestor date si de drepturile conferite de aceasta (dreptul de acces, dreptul de interventie asupra datelor, dreptul de opozitie, dreptul de a nu fi supus unei decizii individuale, dreptul de a ma adresa justitiei) si consimt in mod expres la prelucrarea datelor mele cu caracter personal de catre banca si/sau partenerii si imputernicitii acesteia. Sunt de acord ca Banca poate folosi datele mele cu caracter personal in scopuri statistice si de marketing.
Reprezentant legal/Authorised signature: Reprezentant legal/Authorised signature: Reprezentant legal/Authorised signature: Reprezentant legal/Authorised signature: Da/Yes Da/Yes Da/Yes Da/Yes Nu/No Nu/No Nu/No Nu/No

Unless otherwise specified, it will be assumed that each person listed on list above will have the right to sign singly. If joint signature authorization is expressly stipulated, it will be assumed that any two persons listed above may sign jointly. The client confirms that the empowered persons mentioned above have duly noted and agreed that his business relations with the Bank are governed by General Business Conditions of the Bank as amended from time to time and handed to us. We hereby certify that the information contained herein is correct and the signature(s) affixed above have been verified on the basis of the official identification documents mentioned above. We acknowledge the provisions of the law no. 677/2001 regarding handling and diffusion of Client's personal information and the rights provided by this law (access right, data modification, opposition right, the right of not submitting a individual decision, right to call the court) and I deliberately agree that my personal data can be processed by the bank and/or bank's partners and representatives. I agree that the Bank may use my personal data for statistic and marketing purposes.
Imputernicit 1/Empowered 1: Imputernicit2/Empowered 2: Imputernicit 3/Empowered 3: Da/Yes Da/Yes Da/Yes Nu/No Nu/No Nu/No

Prezenta Anexa este parte integranta a Cererii de deschidere de cont - Persoane Juridice nr. ., din data de ..
Semnaturi/ Signatures Titular de cont Nume/Name: Representanti legali / Legal representatives: Semnatura:

The Annex hereto constitutes itself part of the Account Opening Application- Corporate no. .., dated ..
Banca Nume/Name: Verificat de/ Verified by: Director Sucursala / Branch Manager Semnatura /Signature: Nume/Name: Functie/Position: Semnatura /Signature:

Nume/Name: Semnatura: Stampila/Stamp Authorised signature Stampila/Stamp

EMPORIKI BANK ROMANIA S.A. Str. Berzei 19, Sector 1, Bucuresti, Romania. + 40 21 310.3955, + 40 21 315.9783; + 40 21 310.3991 bank@emporiki.ro; http://www.emporiki.ro

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Capital Social:196.089.737,27 RON Cod unic de inregistrare: 8490099 Reg. Comertului Nr. J40/3797/1996 Registrul Bancar Nr. RB-PJR-40-033/1999