Application to Borrow Bank Instruments

01

Lessor / Intermediary Reference

If this link was not received directly from us, enter the intermediary’s details.

CompanyNameEmail

Borrower’s Company Information

Company Name *Address *City *State / ProvinceZIP / Postal Code

Authorised Signatory

Authorised Signatory (Full Name) *Address *City *Country *Email *Required to receive the contract.

02

Borrower’s Designated Bank

Not a bank on US territories

Bank Name *Branch *SWIFT Code *Address *CityPhone *Bank Officer in Charge *Account Holder *Account Number *

Borrower’s Receiving Bank

Complete only if different from the designated bank.

Not a bank on US territories

Receiving Bank NameBranchSWIFT CodeAddressCityPhoneBank Officer in ChargeAccount HolderAccount Number

03

Confirmation Option

Choose one option * Receive the instrument by SWIFT MT760 to my designated bank Receive Proof of Funds (POF) instead of the instrument

Bank Instrument Requested

From the List # *Type *Issuing Bank *Currency *Amount *Minimum 5 million in any currency.ISIN Code (12-digit) *Price Fees % *

Options

With Pre-Advice * Yes NoA pre-advice is necessary only if required by the client’s bank and carries an additional cost.

Monetization of the Chosen Instrument * Yes No

04

Bank Expenses — Call Option Reservation

We are ready to deposit in a designated account the bank expenses necessary to reserve the bank instrument:

From 5M to 499M€20,000

From 500M to 999M€25,000

From 1 Billion onward€30,000

We are also ready to cover, against invoice, the €85,000 expense for delivery of the Pre-Advice. Reservation and pre-advice fees will be refunded after successful closing by the Lender or deducted when leasing fees are paid.

Brief Summary of the Financial Project

Every leasing request must be accompanied by a brief description on company letterhead of the project or purpose.

Project Description Project description on company letterhead (PDF, DOC, DOCX — max 10 MB)

Confirmed and Approved by the Borrower

The person signing this form must be the Borrower. Any abuse of this document will be fully prosecuted by law. The sending of this document is monitored and the source is known.

Signature *

Use your mouse or finger to draw your signature.

Authorized Signature Printed Name *Title *Date *

05

Client’s Information Sheet

Face Value Amount Requested *Currency *Type *

Leasing Fees Payment Terms

Select one * 1) Conditional Irrevocable Corporate Pay Order endorsed by borrower’s bank

Issue Date *Expiration Date *

2) Bank Backed Promissory Notes with aval and/or endorsement of an acceptable bank 3) Conditional SWIFT MT103 or MT700

Mode of lease: SWIFT transfer of the instrument by MT760

Borrower Full Name *Title *Nationality *Passport Number *Issued Country *Issue Date *Expiration Date *Company Name *Office Address *Mobile Phone *Business Telephone *Business FaxEmail *Legal Advisor NameLegal Firm Email AddressLegal Firm Phone Number

06

Required Confirmations

My bank is listed in the International Bankers Almanac * Yes NoIf no, you must prepare a closing bank with all details received from your banker sent to the Provider.

Confirmed and approved by the Borrower (Corporation Name) * Yes No

Procedure and contract confirmation * I confirm that I have read the procedure and draft contract, am ready to sign it, and will pay the reservation fee invoice attached to the contract within five banking days.

The person signing this form must be the Borrower. Any abuse of this document will be fully prosecuted by law. The sending of this document is monitored and the source is known.

Signature *

Use your mouse or finger to draw your signature.

Authorized Signature Printed Name *Title *Date *

07

Review and Submit

Review the information below before sending your confidential application.

Do not submit this confidential application from a public or shared device.