OffshoreSimple.com

Bank Account Application for the
OFFSHORE COMPLETE PACKAGE
ORDER FORM

Please use this form for Offshore Complete Package ORDERS .

PLEASE COMPLETE IN FULL. Receipt of this form plus full payment (check here payment options and fees)  will constitute a confirmed and irrevocable order. Proceeding beyond this point and submitting this form is on this strict understanding. Forms received without matching payment will be held for a maximum period of 1 month then destroyed.

Contact us for general inquires.

If you would rather send us this form encrypted with PGP, please DON'T fill in the boxes yet, but highlight the whole of the form using your mouse (or Ctrl+A), save to clipboard using Ctrl+C then paste into your PGP program. Then indicate the names, options etc., you would like and when complete, encrypt and contact us . Don't forget to send your public key for us to reply to you using PGP!

US Fax: +1 212 202-6468 
UK Fax: +44 207 900 1987

Please incorporate the following Company, details as below, as soon as possible. I have authorized payment to you by the method indicated at the foot of the order form.

For your review:

We will combine your offshore company application, with this application for the bank account, cards and merchant account, (you must use the same e-mail address),
will calculate your total, and apply your discount,
after that we will send you a confirmation e-mail with your order number and payment instructions.
 
Corporate Bank Account (€450)

 
Internet Banking log-on details:
(You'll be provided with a password that you will have to change at first log on)
Username
*

 

Personal information
(Should be spelled exactly as in the ID)
Title
 
First name
*
Middle name
 
Last Name
*
Date of birth
In the format dd/mm/yyyy
*
Street, office/apartment number
*
City
*
State/province
 
Country
*
Zip/postal code
*
Your E-mail address: 
This must be the same you used to order the Offshore company !!  
*
 
Identification document details
(valid passport, DL or ID card)
ID number
*
ID was issued on
In the format dd/mm/yyyy
*
ID expires on
In the format dd/mm/yyyy
*
City and country where ID was issued
*

 

 
Company's official representative details
Title
First name
*
Middle name
Last name
*
Date of birth
Date in form dd/mm/yyyy
*


Actual user personal information (passport, DL or ID card) details
Title
First name
Middle name
Last name
Date of birth
Date in form dd/mm/yyyy


Actual user identification document (valid passport, DL or ID card) details
ID number
ID was issued on
Date in form dd/mm/yyyy
ID expires on
Date in form dd/mm/yyyy
City and country where ID was issued

OPTIONS (not included in the package price)

Debit Card  details (if you need one)
Please note that Apostille on the Signature Sample Card we will send you will be required.

 SUPER BONUS: 1/2 Price for first debit card !

VISA Electron debit Card    € 180  €90   (now with on-line access !!)
or    Maestro debit Card   € 180  180  €90      (now with on-line access !!)
The name of the card holder and the name of the company will be embossed on the card

No debit card. Thank you 

Card account options

Would You like to receive monthly statements
Click on a circle next to an appropriate option.
*
Yes   No

OR
Please note that Apostille on the Signature Sample Card we will send you will be required.

International ATM CashCard   € 190 €95
 (card number and card account number embossed on the card)

Corporate Card account options

Would You like to receive monthly statements
Click on a circle next to an appropriate option.
*
Yes   No

 

Credit  Cards details (if you need one)
Please note that Apostille on the Signature Sample Card we will send you will be required.

Card account options
Card type
Click on a circle next to an appropriate option.
*
No credit card. Thank you.
VISA Classic € 250
VISA Business € 290
VISA GOLD € 350
EC/MC Mass € 250
EC/MC Business € 290
EC/MC Gold € 350
How would you like it to be embossed
Maximum 24 characters.
*
Would You like to receive monthly statements
Click on a circle next to an appropriate option.
*
Yes   No

Security deposit:
* VISA Classic, MasterCard Mass:
       € 3,000
* VISA Business, MasterCard Business:
       € 4,000
* VISA Gold, MasterCard Gold:
       € 5,000
You'll have to send to the bank (directly), prior to account opening.

Virtual Card details (if you need one)

Login name
*
Card type
Click on a circle next to an appropriate option.
*
VISA   MasterCard
Currency of the card account
Click on a circle next to an appropriate option.
*
€   GBP   
Account validity period
*
  3 months: €20
  6 months: €36
  9 months: €50
12 months: €60
 
Bank account package delivery service:
Courier delivery service.
Please note that it costs an extra 100 €
DHL      FedEx      UPS   
In case you don't select courier delivery, the package will be delivered by registered post. 

 

Cards DELIVERY option.
The cards can be prepared and sent to you only AFTER the account will be activated.
It means that we have to send you another package with the cards.
Cards courier delivery service.
Please note that it costs an extra 100 €
DHL      FedEx      UPS   

In case you don't select courier delivery, the CARDS will be delivered by registered post.
 

 

Banking papers Delivery  details
Name
*
Street, office/apartment number
*
City
*
State/province
*
Country
*
Zip/postal code
*
Phone number
*

Write here please any comments
or observations related to your order.

  

 
Information presented by me is true and correct

Please send a copy of your passport, either scanned and attached to an email,
either faxed to:  US fax: +1 212 202-6468 or UK fax: +44 207 900 1987

 
Delivery Details

Please provide us with a Name and Address for delivery of the Company Kit. This can be anywhere in the world and can itself be a mail drop address if you require additional privacy. Please note however that because we normally deliver by Courier, we must have a full street address. A P.O. Box or General Delivery address will not suffice. If you do insist on a P.O. Box or a General Delivery address, your Company documents will be sent to you by ordinary mail. If this happens, delivery by sea-mail can be lengthy - several weeks in fact. If any banking facilities are required, your name and street address are a must.

DELIVERY address of incorporation documents:
 

Name: 
Street Address: 
District: 
City:
State/County:
Zip/Post Code:  
Country:
Phone:

In case we need to contact you we would appreciate some contact numbers. These are optional however but please note that if there is a problem with your order and we cannot contact you other than by post, substantial delays could occur and we cannot be held responsible for any actual or consequential loss due to these delays.

If you wish to receive ANY return e-mail correspondence from us, your e-mail address is a must!

E-mail:     
Telephone:
Fax:  (Please include your country code.)

Merchant Account: details

Yes, I want the merchant account that comes with the package.
No, thank you.

Payment Methods

I will pay by:   Please check here all accepted payment methods 



Total of your order €:
(don't forget to click the "Send Order Now" button below)

Insert here any promotional code or special offer:

After you submit your order,
we will reply with a tracking number and payment instructions.

IMPORTANT NOTES:

1/ Please quote your name or e-mail address as a reference with your wire transfer. Otherwise we may not be able to tie in receipts with specific orders, which can delay the opening of your account!

2/ Please ensure that the GROSS order value is wired to our account. All currency exchange and wire costs, including those of any intermediary banks, MUST be debited from YOUR account.

ALL INFORMATION SUPPLIED IS TOTALLY CONFIDENTIAL AND WILL NOT BE DIVULGED TO ANY THIRD PARTY OTHER THAN TO ANY BANK CONCERNED WITHOUT EITHER YOUR EXPRESS PERMISSION IN WRITING OR UNDER THE TERMS OF A COURT ORDER.

Warning - before you order:  receipt of this form plus accompanying payment by any means will constitute a confirmed and irrevocable order. Please also read the Disclaimer on our Introduction Page.

     

 

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