(j PRVA BANKA CG S e~ OSNOV ANA 1901. PRISTUPNICA ZA ... · prema opstim aktima banke u duhu...

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(j S e~ PRVA BANKA CG OSNOV ANA 1901. Organisation Details PRISTUPNICA ZA ORGANIZACIJE ORGANISATION APPLICATION FORM Naziv organizacije Company Name Maticni broj Registration No. Poreski broj Tax.No. Ulica i broj Address Mjesto Town Lice ovlasceno za zastupanje Authorized representative Kontakt osoba Contact Person Kontakt telefon Contact Phone Pristup racunima kod drugih banaka? Access Accounts Held at Other Banks 0 Da 0 Ne Yes No Pristup racunima preko agencije? Access Accounts Via Agency ODa ONe Yes No Internet bankarstvo Intemet Banking 0 Web servis Web Service 0 FX Desktop aplikacija FX Desktop Application 0 WAP servis WAP Service 0 FX Enterprise aplikacija FX Enterprise Application Mobilno bankarstvo Mobile Banking 0 SMS servis SMS Service Tele bankarstvo Tele Banking 0 Govorni servis Interactive Voice Response 0 Faks servis Fax Obavjestenja Alerts 0 Faks obavjestenja FaxAlerts 0 E-mail obavjestenja E-mail Alerts 0 SMS obavjestenja SMS Alerts I..;l='r. m1 t;) IT1 oi , Ii 11, I f; 1 Account Details Valuta Currency Tip racuna* Account Type. Broj racuna Account Number Authorized Users * Tip racuna: tekuci I devizni I oroceni depozit I kredit * Account type: current / foreign / term deposit / loan Ime i prezime Name and Surname JMBG National ID Number .-. Izjavljujem pod punom materijalnom i krivicnom odgovornoscu da su podaci u ovoj pristupnici tacni. Prihvatam Opste uslove koriscenja usluge elektronskog bankarstva koji su prilog ove pristupnice. Svi odnosi koji proisteknu koriscenjem usluge elektronskog bankarstva bice regulisani prema opstim aktima banke u duhu pozitivnih zakonskih propisa. Ovim ovlascujem banku da gore navedene racune zaduzi za transakcije i troskove nastale koriscenjem usluge elektronskog bankarstva prema vazecim tarifama banke bez prethodnog obavjestenja. I hereby confirm under penalty of perjury or fraud that all details I have given in this form are true and accurate. I have received, understand, agree with and accept the General Terms and Conditions with this Application Form. All issues resulting from use of electronic banking services are to be regulated according to the General Act of the bank and applicable laws. I hereby irrevocable authorize the bank to charge my accounts listed above with all transactions and fees resulting from the use of electronic banking services, according to its effective Bank Tariff without prior notice. Pecat i potpis zastupnika ill prokuriste Stamp and Signature of Authorized Representative ~;\'r.II'r.I~I~ Broj pristupnice Application Number Pristupno mjesto Place of Application Datum prijema Application Date Primio Acceptant Transakcije Kolektivni potpis Transactions Group Authorization 0 Da 0 Ne 0 Da 0 Ne Yes No Yes No 0 Da 0 Ne 0 Da 0 Ne Yes No Yes No 0 Da 0 Ne 0 Da 0 Ne Yes No Yes No

Transcript of (j PRVA BANKA CG S e~ OSNOV ANA 1901. PRISTUPNICA ZA ... · prema opstim aktima banke u duhu...

Page 1: (j PRVA BANKA CG S e~ OSNOV ANA 1901. PRISTUPNICA ZA ... · prema opstim aktima banke u duhu pozitivnih zakonskih propisa. I hereby confirm under penalty of perjury or fraud that

(j Se~PRVA BANKA CG

OSNOV ANA 1901.

Organisation Details

PRISTUPNICA ZA ORGANIZACIJEORGANISATION APPLICATION FORM

Naziv organizacijeCompany Name

Maticni brojRegistration No.

Poreski brojTax.No.

Ulica i brojAddress

MjestoTown

Lice ovlasceno za zastupanjeAuthorized representative

Kontakt osobaContact Person

Kontakt telefonContact Phone

Pristup racunima kod drugih banaka?Access Accounts Held at Other Banks

0 Da 0 NeYes No Pristup racunima preko agencije?

Access Accounts Via AgencyODa ONe

Yes No

Internet bankarstvoIntemet Banking

0 Web servisWeb Service

0 FXDesktop aplikacijaFX Desktop Application

0 WAPservisWAP Service

0 FXEnterprise aplikacijaFX Enterprise Application

Mobilno bankarstvoMobile Banking

0 SMS servisSMS Service

Tele bankarstvoTele Banking

0 Govorni servisInteractive Voice Response

0 Faks servisFax

ObavjestenjaAlerts 0 Faks obavjestenjaFaxAlerts 0 E-mail obavjestenja

E-mail Alerts0 SMS obavjestenja

SMS Alerts

I..;l='r.m1 t;) IT1 oi ,Ii 11, I f; 1 Account Details

ValutaCurrency

Tip racuna*Account Type.

Broj racunaAccount Number

Authorized Users

* Tip racuna: tekuci I devizni I oroceni depozit I kredit* Account type: current / foreign / term deposit / loan

Ime i prezimeName and Surname

JMBGNational ID Number

.-.Izjavljujem pod punom materijalnom i krivicnom odgovornoscu da su podaci u ovoj pristupnici tacni. Prihvatam Opste uslove koriscenja uslugeelektronskog bankarstva koji su prilog ove pristupnice. Svi odnosi koji proisteknu koriscenjem usluge elektronskog bankarstva bice regulisaniprema opstim aktima banke u duhu pozitivnih zakonskih propisa. Ovim ovlascujem banku da gore navedene racune zaduzi za transakcije itroskove nastale koriscenjem usluge elektronskog bankarstva prema vazecim tarifama banke bez prethodnog obavjestenja.

I hereby confirm under penalty of perjury or fraud that all details I have given in this form are true and accurate. I have received, understand, agreewith and accept the General Terms and Conditions with this Application Form. All issues resulting from use of electronic banking services are to beregulated according to the General Act of the bank and applicable laws. I hereby irrevocable authorize the bank to charge my accounts listedabove with all transactions and fees resulting from the use of electronic banking services, according to its effective Bank Tariff without prior notice.

Pecat i potpis zastupnika ill prokuristeStamp and Signature of Authorized Representative

~;\'r.II'r.I~I~

Broj pristupniceApplication Number

Pristupno mjestoPlace of Application

Datum prijemaApplication Date

PrimioAcceptant

Transakcije Kolektivni potpisTransactions Group Authorization

0 Da 0 Ne 0 Da 0 NeYes No Yes No

0 Da 0 Ne 0 Da 0 NeYes No Yes No

0 Da 0 Ne 0 Da 0 NeYes No Yes No

Page 2: (j PRVA BANKA CG S e~ OSNOV ANA 1901. PRISTUPNICA ZA ... · prema opstim aktima banke u duhu pozitivnih zakonskih propisa. I hereby confirm under penalty of perjury or fraud that

CJ PRVA BANKA CG Ei'IT-1TII11f -

OSNOV ANA 1901.

Personal Details

PODACI 0 OVLASCENOM KORISNIKUAUTHORISED USER DETAILS

Mobilni telefon*Mobile Phone"

Faks*Fax"

JMBGNationalIDNumber

Ime i prezimeName and Sumame

Ulica i brojAddress Postanski broj

Postal Code

E-mail*E-mail"

* Kontakt podaci ce biti upotrebljeni za dostavljanje obavjestenja* Contact details will be used to deliver alerts

1L;.c:r:m1t:)~Internet bankarstvoIntemet BankinIl

D Web servisWeb SeN/ce

D FXDesktop aplikacijaFX Desktop Application

D FX Enterprise aplikacijaFX Enterprise Application

D SMS servisSMSSeN/ce

Mobilno bankarstvoMobile Banking

D WAPservisWAP SeNice

Tele bankarstvoTele Banking

D Govorni servisInteractive Voice Response

D Faks servisFax

ObavjestenjaAlerts D Faks obavjestenja

FaxAlertsDE-mail obavjestenja

E-mail AlertsD SMS obavjestenja

SMS Alerts

Account Details

Broj racunaAccount Number

Tip obav.*I

Broj racunaAlerttype" AccountNumber

ValutaCurrency

Napomena*Note"

201 Zakazano obavjestenje 0 izvodu202 Zakazano obavjestenje 0 stanju101 Obavjestenje 0 prilivu201 Scheduled Statement Alert202 Scheduled Balance Alert101 Instant Income Alert

Dostavlja se dnevno. U napomenu unesite ocekivano vrijeme prijema obavjestenja .Dostavlja se dnevno. U napomenu unesite ocekivano vrijeme prijema obavjestenja.Dostavlja se momentalno. U napomenu unesite minimalni iznos priliva za prijem obavjestenja.Delivered daily. Use note field to specify expected delivery time.Delivered daily. Use note field to specify expected delivery time.Delivered immediately. Use note field to specify minimal amount of income to receive alert .

~1:(']I_~IT1...-Izjavljujem pod punom materijalnom i krivicnom odgovornoscu da su podaci u ovoj pristupnici tacni. Prihvatam Opste uslove koriscenja uslugeelektronskog bankarstva koji su prilog ove pristupnice. Svi odnosi koji proisteknu koriseenjem usluge elektronskog bankarstva bice regulisaniprema opstim aktima banke u duhu pozitivnih zakonskih propisa.

I hereby confirm under penalty of perjury or fraud that all details I have given in this form are true and accurate. I have received, understand, agreewith and accept the General Terms and Conditions with this Application Form. All issues resulting from use of electronic banking services are to beregulated according to the General Act of the bank and applicable laws.

Potpis ovlascenog korisnikaSignature of Authorized User

..~ Filled by the bank

Broj pristupniceApplication Number

Datum prijemaApplication Date

Pristupno mjestoPlace of Application

PrimioAcceptant

Valuta I Maksimalni iznos transakcije I

Transakcije Samostalni potpisCurrency Maximaltransactionamount Transactions SingleSignature

D Da D Ne D Da D NeYes No Yes No

D Da D Ne D Da D NeYes No Yes No

D Da D Ne D Da D NeYes No Yes No

Dostava prekoDeliveryvia

D Faks D SMS DE-mailFax SMS E-mail

D Faks D SMS DE-mailFax SMS E-mail

D Faks D SMS DE-mailFax SMS E-mail