CLIENT INFORMATION SHEET

IN ACCORDANCE WITH ARTICLES TWO (2) THROUGH FIVE (5) OF THE DUE DILLIGENCE
CONVETION AND THE FEDERAL BANKING COMISSION CIRCULAR OF DECEMBER 1988, CONCERNING THE
PREVENTION OF MONEY LAUDERIN, THE FOLLOWING INFORMATION MAY BE SUPPLIED TO BANKS
AND/OR OTHER FEDERAL INSTITUTIONS FOR PURPOSES OF
VERIFICATION.

DE ACUERDO CON LOS ARTÍCULOS DOS (2) A CINCO (5) (5) DE LA DEBIDA CONVENCIÓN DE LA
DILIGENCIA Y LA CIRCULAR DE COMISIÓN FEDERAL DE BANCA DE DICIEMBRE DE 1988, SOBRE
LA PREVENCIÓN DEL DINERO LAUDERIN, LA SIGUIENTE INFORMACIÓN PUEDE SUMINISTRARSE A LOS
BANCOS Y / U OTRAS INSTITUCIONES FEDERALES PARA PROPÓSITOS DE VERIFICACIÓN.

CLIENT INFORMATION

Name: Francisco Jesús Guerrero Pacheco

Address: Street Avd. Puerta del Mar 58 3º C, 29680 ESTEPONA SPAIN

NIF Number: 78972055-Z

Issue Date: 01/04 2022

Expire Date: DEFINITIVE

Country of issue: Spain

BANK INFORMATION

Bank Name: Revolut Bank

Swift/bic code: REVOLT21

IBAN: LT82 3250 0469 4165 1107

Account Name: Francisco Jesús Guerrero Pacheco

Account Number: LT82 3250 0469 4165 1107

Bank Officer Name: REVOLUT BANCK, Francisco Jesús Guerrero Pacheco

DECLARATION: I hereby swear under penalty of perjury that the information provide here to is both true
and accurate. I am the signatory on the aforementioned bank account. All monies engaged in this
transaction are derived from non-criminal origin, and are good, clean and the origin of founds are in
compliance with anti- money laundering policies as set forth by the Financial Action Task Force (FATE)
6/01 and FATCA compatible

Fco. J. Guerrero Pacheco

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Declaración: Por la presente, lo juro bajo la pena de perjurio que la información resultó anteriormente es
verdadera y precisa. Soy el signatario en la cuenta bancaria antes mencionada. Todos los fondos dedicados
a esta transacción se derivan de origen no criminal, y son buenos, limpios y los originales de los
fundamentos cumplen con las políticas de lavado de dinero según lo establecido por la Fuerza de Task de
Acción Financiera (FATE) 6/01 y FATCA compatible

FCO. J. Guerrero Pacheco

__________________________________ FIRMA:
Francisco Jesús Guerrero Pacheco N° PASAPORTE:
PAL045920.
NIF: 78972055-Z

National Indentity Card

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Copy of Passport

Credit card Front Side

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Credit Card Back Side

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Receiver/Card Number: 4165 9800 3811 5073
Receiver/Card Holder Name: FRANCISCO J GUERRERO
Receiver/Card Expiration Date: 04/27
Receiver/Card Issuing Bank: REVOLUT LTD
Receiver/Card Type: VISA DEBIT CARD
Receiver/ISO Country A1 CODE: UNITED KINGDOM OF GREAT BRITAIN
Receiver/ISO Country A2 CODE: GB
Receiver/ISO Country A3 CODE: GBR
Receiver/ISO Country Number: 826
Receiver/Total Amount: 1,500,000,000 #USD#
Receiver/Amount First Tranche: 1,500,000,000.00 #USD#
Receiver/Approval Code: 3014
CVV: 465
Receiver/Global Time Transfer: Thursday, October 26, 2023 12:00:44 GMT-7
Receiver/Status Transaction: OK
Receiver/Date:10/26/2023 - Start time – 12:00:44 / Finish time – 12:14:18
Receiver/Operational Status: GREEN Verified
Receiver/Account Type: 101.1 ONLINE SALES 4 DIGIT PIN
Receiver/Special Instructions: ONLINE DEBIT ON

FROM : VISA INC

REUTERS CODE: USA.VISA.COM
VISA WORLDWIDE USA
042023-12:36:28
NOTE SCREEN DATE: OUT 10/26/2023
SCREEN TIME OUT 12:04:28 GMT-7
SCREEN VALUE DATE: 10/26/2023
SECURITIES INFORMATION:
SECURITY NAME: VISAINC_ORDSHR
ISSUEWR BANK: REVOLUT LTD [GB]
TYPE: VISA DEBIT CARD
ISSUER CATEGORY: CREDIT INSTITUTION
OPERATION ISIN: US92826C8394
CUSIP: 92826C839
WKN: AONC7B
SEDOL: BSJC9L6
CARD NUMBER: 4165 9800 3811 5073
EXPIRE DATE: 04/27
CURRENCY: USD
AMOUNT: 1,500,000,000.00
BENEFICIARY: FRANCISCO J GUERRERO
SETTLEMENT INFORMATION:
ACCOUNT: 758884
CBL ACCOUNT: 681
AVAILABLE ACC: 032
AUTHORIZED ACC: 927
CFI CODE: ESVUFR
PROTOCOL: 101/1
SERVER STATUS: ONLINE
CARD STATUS: ACTIVE

SYSTEMDEPARTMENT/ACCESS/VIS91 67248 12:04:28 5073

SCREEN FROM www.usa.visa.com/vis91/access
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