Zahtev ovlašćenog lica o mestu i načinu dostavljanja naloga PP

ZAHTEV OVLAŠĆENOG LICA O MESTU I NAČINU DOSTAVLJANJA NALOGA PLATNOG PROMETA
EKSPOZITURAMA BANCA INTESA AD BEOGRAD / REQUEST OF THE AUTHORIZED PERSON ON THE PLACE
AND MANNER OF SUBMISSION OF PAYMENT ORDER IN BRANCHES OF BANCA INTESA AD BEOGRAD
REGISTROVANO POSLOVNO IME PRAVNOG LICA / PREDUZETNIKA: __________________________________________
REGISTERED BUSINESS NAME OF THE LEGAL ENTITY / ENTREPRENEUR:
_______________________________________________________________________________________________________
Sedište, adresa i opština:__________________________________________________________________________________
registered office, address and municipality:
Matični broj: /ID no.
Poreski identifikacioni broj-PIB:/TIN:
Šifra pretežne delatnosti: / Main activity code:
LICE OVLAŠĆENO ZA ZASTUPANJE PRAVNOG LICA / PREDUZETNIKA IZ REŠENJA O UPISU KOD NADLEŽNOG / Person
Authorized for Representation of the Legal Entity / Entrepreneur from the Decision on the Entry with the Competent registration
Body
REGISTARSKOG ORGANA: _______________________________________________________________________________
(ime i prezime, funkcija/name and surname, title)
________________________________________________________
(lični ili personalni broj iz (broj, mesto i datum izdavanja lične/putne isprave/ number, place and date of )
ličnog/putnog dokumenta/ personal ID no from issue of personal document / passport
personal document / passport )
OPREDELJENE EKSPOZITURE I OVLAŠĆENA LICA ZA PREDAJU NALOGA PLATNOG PROMETA /
DESIGNATED BRANCHES AND PERSONS AUTHORIZED TO SUBMIT PAYMENT ORDERS
Ekspozitura Banca Intesa ad / Banca Intesa ad Branch
R.
br./ser.no.
Opera -
tivni broj
Eksp./
branch
operational
no.
Adresa
Ekspoziture/
branch address
Broj tekućeg
računa pravnog
lica
/preduzetnika/
current account
no. of the legal
entity /
entrepreneur
Ovlašćena lica za predaju Naloga za prenos i Naloga za isplatu/
persons authorized to submit transfer orders and withdrawal
orders
Ime i prezime/ name and surname
Lični broj građana iz lične
karte (JMBG) / personal
ID number
1.
2.
3.
4.
Dovoljna je kontrola instrumenata platnog prometa u skladu sa pozitivnim zakonskim propisima u ekspoziturama banke
i ne želimo da imenujemo ovlašćene donosioce naloga
It is sufficient to control the payment instruments in accordance with positive legislations in the Bank’s branches and we
do not want to appoint persons authorized for submission of orders
Da/ yes

Naloge za prenos izvršavamo elektronskim putem, navedena ovlašćena lica izuzetno podnose Naloge za gotovinsku
isplatu i Naloge za prenos u navedenim ekspoziturama Banke
We execute transfer orders electronically, the stated authorized persons only exceptionally submit Withdrawal orders
and Transfer orders in designated Bank’s branches
Da / yes
___________________________
Mesto i datum podnošenja zahteva/
place and date of the application
Klijent/ client __________________________ (M.P) Radnik banke/ Bank employee__________
potpis lica ovlašćenog
štambilj i potpis/
za zastupanje pravnog
tamp and signature
lica/preduzetnika /
signature of the person
authorized for representing
legal entity / entrepreneur
Prilog: Izjava klijenta - ovlašćenog lica po ovom zahtevu, o pristanku za prukupljanje, obradu i korišćenje
podataka o ličnosti prema Zakonu o zaštiti podataka o ličnosti
Enclosure: Statement of the client- authorized person according to the request on the approval of collecting,
processing and using personal data according to the Law on Personal Data Protection