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Rabobank International
Standard Bank Confirmation - Application form (for Rabobank International customers only)
A. Information beneficiary (1)
Name of business:
Ms.
Name of applicant:
Mrs.
Mr.
Address:
When entity is established and physically located outside the Netherlands.
Zip Code:
Vat Code:
Domicile:
Country:
Telephone number:
E-mail:
Netherlands
-1 Beneficiaries hat have a Rabobank International account, need to list the account number under section B. When beneficiaries want to request Standard Bank Confirmations for groupcompanies,
section B needs to filled out completely as well (accountnumbers included). When beneficiary does not have a Rabobank International account, but beneficiary is a Rabobank International customer,
then account information can be kept `blank'. In any case “Month ” and “Year” fields have to be filled out completely.
B. IBAN/Account number(s) (2)
Account number:
Name of the entity:
Account number:
Name of the entity:
Account number:
Name of the entity:
Standard bank certificate as at end of (month / year):
Month
Year
(only possible as at end of month)
-2 If applicable please state the account number for all entities for which a standard bank certificate is applied for.
If there are more entities than can be listed on the form, please enclose all account numbers in a separate attachment that will be submitted together with the application form
IBAN = International Bank Account Number.
Note: when the account is held at a Rabobank Member Bank, please contact Rabobank Members Bank's Client Advice department.
C. Auditor information (3)
Name of firm:
Name of auditor:
Address:
Zip Code:
Domicile:
-3 If the above is left blank, a copy will be sent to the client only.
D. Signature (4) I hereby confirm that I have truthfully completed this form.
If applicable, Rabobank International is authorized to automatically debit the fee for the Standard Bank Confirmation(s):
Yes, account at Rabobank Int.
Account number:
Name:
Date:
No account at Rabobank Int.
Please remit the amount of EUR:
to account number:
IBAN NL49 RABO 0100 9116 68
SWIFT RABONL2U
Stating: SBV + Date (period to which application applies) + Name of business (e.g. SBV-31072011-COMPANY XYZ).
The application will lapse if the amount payable has not been paid within 14 days.
Signature
Authorized Person
-4 Standard Bank Confirmations fees.
When entity is established and physically located whithin the Netherlands:
1 t/m 5 entities: EUR 121,00 (100,00 + 21% VAT) | 6 t/m 10 entities: EUR 242,00 (200,00 + 21% VAT) | 11 t/m 15 entities: EUR 363,00 (300,00 + 21% VAT) | Etc.
If an entity has a VAT number( which must be filled in on our application form), then this entity is exempted from Dutch 21% VAT.
BANKS AND RABOBANK AFFILIATED COMPANIES ARE EXEMPTED FROM PAYING STANDARD BANK CONFIRMATIONS FEES.
Please send your application form to: sbv@rabobank.com