Eurocard Corporate Limit


Eurocard Corporate Limit
Eurocard Corporate Limit
Spending limit – individual purchase. SEK
The company is liable for payment – Individual invoicing
Agreement No
Company information
Corporate ID No.
Spending limit –
individual purchase. SEK
Cash withdrawals
Spending limit – 30 days. SEK
0 0 0
0 0 0
Full company name
Invoice address
Telephone (including area code)
Card delivery address
Company name on the card (max. 26 characters)
Contact, name
Telephone (including area code)
Card to be sent to
Invoice to be sent to
The company
The company
Annual fees will be debited
Cardholder’s invoice
Name of parent company (if applicant is a subsidiary)
Bank (name of the bank and contact)
The company
Corporate ID No. of parent company
Telephone (including area code)
Eurocard Corporate Limit ordered for. When ordering more than one card, attach a copy of “Tillägg Eurocard Corporate Limit” P2060.
First name (given name)
Personal ID No.
Employment No./Cost centre
Mobile number
Address (if different from registered address)
E-mail address (Enter this to receive our latest offers and information)
Auxiliary services
Yes, we wish additional travel insurance for the cardholder and have read the terms and conditions available at
The receiver of the application and the sender of the offer regarding insurance is the insurance provider Trygg Hansa.
I/We apply herewith for a Eurocard Corporate Limit and
confirm that the details supplied are correct. The General
Conditions and prices can be found at, or
P 2039eng MP-id 17 130306
obtained from Eurocard’s customer centre. I am/We are
aware that this application will be subject to a routine credit
check, during which credit information may be obtained. I/
We have read and agree to comply with the conditions.
This agreement will become effective on the day Eurocard
approves the application.
Authorised company signature
Printed name
Personal ID No.
Printed name
Personal ID No.
Additional information that may influence the credit checking process, such as applications
to the Swedish Companies Registration Office to make changes to the company or the
company’s Board of Directors, should be supplied in a separate appendix.
Send your application to Frisvar, Eurocard AB,
Svarspost 2008 1118, SE-110 07 Stockholm, Sweden.
The postage is pre-paid.
AFN code
Clearing No.
Eurocard AB
SE-103 83 Stockholm, Sweden
Tel. switchboard: +46 8 14 67 00
Tel. Customer Service: +46 8 14 67 37
[email protected]
Bankgiro: 849-0005
Corporate ID No.: 556070-4453
Intyg om verklig huvudman/
Certificate regarding Beneficial Owner
Företag/Company name
Företagsnamn/Company name
Organisationsnr/Corporate id no.
Land för styrelsens säte (om annat än Sverige)/ Country of registered office (if other than Sweden)
Kontaktperson, telefonnr (även riktnr)/
Contact, phone No. (incl. area code)
Verklig huvudman/Beneficial owner
Verklig huvudman är en fysisk person som ytterst kontrollerar företaget genom direkt eller indirekt ägande av eller kontroll över mer
än 25 % av aktierna (kapital, andelar eller motsvarande) eller rösträtterna, eller som på annat sätt utövar kontroll över företaget.
Beneficial owner is a natural person who ultimately controls the Company by direct or indirect ownership or control of more than
25% of the shares (capital, ownership and equivalent) or the voting rights, or who otherwise exercises control over the Company.
Personnr eller födelsedatum/
Personal id No. or date of birth*
Adress (inkl. land)/Address (incl. country)
Ägarandel i %/
Ownership %
Det finns inte någon fysisk person som äger eller har kontroll över mer än 25 %./ No natrual person owns or controls more than 25%.
* If not a Swedish Personal ID No. always state date of birth.
Ägar- eller kontrollstruktur/Ownership or control structure
Om ägandet eller kontrollen utövas genom en juridisk person redogör för ägar- eller kontrollstuktur med en skiss eller genom att bifoga
ett organisationsschema. Ange den juridiska personens firma, organisationsnummer, adress (inkl. land) och ägarandel i procent.
If the ownership or control is exercised via legal entities, please clarify your group structure and/or control structure with a drawing or
attach an organisation chart. State the legal entities company name, Registration No., address (incl. country) and ownership in percentage.
Se bifogat organisationsschema/See attached organisation chart
Registration No.
Adress (inkl. land)/Address (incl. country)
Ägarandel i %/
Ownership %
Underskrift av behörig firmatecknare/Authorised signatory(ies)
Härmed intygas att ovanstående uppgifter är riktiga och sanningsenliga.
Vi förbinder oss samtidigt att omgående meddela Diners Club Nordic AB om det skulle inträffa förändringar i dessa förhållanden.
We certify and confirm that the above stated information is true and complete. We undertake to inform Diner Club Nordic AB
immediately of any changes whatsoever to information given herein involving a new beneficial owner being added or a previous
beneficial owner no longer being a being a beneficial owner.
EC2233 150109
Namnförtydligande/Name in print
Eurocard AB
103 83 Stockholm, Sweden
Tel växel: +46 8 14 67 00
Tel kundservice: +46 8 14 67 37
[email protected]
Bankgiro: 849-0005 556070-4453