3.1. Бланк для открытия счета в банке

Applicant

Title Mr Mrs Miss Ms

Surname

First name(s)

Date of birth (day / month / year)

Country of origin

Present address

Post code

When did you move to this address? (day / month / year)

Permanent address (if different from above)

Post code

Telephone no. (home)

Telephone no. (work)

Marital Status

Single Married Divorced Widowed

No. of dependent children

Residential details

Owned Rented

Where do you reside?

With parents With a partner Along

Employment status

Employed full-time Employed part-time Self-employed

Unemployed Retired

Income details

Annual income €

Signature

Date (day / month / year)

Each arriving traveler or head of a family must write in the following information.

PLEASE PRINT

1. Family name Given name Middle initial

2. Date of birth (Mo. / Day / Yr.)

3. Vessel or airline & flt. No.

4. Citizen of (Country)

5. Resident of (Country)

6. Permanent address

7. Address while in the United States

8. Name and relationship of accompanying family members

9. Are you or anyone in your party carrying any fruits, plants, meats, other plant or animal products, birds, snails, or other live organisms of any kind?

Yes No

10. Have you or anyone in your party been on a farm or ranch outside the U. S. A. in the last 30 days?

Yes No

11. Are you or any family member carrying over $5000.00 (or the equivalent value in any cur­rency) in monetary instruments such as coin, currency, traveler’s checks, money orders, or negotiable instruments in bearer form? (If yes, you must file a report on Form 4790, as required by law.) Note: It is not illegal to transport over $5000 in monetary instruments; however, it must be reported.

Yes No

12. I certify that I have declared all items acquired abroad as required herein and that all oral and written statements which I have made are true, cor­rect and complete.

SIGNATURE:

NON-CITIZENS ONLY

13. U. S. VISA ISSUED AT (Place)

14. VISA DATE (Mo. / Day / Yr.)