REQUEST FOR GRANT OF DECLARATION OF BENEFITS OR TO ENGAGE IN SPECIAL INVESTMENT AGREEMENT I. REQUEST Grant of declaration of Engage in special Request Nr. _____/______ benefits investment agreement IDENTIFICATION OF THE INVESTOR Name: _____________________________________________________________ Type of Investor National Investor: Foreign Investor: Office: ________________________________________________________________ Company Unique Number: Phone contact: E-mail contact: DIRECTOR / LEGAL REPRESENTATIVE Name: _____________________________________________________________ Nr. of the Identification Issue Date: Valid until: document: ______________________ ____________________ ______________________ Position: Address: ______________________ Phone contact: E-mail contact: ______________________ INVESTMENT Sector / Area of investment: Amount invested in USD: State property lease: Location: ___________________________
REQUEST FOR GRANT OF DECLARATION OF BENEFITS OR TO ENGAGE IN SPECIAL INVESTMENT AGREEMENT I. REQUEST Grant of declaration of benefits Engage in special investment agreement Request Nr. _____/______ IDENTIFICATION OF THE INVESTOR Name: _____________________________________________________________ Type of Investor National Investor: Foreign Investor: Office: ________________________________________________________________ Company Unique Number: Phone contact: E-mail contact: DIRECTOR / LEGAL REPRESENTATIVE Name: _____________________________________________________________ Nr. of the Identification document: ______________________ Issue Date: ____________________ Valid until: ______________________ Position: ______________________ Address: Phone contact: ______________________ E-mail contact: INVESTMENT Sector / Area of investment: Amount invested in USD: State property lease: Location: ___________________________
DB_in_English_Version_2018.docx