POS terminals Company information 1 Name of the company: * Company's registration number: * Registration date * Type of business/industry * Legal address: * Actual address: * E-mail address for receiving reports: * E-mail address for receiving the annexes to the Agreement: * Authorized representative of the company: 2 Name, Surname: * Phone: * Е-mail: * Company contact person 3 Name, Surname: * Country code * ---+371 (Latvia)+372 (Estonia)+370 (Lithuania)Other Other (please specify) Phone: * E-mail * Information on the use of POS terminals 4 Number of existing/planned trading places: * Please provide the addresses of the trading places in the Appendix No. 1Monthly turnover in EUR via POS terminal/s Existing: EUR Планируемый: EUR None Average size of one transaction in EUR: * Add new Company representative:(Signature) (Date)Accepted:(Signature) Additional information: Appendix No. 1 to AS "Industra Bank" Trader's questionnaire 5 No. * Address * City * Name of the trading place * Contact person * Phone * Required device Stationary / IP POS Number of stationary/IP POS Mini POS Number of mini POS vPOS Моb. POS Number of mobile POS's Cash register Number of cash registers Self-service station Number of self-service POS terminals Add new Уполномоченное лицо компании:(Имя, Фамилия)(Занимаемая должность) I am informed that AS "Industra Bank" processes my personal data for the provision of services and communication related to these services, ensuring that my rights are exercised in accordance with the Personal Data Processing and Protection Policy. * mandatory fields Apply