Zahtev za UniCredit e-b@nking / MultiCash Order form UniCredit e-b@nking / MultiCash

Podaci o klijentu Client details Naziv privrednog drutva: Name of the company: Mesto i adresa: Place and address: Poreski broj: Tax No Matini broj: Company ID No Kontakt osoba: Contact person:

Broj telefona: Telephone No: E-mail: E-mail:

MultiCash

UniCredit e-b@nking

Novi zahtev/new reqquest

Dodatni zahtev / additional request

Korisnici sistema / Users Sigurnosna sredstva / Security devices * Ime, prezime i JMBG /
Name, Surname and Personal ID
HALCOM sertifikat/ certificate

Ovlaenja po raunima / Account authorization

Bez prava potpisa No Signing Authorisation

UniCredit e-banking
Serijski broj digitalne potvrde**/Serial Number of Digital Certificate** WEB korisniko ime/ username Broj rauna/Account number Sva prava Unrestricted

1.

_______

2.

_______

3.

_______

4.

_______

Dodatna oprema * Additional equipment

ita kartica SmartCard reader

Koliina Quantity

* Samo za korisnike UniCredit e-b@nking-a/Only for UniCredit e-b@nking users

** Seriski broj digitalne potvrde se popunjava samo u sluaju da Korisnik ve poseduje HALCOM digitalnu potvrdu/Digital certificate serial number has to be entered
only in case when User is already owner of HALCOM digital certificate

Potpisom na ovom Zahtevu Klijent izjavljuje da prihvata pruanje usluge elektronskog bankarstva preko Banke, kao i da je upoznat i u potpunosti prihvata pravila pod kojima posluju proizvoai softvera (Halcom/ Multicash) i Opte uslove poslovanja UniCredit Bank a.d. Beograd/By signing this Request
Client accepts to receive electronic banking services through the Bank and that it is conversant and fully accepts business rules of electronic banking software producers (Halcom/MultiCash) and General Terms and Conditions of UniCredit Bank Serbia JSC

Ovim Zahtevom klijent izjavljuje da su lica oznaena kao korisnici sistema dobila ovlaenja za gore oznaene radnje poev od: ___________________
With this request, Client declares that peoples and their authorizations, entered above are valid begging with

Mesto / Place: ______________________________________ Peat i potpis Banke (Dokumentacija i potpis klijenta provereni od) Bank's signature and the stamp (the documents and signatures verified by) Napomena / Remark:

Datum / Date: ______________________________________ Potpis podnosioca i peat Signature of the Client and the stamp

Popunjava elektronsko bankarstvo: Predmet obradio : ________________________ (potpis), Datum: ______________ Predmet proverio: ________________________ (potpis), Datum: ______________