1.

Principal:

a) Represented By: Amir Hmaghsoud

b) Nationality: US
c) Passport Number:
d) Date Of Issue:
e) Date Of Expiration:
f) Date Of Birth:
g) Place Of Birth:
h) SSN/Identity No.: 072-02-5170
i) Contact Address:
j) Contact Telephone No.:
k) Mobile Telephone No.:
l) Facsimile No.:
m) E-Mail Address: amirhmaghsoud@gmail.com
n) Occupation:
o) Business Name:
p) Business Website:
q) Business Address:
r) Business Telephone:
s) Business Facsimile:
2. Address For Mail: 1134 st, times Sq, New York, NY(US) 10005
3. Address For Courier:
4. Legal Counsel: Pola Andrson
a) Address:
b) Telephone No.:
c) Email.: amirhmaghsoud@gmail.com
5. Bank Name: American Express
a) Bank Address: New York Head office
b) Beneficiary Account Name: Amir.hmaghsoud
c) Beneficiary Acc No:
d) S.W.I.F.T Code:AEIBUS33XXX
e) Acct. Signatory Name:
f) Bank Officer Name: j.johanson
g) Bank Telephone Number: 1 3474747867
SSN072-02-5170
issued in New York (NY)
Driver License 103 283 713 issued in New York (NY) on
09/11/2018,
expires 04/29/2023
US Federal Taxpayer Identification Number (TIN / Tax ID)
P47178871
Preparer Tax Identification Number (PTIN)

Interim PTIN (temporary PTIN) P99995170

Employer Identification Number (EIN) 451007799

Individual Taxpayer Identification Number (ITIN) 912769024

Adoption Taxpayer Identification Number (ATIN) 244941200

BANK ACCOUNT DETAILS

PASSPORT COPY
Passport No.: 103286626
issued: May/25/2016
expires: May/24/2026
P<USAMAGHSOUD<<AMIR<H<<<<<<<<<<<<<<<<<<<<<<<
1032866268USA8604297M2605247<<<<<<<<<<<<<<04

UTILITY BILL COPY

PROOF OF FUNDS COPY