1. Leasing of London //
Your Bank Guarantee Leasing Company
__________________________________________________________________________________
Telephone&Fax+44 (0) 208711 2793
EmailLeasingofLondon@gmail.com
Skype LeasingofLondon
ManagingDirectorAl Wertheimer(Ms)
David Gribkowski,Assistant to the CEO
Leasing of London is nota licensed security brokerage firm. We do not give financial investment advice, securities advice, legal or accounting advice. Leasing of London is not a commercial or residential real
estate broker or acting as such in any capacity. We are not,nor representto be employees of any bank or financial institution. Leasing of London is nota UK registered, or regulated company. The company
operates, and is registered in major offshore jurisdictions and does notmaintain an office in London, or in the UK. Leasing ofLondon strategically tailors personalized funding solutions, bridge relationships;
introduce institutions and investors to fund private transaction requests or place project funding requests utilizing our ext ensive consortium of financial professionals. We strongly recommend that all clients
seek their own legal, investment, financial and advisor representation outside of our firm and our partners firms. Doing so e nsures you have completed proper due diligence and have kept all options open for
understanding. Notice regarding the Use of Financial Instruments: We are not involved in their uses at the beneficiary's end and we give no warranty that these
instruments can be used as described, and we are not responsible if the client cannot use the bank instrument after it is issued. Our responsibility ends once the bank
instrument is issued.
Confidential Application – Broker Details
This is confidential information for the intended recipientonly!

2. DATE :
LESSEE’S TRANSACTION NO. :
THE LESSEE :
E1 BROKER FULL NAME AND TITLE
E2 MOBL
E3 EMAIL
E4 SKYPE
SECTION 3
F BROKER: PAYMASTER DETAILSFOR
COMMISSION DISTRIBUTION
F2 NATIONALITY
F2 BIRTH DATE
F3 PASSPORTNO.
F4 BROKER HOME ADDRESS
F5 BANK
F6 ADDRESS
F7 ACCOUNTNAME
F8 ACCOUNTNO.
F9 ACCT.SIGNATORYNAME
F10 BANKOFFICER
F11 BANKOFFICEREMAIL
F12 BANKOFFICERTELEPHONE
F13 BANKOFFICERFACSIMILE
F14 SWIFT
F15 IBAN