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Authenticated
S.W.I.F.T :
TO NOMINATED BANK ACCOUNT) Date
: Reference
No.
: To
: Account No.
: Safekeeping Receipt No.
: WE, (FULL NAME & ADDRESS OF CUSTODIAL BANK), HEREBY CONFIRM WITH FULL BANK RESPONSIBILITY THAT THE (DESCRIPTION OF INSTRUMENT(S), REFERENCED HEREIN, HAS BEEN AUTHENTICATED BY US AND WE HAVE VERIFIED AND GUARANTEE THE TOTAL VALUE TO BE UNITED STATES DOLLARS (AMOUNT IN WORDS) U$S _______________________________________________________________________________________________ WE,
FURTHER CONFIRM THAT THE SAID INSTRUMENT(S) SHALL BE HELD IN YOUR SAFE
CUSTODY ACCOUNT, ACCOUNT NUMBER____________________ AT OUR BANK FOR A
PERIOD OF ONE (1) YEAR AND FIFTEEN (15) DAYS. THE TERM OF THIS SAFE CUSTODY
MAY BE EXTENDED AT YOUR REQUEST. DESCRIPTION
OF THE (FINANCIAL INSTRUMENT(S): DEPOSITED
IN FAVOR OF : (EXAMPLE)
EXCEL GLOBAL, LTD., NEW YORK.
Currency
:
U$S Total
Value
: U$S Issuing
Party
: Date
Of Issue
: Reference
No.
: THIS
IS A FULL RECOURSE COMMITMENT AND MAY BE VERIFIED BY THE ISSUING OFFICERS
AT OUR BANK.
NAME
OF BANK:
__________________________ _ _________________________ AUTHORIZED OFFICER AUTHORIZED OFFICER
NAME
& TITLE:
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