Beruflich Dokumente
Kultur Dokumente
(client's name)
...................................................................................................................................................................
Efendy
do hereby constitute and appoint Mr/Mrs/Messrs ...................................................................................
...................................................................................................................................................................
(representative's name)
indonesian
of .................................................................... (country) holder of passport/identification card number
.........................................................................................
3173022904810003 be my my/our true and lawful Attorney and in
my/our name and on my/our behalf do and execute all or any of the acts and things following, namely:
1. To deposit and / or receive money to and from Tickmill Ltd., a Company duly registered under the
laws of Republic of Seychelles, regulated by Financial Services Authority (FSA), License No SD008 ("the
Company"), to give orders to deposit money on my/our account with number
........................................., with the Company, to withdraw and/or transfer and give orders to withdraw
and/or transfer money credited on my/our account, with number ..........................................., by the
Company and/or charge such account with unlimited amount of money.
2. To apply charges for that may need to be applied when executing this Power of Attorney.
3. To sign in my/our behalf all and any necessary and required documents and /or disposals and /or
transfers and/or receipts and/or statements and/or applications and/or forms in order to execute
above mentioned acts;
AND I/WE HEREBY DECLARE, AGREE AND UNDERTAKE to accept, ratify and confirm all and
whatsoever my/our said attorney shall lawfully do or cause to be done or purport to do by virture of
this Power of Attorney.
IN WITHNESS WHEREOF I/WE hereunto set my/our respective name(s) and hand(s) this ..................
day of the month of ................................., 2016.
........................................................ .................................................
Signature: ........................................................
Securities Dealer Licence no SD008. Authorised and regulated by Financial Services Authority
Office: F28, Eden Plaza, Eden Island, the Republic of Seychelles | Phone: +852 5808 2921, +65 3163 0958 | E-mail: support@tickmill.com | www.tickmill.com