ELLERI CONSULTING

603 Fidalga Street, Pinheiros, Sao Paulo, SP, Zip Code 05432-070 - Brazil

CUSTOMER REGISTRATION FORM

Directions: This document must be completed in full. If a line item does not pertain then
insert the term: “N/A” (non-applicable).
Business Name : ELLERI CONSULTING
Partner : EDISSON ELLERI FAUST FILHO
Passport : FU653051
Foundation Date : 02/13/2004
CNPJ: 06.153.471 / 0001-16
Country of Citizenship : BRASILEIRO
Home Street Address : Euclides da Cunha 1560, apt 243,
City : CURITIBA
State : PARANA
Country : BRAZIL
Mobile Number : +55 41 9790-1397
Email Address : e.faust@ellericonsulting.com.br
Site Address : www.ellericonsulting.com.br
Bank Information
Bank : SANTANDER
Agency / Account Number : 2190- 13003907-3
ADRESS: RUA JOAO BETTEGA, 106
Account signatory name : ELLERI CONSULTARIA TECNOLOGIA INFORMATICA LTDA
ABA :
SWIFT CODE : BSCHBRSP

Main Activities:
▪ Business and Financial Developer:

Declaration:
I, EDISSON ELLERI FAUST FILHO, swear under penalty of perjury, that the information given
above is both true as of this date.

ELLERI CONSULTING
603 Fidalga Street, Pinheiros, Sao Paulo, SP, Zip Code 05432-070 – Brazil
Phone: +55 (41) 99790-1397Email: e.faust@ellericonsulting.com.br
 ELLERI CONSULTING
603 Fidalga Street, Pinheiros, Sao Paulo, SP, Zip Code 05432-070 - Brazil

Passport Copy
EDT (Electronic Document Transmission) will be deemed valid and enforceable with respect to any provision of
this Agreement. As applicable, this agreement will: 1-Incorporate US Public Law 106-229, '' Electronic Signatures
into the Global and National Trade Law '' or any other applicable law in accordance with the UNCITRAL Model
Law on Electronic Signatures (2001 ) and 2 E-COMMERCE AGREEMENT (ECE / TRADE / 257, Geneva, May 2000)
adopted by the United Nations Center for Trade Facilitation and Electronic Commerce (UN / CEFACT). 3-EDT
documents are subject to European Community Directive No. 95/46 / EEC as applicable. Either Party may
request a hard copy of any document that has been previously transmitted by electronic means, provided that
in any event such request does not delay the Parties from fulfilling their respective obligations and duties under
the EDT instruments.
COMMITMENT TERM:
I declare that the information provided above is true, and I assume full responsibility for it.
------------------------------------------------------------End of document------------------------------------------------------------------

CURITIBA, PR OCTOBER 21™, 2021

Signature :
Name: EDISSON ELLERI FAUST FILHO
Passaport Number: FU653051
Country of Issuance: BRAZIL

ELLERI CONSULTING
603 Fidalga Street, Pinheiros, Sao Paulo, SP, Zip Code 05432-070 – Brazil
Phone: +55 (41) 99790-1397Email: e.faust@ellericonsulting.com.br
 ELLERI CONSULTING
603 Fidalga Street, Pinheiros, Sao Paulo, SP, Zip Code 05432-070 - Brazil

ELLERI CONSULTING
603 Fidalga Street, Pinheiros, Sao Paulo, SP, Zip Code 05432-070 – Brazil
Phone: +55 (41) 99790-1397Email: e.faust@ellericonsulting.com.br
 ELLERI CONSULTING
603 Fidalga Street, Pinheiros, Sao Paulo, SP, Zip Code 05432-070 - Brazil

ELLERI CONSULTING
603 Fidalga Street, Pinheiros, Sao Paulo, SP, Zip Code 05432-070 – Brazil
Phone: +55 (41) 99790-1397Email: e.faust@ellericonsulting.com.br