JOINT-STOCK COMPANY

COMMERCIAL BANK «PRIVATBANK»

Registered address:
1D Hrushevskoho St., Kyiv, 01001, Ukraine
Contact us:
30 Naberezhna Peremohy St., Dnipro, 49094, Ukraine
Phones: 3700 (free from mobile in Ukraine)
(056) 735 32 82
www.pb.ua e-mail: help@pb.ua
from 25.11.2021 12:12 № OFVRCSEFHDJDE9LR Page  1 of  1

KAPUSH VASYL
TIN: 3638904892, date of birth: 18.08.1999
NATIONAL PASSPORT КЛ 110393, issued by SKOLIVSKYM RSHU DMSU UKRAINY U LVIVSKII OBLASTI date of issue 01.03.2016
Registration address: Ukraine, 76010, region Ivano-Frankivska, city Ivano-Frankivsk, boulevard Pivdennyi, building 32, flat 46

Statement of card/account 516936******3095 (UA213052990262046400915242059) and additional accounts of the agreement

SAMDNWFC00072293645 on 25.11.2021 for the period 26.08.2021 — 25.11.2021

Credit limit: 0.00 Total outflow: 0.00

Account currency: UAH Total inflow: 5.00
Opening balance: 0.00 Amount of charges: 0.00
Ending balance: 5.00 Amount of discounts: 0.00

Amount in Amount in Amount Amount Balance

Transaction
Account Transaction details transaction card of of after
date
currency currency charges discounts transaction
516936******3095 Transfer from own
5.00
25.11.2021 Contract No. SAMDNWFC00072293645 card 41**90 via 5.00 0.00 0.00 5.00
from 25.11.2021 
UAH
Privat24
 

The certificate is issued to be provided upon request

Head of Maintenance Department Head-Office Ivanova Nina

Formed by Privat24 self-service system

The facsimile seal and signature are used by agreement of the parties in accordance with Article 207 of the Civil Code of Ukraine
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