INVICTUS GREEN BAHAMA INC.

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CLIENT INFORMATION SHEET

Directions: This document should be completed in full. If a line item does not pertain, then insert
the term: “N/A” (non-applicable).

Corporate Information (if applicable)

Full Name of Corporation: Invictus Green Bahama Inc.

Date of Incorporation: 03/08/2023
Incorporated in (City/State/Country): United States
Registration Number: 6758882
Board of Directors (Name & Title):
Officers (Name & Title):
Shareholders:

Personal Information of Principal Signatory

First Name: Rabindra Singh

Middle Name:
Last Name: Singh
Gender: Male
Date of Birth: 10/16/1972
EIN Number: 9 2 - 3 9 9 6 2 0 1
Country of Citizenship: Guyana
Languages: English

Passport Number: R1101284

Date of Issue: 9/04/2020
Date of Expiry: 9/03/2025
Issuing Authority: Republic of Guyana

Registered Address (for Corporation only)

Street Address:
State: New Yok
Country: USA
Postal Code: 11428

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 INVICTUS GREEN BAHAMA INC.
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Location of Address: Living or Mailing Address

Street Address: 94-33 214th Place

City: Queens Village
State: New York
Country: USA
Postal Code: 11428

Contact Information

Telephone Number:
Fax Number:
Mobile Number:
Email Address: invictusbahamas@yahoo.com

Languages / Translator

Languages: English
Does the Signatory speak English?: Yes
If No, Name of Translator:
Tel Number:
Email Address:

Legal Advisor

Full Name: Heidi R. Gliboff, Esq

Company: Messer Law Group, PLLC
Address: 5907 175th Place, Suite PH
City: Fresh Medows
State: New York
Country: USA
Postal Code: 11365
Telephone Number: 917 363 3753
Fax Number:
Email Address: hgliboff@messeresq.com

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Bank Information

Bank Name (where funds are currently on deposit): Chase Bank

Street Address: 74-07 Eliot Ave
City: Middle Village

State: New York

Country: USA
Postal Code: 11379

Account Name: Invictus Green Bahama Inc.

Account Number: 956689290
Sort Code ABA No.: 021000021
SWIFT Code:
Account Signatory (1): Rabindra Singh
Account Signatory (2):

Bank Officer # 1 Name: Stevenson Bruneus

Bank Officer # 2 Name: Wilson Weng
Telephone Number: 718 775 9917
Fax Number: 718 247 5649

For and on behalf of Invictus Green Bahama Inc.

Signature: SEAL OF COMPANY

Name / Title:
Company: Invictus Green Bahama
Passport Number: R1101284
Date of Issue: 9/04/2020
Date of Expiry: 9/032025
Country of Issuance: Republic of Guyana

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 INVICTUS GREEN BAHAMA INC.
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PASSPORT

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 INVICTUS GREEN BAHAMA INC.
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