CONTRACT REF “1.

2021”

PRIVATE BTC EXCHANGE AGREEMENT

This private BTC exchange agreement and the two annexes attached thereto are entered on this
4/16/24 by and between:
INVESTOR or PARTY A
Company Name : xx

Company Address xx

Company re xx

Passport Number : xx

Passport issued by and on : xx

hereinafter the "BTC-BUYER" and sender of funds

And
BTC-PROVIDER

Company Name :

Company Address :

Company representative :

Represented by

ID Number :

ID issued by and on :

hereinafter the "BTC-PROVIDER" and receiver of funds

The BTC-PROVIDER represented by the receiver of funds from the Buyer…………………… and having the
Paymaster …………………………….. (according to their relevant license with registration No. 002-349-756 as
granted by Canadian laws and conditions) and hereinafter jointly referred as the “BTC Provider.”

WHEREAS, in consideration of the promises and the mutual covenants, warranties, terms and conditions
herein contained and for other good and valuable consideration, the receipt and sufficiency of which are
hereby acknowledged, the undersigned Parties agree and state that they wish to enter into this
agreement for the exchange of Euro €/USD for BITCOIN (“BTC”) under the following terms and
conditions:

WHEREAS BUYER OF RECORD warrants that, under penalty of perjury, that the Euro / USD funds are
totally derived from legal sources and not from any illegal drug traffic or money laundering activities,
terrorist group or association and neither from any other criminal activity, and confirm that the funds
are good, clean cleared, of non-criminal origin, free from any liens and taxes.
WHEREAS BTC-PROVIDER warrants that, under penalty of perjury, that the BTC are totally derived from
legal sources and not from any illegal drug traffic or money laundering activities, terrorist group or
association and neither from any other criminal activity, and confirm that the funds are good, clean
cleared, of non-criminal origin, free from any liens and taxes and are freely transferable BITCOIN to be
exchanged for Euro.
WHEREAS the Parties shall comply with the requirements established in the regulations of banks in
connection with the laws against terrorism in World, and BUYER OF RECORD and BTC-PROVIDER
committed not to participate in actions related to any money laundering, and that each party,

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BUYER or his REP. with FPOA BTC PROVIDER – ASA
Energy
 CONTRACT REF “1.2021”
individually and separately, accepts the obligation to pay customs taxes, duties or import duties that
may be applicable during the execution of its institutional obligations in the transaction.

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BUYER or his REP. with FPOA BTC PROVIDER – ASA
Energy
 CONTRACT REF “2021”

BASED ON THE FOREGOING THE PARTIES AGREE THE FOLLOWING:

I.
1. Object of the Agreement
This BTC transaction will be executed as a bank-to-bank transaction and will be executed on a
RTGS or TURBO SWIFT MT103/GPI (not manual) basis based on the bank procedures applicable
and the terms and conditions as agreed in the present agreement. (In case GPI will not be
available the TRN of the turbo express swift MT103/202 will have to be submitted as soon as
the transfer will be effectuated).
2. Description of the Euro/USD Currency:
Il

CURRENCY : Euro or USD

ORIGIN OF CURRENCY Funds are totally derived from legal sources and not from any
illegal drug traffic or money laundering activities, terrorist
: group or association and neither from any other criminal
activity, and the funds are good, clean cleared, of non-criminal
origin, free from any liens and taxes, free transferable Euro to
be exchanged for BITCOINS

CONTRACT QUANTITY : __________BITCOIN with R&E,

FIRST TRANCHE : TBA BTC min.

WALLET ID TBA
Buyers Receiving Wallet ID:

It is agreed by………… (BTC supplier), that they will take full responsibility for sending BTC to the Buyer’s
wallet TBA (or, for entire wallets, the private key and password can be transmitted so to enable a much
faster proprietary transfer), equivalent to the available amount received, within 30 minutes max from
the receipt of the RTGS currency settlement for the purchase of BTC via HSBC trading Platform. Once the
Buyer will notify the paymaster (directly or via their representatives) to have received the BTC, the
paymaster will forward the relevant payment to the BTC owner account (acting, this way, as an Escrow
according to the present Canadian laws and conditions).

BUYER WALLET ID (pls TBA

state one or more)

3. Description of the BITCOIN Currency:

CRYPTO CURRENCY : BITCOIN

ORIGIN OF CURRENCY : Funds are totally derived from legal sources and not from any
illegal drug traffic or money laundering activities, terrorist
group or association and neither from any other criminal
activity, and the funds are good, clean cleared, of non-criminal
origin, free from any liens and taxes, free transferable Euro to
be exchanged for BITCOINS.
Up to _________BITCOIN with R&E, LESS DISCOUNT net
CONTRACT QUANTITY :

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BUYER or REP. with BTC PROVIDER –
 CONTRACT REF “2021”

FIRST TRANCHE : TBA BTC min

WALLET ID : TBA (for your forensic analysis)

II.
1. Transaction Conditions: Pricing and Commissions. It is agreed by the Paymaster or their
representative, to disburse the commission's percentages amount in accordance with this
agreement without protest or delay to the account listed below in the protection
agreement.
2.
TRANSACTION MODE : BANK TO BANK TRANSFER

BUYER PRICE According to the Morning fixing price New York time, as indicated on
: blockchain.com, BUYER WILL PAY the corresponding price less the
agreed ____% net discount .BTC will be transferred as soon as the total
amount has been received to the seller’s account.

DISCOUNTS : GROSS discount ___&% and NET discount .

TOTAL COMMISSION FEES

:

SETTLEMENT PAYMENT : Settlement payment must be paid in BTC or in cash, by wire transfer to
final beneficiaries accounts to be informed accordingly.
3.

3. Transaction and payment Procedure:

3.1. The BTC-PROVIDER signs the contract and sends it to the Buyer, including the public wallet(s) strings
address, for allowing them to make their forensics analysis verification and let them sign it. Then
buyer will return it to the Seller (with at least 3 public strings where to transfer the purchased
wallets) who will deposit it in the receiving bank. IT IS IMPERATIVE THAT THE VERBIAGE IN
MOTIVATION OF THE TRANSFER, IT WILL HAVE TO MENTION ONLY "INVESTMENT ENERGY
TRADING" AND THE "CONTRACT NUMBER".
3.2. Please note that by mentioning in the verbiage "bit coin purchase" it will cause the block of the
transaction as only few Banks are officially authorized to deal with Bitcoin transactions.
3.3. After checking the legitimacy of the wallets (which are anyway already derived or unlocked from a
trading HSBC platform and by them already duly double-checked), the Bank of the BUYER OF
RECORD sends the payment via RTGS (Real Time Gross Settlement) or via TURBO SWIFT MT103/GPI
(not manual) or, if not available a TURBO EXPRESS MT103/202 (providing TRN and carbon copy of
the payment as soon as effectuated), at net of the agreed discount for the full amount to the
receiving Bank of BTC-PROVIDER to the following details:

BANK NAME :

BANK ADDRESS
:

ACCOUNT NAME :

ACCOUNT NUMBER :

SWIFT :

2. Once the payment has been made, the BUYER OF RECORD must send the carbon copy or TRN to
inform immediately the BTC-PROVIDER by email to the following email addresses (so to prepare
the platform to unlock the wallets): ____&_ and _____.
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BUYER or REP. with BTC PROVIDER –
 CONTRACT REF “2021”

3. Upon receipt of the payment, the BTC PROVIDER’s bank officer will reply and notify, by SWIFT, the
Buyer's final bank officer stating the successful receipt of the payment RTGS or TURBO SWIFT
MT103/ GPI.

4. After receiving confirmation of the RTGS or of the TURBO SWIFT MT103/GPI not re-callable
payment notification (the carbon copy of the TRN, or of the GPI transfer, is imperative) at the
BTC- Provider's bank in Canada, they will immediately (according to relevant time zones) notify
HSBC platform in London, to proceed with the transfers of the Bitcoins to the Buyer's wallet(s)
to be informed, for the equivalent amount stated in the RTGS or TURBO SWIFT MT103/GPI,
according to the BLOCKCHAIN value at the rate of the day less discount (the exchange value will
be made in the date and exact hour as stated on the carbon copy receipt of the payment) . Please
note that, according to internal agreements between platform and bank, the transfer of BTC must
be realized within 30 minutes max after receipt of the RTGS or of the TURBO SWIFT MT103/GPI
notification and duly confirmed by the BTC-PROVIDER’s Paymaster who will transfer the amount
of the payment from Buyer to the final account of the BTC provider only after the notification,
from the Buyer, to have duly received the BTC (as per BTC-PROVIDER’s Bank Officer notification to
the HSBC platform).
5. The BUYER can receive the BTC in his at least 3 designated strings wallet(s) in few minutes from
final transfer receipt confirmation of the GPI by Paymaster’s Bank as also the GPI transfers are
received in few minutes and, whenever possible (i.e. only when the full wallet will be sold, the
platform's representative will provide the private key ID together with the relevant Password so
to allow an immediate transfer of property to the Buyer for the entire wallet content. For the
transfer of only a part of the wallet content, the normal block chain transfer procedures will be
used (with Six (6) confirmations of the Block-chain). Euro or USD Provider's bank of BUYER OF
RECORD sends immediate confirmation to BTC-PROVIDER or his representatives, by email to the
following email addresses: _____and _______ so to start preparing the platform to unlock the
wallets and deliver the BTC to the Buyer within the very narrow window time of 30 minutes and
before 3,30 pm cut off of the trading HSBC platform London time. The only window time available
every day to perform the transfer(s) will be, therefore, between 9 and 10,30 am Toronto/Montreal/
NY time zone.

After the buyer (or his representative with FPOA) has received our contract and send it back duly signed, we
will confirm that we are RWA to receive the payment operation (normally a max of 15 minutes are
sufficient for a GPI to be transferred), and, as soon as the amount will be cashed in the paymaster’s
account, we’ll immediately start the wallet unlock operations (as soon as our BO will be available according
to respective time zones) and the relevant delivery of the private key and Pass Word (when the full wallet
can be delivered), allowing, this way, the buyer to become immediately the new owner of the wallets by
replacing immediately the PW (partial wallets can be delivered only via the normal BLOCK CHAIN with the 6
verification process which might take some longer time) and forwarding them to other final buyer’s
destination wallets to avoid any attack from hackers.

Please note that, due to the different local time zones (of our ……….. and our Platform in London) there is
only one-hour about (from 9 to 10 am in ) required by the BO of the platform in London to unlock the wallets
(i.e. before 3pm London time) and to start delivering them to buyer (which timing will be informed
accordingly). Within this Window time, multiple tranches (e.g., smaller than 50 M €) can be performed unless
different larger amounts will be agreed between bank officers. For RTGS and GPI transfers there should not
be any limit on value provided the right verbiage as “INVESTMENT” will be used.

6. The BUYER OF RECORD sends a RTGS or a TURBO SWIFT MT103/GPI (not manual) payment in Euro
€ or USD $ to the BTC- Provider's Paymaster, for each other tranche of Bitcoins until the total
volume of the contract is reached.
7. The BTC-PROVIDER transfers the tranche of Bitcoins, for which he has received the RTGS or
TURBO SWIFT MT103/ GPI payment, from its wallet to the wallets specified by the BUYER OF
RECORD for each other tranche of Bitcoins until the total volume of the contract is reached. The
Buyer is kindly asked to provide at least 3 different wallet’s strings so to avoid any overloading
related risks.
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BUYER or REP. with BTC PROVIDER –
 CONTRACT REF “2021”

III.
1. Non-performance by BTC-PROVIDER:

1.1. If, for any unforeseeable reason, the BTC-PROVIDER fails to transfer the Bitcoins to the wallet of
the BUYER OF RECORD within 24 hours (twenty-four hours) after confirmation of the RTGS or of
the TURBO SWIFT MT103/GPI has been received at the BTC-PROVIDER bank, this agreement will
be entering the “Non-Performance Bond penalties” if the money will not be returned to the Buyer
within a max of 72 hours. If, for any reason, the Buyer does not receive the agreed quantity of
“valid” bitcoins, the SELLER undertakes, unconditionally, to return the full amount plus daily
interests in the amount of 1% per day exceeding the 72 hours, until the amount is returned to the
buyer of record. It is also agreed that the money will be returned automatically without interests
if sent back within a max of 72 hours after receipt of the wire transfer through the GPI or other
swift Systems or wire transfers.

3.1.2. In addition to point 3.1.1., If the BTC-PROVIDER does not execute this agreement as described
under Clause 2, it shall immediately, without any further action or formality being required, become liable
to the BUYER OF RECORD for an immediately due and payable penalty of 30 % (Thirty percent) of
contractual value and without prejudice to the rights of the BUYER OF RECORD to claim damages.

2. Non-performance by Buyer of record:

2.1.If the BUYER OF RECORD fails to transfer the funds for his reasons and motives, within the agreed
window time, to the BTC-PROVIDER’s bank account within further 24 hours (twenty-four hours or
different agreed timing between parties), after the contract is duly signed and returned to become
operative, this agreement will become null and void and the 30% of the TURBO SWIFT MT103/GPI value
will serve as collateral for the same amount in BTC.
2.2. If the BUYER OF RECORD does not execute this agreement as described under Clause 2, it shall
immediately, without any further action or formality being required, become liable to the BTC-
PROVIDER for an immediately due and payable penalty of 30% (thirty percent) and without prejudice to
the right of the BTC-PROVIDER to claim damages.

IV.

1. Banking coordinates and instructions for BUYER OF RECORD and BTC-PROVIDER

The respective bank account details of BUYER and BTC-PROVIDER are listed in "ANNEX B" and can only be
changed by prior written notice of at least five (5) days prior to any change.

2. Exchange rate:
The exchange rate, as agreed within the present agreement, is based on the morning fixing price at 10 AM
New York time as indicated on www.blockchain.com or at the hour as stated in the receipt of the transfer
if lesser.

4.3. Term of Agreement:

This contractual agreement is a full recourse commercial commitment enforceable under the laws of the
jurisdiction of Brussels as it applies and said law shall govern the interpretation, enforce-ability,
performance, execution, validity and any other such matters regarding the present agreement. The present
agreement is in full force and effect until completion of the transaction and it is legally binding upon the
parties, signatories, their heirs, successors and assigns, agents, principals, attorneys, and all associated
parties involved in this agreement.

4. Codes of Identification:
The Parties to the present agreement agree that all documents related to this transaction shall indicate the
codes as indicated herein. In addition, the codes shall not be changed during the tenure of the present
agreement, including all rollovers, renewals, extensions, and all additions.

5. Unauthorized Bank Communication:

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BUYER or REP. with BTC PROVIDER –
 CONTRACT REF “2021”
Neither party can contact the bank of the other party without the authorization of the other party.
Any unauthorized contact act is a breach of the present agreement.

6. Taxes and Costs:

Both PARTIES hereto individually and separately accept liability of taxes, imposts, levies, duties, or charges
that may be applicable in the execution of their respective roles in this transaction.

7. Non-Disclosure and Non-Circumvention:

Both parties are to be bound and to abide by the non-circumvention non-disclosure rules and laws of
England and Wales which shall apply to this transaction for a period of five (5) years, no matter whether
direct or indirect.

8. Governing laws and Jurisdiction:

This agreement and any dispute or claim arising out of or in connection with it or its subject matter or
formation (including non-contractual disputes or claims) shall be governed by and construed in
accordance with English law.
The parties irrevocably agree that the courts of England and Wales shall have exclusive jurisdiction to
settle any dispute or claim that arises out of or in connection with this agreement or its subject matter or
formation (including non-contractual disputes or claims). The seat of arbitration shall be the High Court in
London.

9. EDT –Electronic Document Transmittal and Counterparts:

This Agreement may be executed in multiple copies at different times and places, each being considered
an original and binding upon the parties. All facsimile/ electronic transmittal /communications relating to
this transaction and which are mutually accepted by the parties, shall be deemed legally binding and
enforceable documents for the duration of the transaction.

10. Copies of the Present Agreement:

No copies of this Agreement are to be provided to any third party unless the parties agree mutually the
contrary. The paymaster in charge of distributing commission to all beneficiaries, such as facilitators, shall
receive a copy of the agreement including the irrevocable master fee protection agreement (IMFPA),
bearing identical transaction code.

11. Force Majeure:

The "FORCE MAJEURE" exception clause applicable under the laws and rules of England and Wales, shall
be hereby incorporated and made an integral part of this Agreement. A party cannot be held in default if
the reason is caused by force majeure.

IN WITNESS WHEREOF, the undersigned have read this document and had advise of its legality and after
understanding the content of this Agreement written in the English language, by knowledge of the language
or by professional translation to the Party’s language and legal advice and initialed all the pages of this
agreement. In addition, fully understand and agree that its execution constitutes an acceptance of all its
mutually protective covenants, terms and conditions and it is lawfully binding upon the Parties and their
legal heirs, successors, representatives, and assignee

AGREED AND ACCEPTED THIS AGREEMENT BY THE BUYER OF RECORD

AUTHORIZED BUYER’S SIGNATORY:

SIGNATURE & Date

_______________

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BUYER or REP. with BTC PROVIDER –
 CONTRACT REF “2021”
DATE: 4/16/24

COMPANY NAME :

SIGNATORY

PASSPORT

ISSUING
COUNTRY

ISSUE DA

EXPIRATION

COUNTRY

BY THE BTC-PROVIDER AUTHORIZED SIGNATORY:

SIGNATURE & Seal

____________

DATE: 4/16/24

COMPANY NAME :

SIGNATORY :

ID NO. :

ISSUING :
COUNTRY

ISSUE DATE :

EXPIRATION :
DATE

COUNTRY :

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BUYER or REP. with BTC PROVIDER –
 CONTRACT REF “2021”

ANNEX A first tranche

The buyer of record reserve the right to pay the full amount calculated from the RTGS or GPI amount
where onetime payment and transfer or based on different agreement between the parties including
the definition of the following TRANCHES to be defined accordingly.

PRICE Quanti Total balance in RTGS – GPI Agree

PRE ty Wallet of BTC Transfer d
BTC to Payment purch
deliver ase
amou
nt

€/$ BITCOINS BTC

PRICE /UN TOT
PRICE

TOTAL € €

The following calculations will reflect on the disbursements amounts for commissions. The appointed
Paymaster is required to disburse the BTC as well as the commissions to settle this transaction.

Quanti Disbursement
Tot
ty Payment
al
to
BT
deliver
C

BITCOINS NET net

PRICE

TOTAL R&
E

The following individuals will receive the disbursements in accordance with the agreed amount for
commissions. These percentages are irrevocable percentages and must be paid by Sakha as the appointed
seller of record paymaster and agreed by the Buyer and Seller.

The € xx0.00 It is agreed that the disbursements amount will be

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BUYER or REP. with BTC PROVIDER –
 CONTRACT REF “2021”

disburse made to BTC owner only after the buyer receives the
ment BTC in his wallet
amount

to buyer's side €..00.00 TBA

€/$

seller’s side €/$ TBA

ASA Energy
“SELLER” Platform ID : TBA

Buyer (or Managing Buyer with FPOA)

“BUYER” WALLET ID TBA

LIST OF PUBLIC WALLET'S STRING INCLUDED IN THIS AGREEMENT:

1.
2.
3.
4.
5.
6.

ANNEX B - INFORMATION ABOUT THE PARTIES

MANAGING BUYER PASSPORT COPY

BUYER/EURO-PROVIDER’S COORDINATES

1 CORPORATE NAME
.

2 REGISTRATION NO./YEAR
.

3 REGISTERED OFFICE
.

4 OFFICE ADDRESS
.

5 REPRESENTED BY
.

6 TITLE
.

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BUYER or REP. with BTC PROVIDER –
 CONTRACT REF “2021”

7 ID NO.
.

8 COUNTRY OF RESIDENCE
.

9 ID ISSUE DATE
.

1 PASSPORT EXPIRY DATE

0
.

1 ADDRESS FOR MAIL DELIVERY

1
.

1 PL INVEST E-MAIL ADDRESS

2
.

1 MANDATE’S PARTNER
3
.

1 MANDATE’S PHONE NUMBER

4
.

1 MANDATE’S E-MAIL ADDRESS

5
.

1 BANK NAME
6
.

1 BRANCH OFFICE ADDRESS

7
.

1 SWIFT CODE
8
.

1 ACCOUNT NAME
9
.

2 IBAN
0
.

2 ACCOUNT SIGNATORY
1
.

2 BANK OFFICER NAME/ TITLE

2
.

2 BANK OFFICER PHONE/FAX

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BUYER or REP. with BTC PROVIDER –
 CONTRACT REF “2021”

3
.

2 BANK OFFICER E-MAIL ADDRESS

4
.

2 REFERENCE
5
.

2 SPECIAL INSTRUCTIONS 1.
6
.

2 SPECIAL INSTRUCTIONS 2.
7
.

BY THE BUYER OF RECORD AUTHORIZED SIGNATORY and seal:

…………
Note:
It is agreed by the managing buyer, xxx .. represented by the principle end buyer, to acknowledge their
receiving account listed below and to send the RTGS or GPI bank transfer (not manual) for the agreed € xx ,
to purchase the first tranche and the full available btc, as agreed. .........., authorized appointed signatory
Mr. .........., executes this contract together with HSBC Bank London and will take full responsibility to
supervise and verify that the GPI transfer will be made under the agreed terms and timing required
conditions. It is agreed by the receiver that the account cannot be depleted or moved until the managing
end buyer received his BTC as agreed. .......... and appointed representatives shall take responsibility for the
FREE OF CHARGE commission’s payments disbursement immediately after purchase without protest or any
delays based on the terms of this contract.

BTC-PROVIDER’S BANK COORDINATES

1 CORPORATE NAME ..........(via ..........)

.

2 REGISTRATION NO./YEAR
.

3 REGISTERED OFFICE
.

4 OFFICE ADDRESS
.

5 REPRESENTED BY
.

6 TITLE
.

7 ID NO.
.

8 COUNTRY OF RESIDENCE
.
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BUYER or REP. with BTC PROVIDER –
 CONTRACT REF “2021”

9 ID ISSUE DATE
.

1 PASSPORT EXPIRY DATE

0
.

1 ADDRESS FOR MAIL DELIVERY

1
.

1 BUSINESS PHONE NO.

2
.

1 BUSINESS FAX NO.

3
.

1 MOBIL PHONE NO.

4
.

1 E-MAIL ADDRESSES
5
.

1 BANK NAME
6
.

1 BRANCH OFFICE ADDRESS

7
.

1 SWIFT CODE
8
.

1 ACCOUNT NAME
9
.

2 IBAN
0
.

2 ACCOUNT SIGNATORY
1
.

2 REFERENCE
2
.

BY THE APPOINTED BTC-PROVIDER OF RECORD AUTHORIZED SIGNATORY:

SIGNATURE & Seal

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BUYER or REP. with BTC PROVIDER –
 CONTRACT REF “2021”

----------------
DATE: 4/16/24

COMPANY NAME :

SIGNATORY :

ID NO. :

ISSUING COUNTRY :

ISSUE DATE :

EXPIRATION DATE :

COUNTRY :

BTC- PROVIDER ID COPY

BTC- PROVIDER CERTIFICATE OF INCORPORATION

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BUYER or REP. with BTC PROVIDER –
 CONTRACT REF “2021”

BUYER’S PASSPORT COPY and Certificate of Incorporation

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BUYER or REP. with BTC PROVIDER –
 CONTRACT REF “2021”

Buyer’s Certificate of Incorporation

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BUYER or REP. with BTC PROVIDER –
 CONTRACT REF “ASA-HSBC-GG-15.01.2021”

IRREVOCABLE MASTER FEE PROTECTION AGREEMENT / PAY ORDER TO FACILITATORS FOR THE
TRANSACTION OF THE PRIVATE BTC EXCHANGE EURO/BTC AGREEMENT
TO TRANSACTION CODE:………………….
DATED ON ………..2021

To be signed by ………. as ..........representatives, to the Beneficiaries of this Fee Agreement:

On the matters of the transaction code indicated herein for the exchange of BITCOIN against Euro / USD the total
contract amount of BTC up to 37.000 BITCOIN with R&E and from (___ percent) gross of total Gross discount, ___%
(___ percent) net discount .

We, ……………………. (registration …..), in solid with and on behalf of ..........(registration No. ), appointed as
paymaster of record hereby agree and guarantee to protect, and disburse payments without any extra charge and
through the Banking coordinates provided by the interested parties and beneficiaries, the total amount of 00 % (00
percent) of the purchase price in Euro or USD per each BITCOIN tranche delivered of the total Contract amount to
be paid and shared among the intermediaries as agreed herein. The delivery of these funds is guaranteed with full
corporate authority and responsibility as good, clean, clear funds of non-criminal origin. The undersigned agree that
this payment is irrevocable, and unconditional, and shall be made immediately by SWIFT wire transfer to each party
in USD, EURO or BITCOIN on each tranche unless different instructions from parties.

DISBURSEMENTS PAID BY APPOINTED ESCROW OF RECORD TO THE FOLLOWING PARTIES:

Total payment of 0% (0percent) for intermediaries and/or bank officers of the total face value of the BTC transaction
with transaction code CONTRACT REF ______________ including, but not limited to, all rolls/rollovers, all
extensions, all add-ons/additions, all renewals, all parallel contracts and/or agreements, all cancellations and re-issues and all
third parties transfers whatsoever.

BTC-MANAGING COORDINATOR AND PAYMASTER BANK ACCOUNT will supply the Paymaster service without any
charge for the parties.

If different entity will be agreed between parties, please fill up the following form:

Paymaster Name

Bank Name

Account Name

Account No.

Routing No.

Bank Address

SWIFT Code

Paymaster

Beneficiaries

S
p
e
c
i
a
l

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BUYER or REP. with FPOA BTC
 CONTRACT REF “ASA-HSBC-GG-15.01.2021”

AGREED AND ACCEPTED THIS IMFPA BY THE Euro or USD PROVIDER / AUTHORIZED
SIGNATORY:
BUYER OF RECORD AUTHORIZED SIGNATORY:

SIGNATURE

DATE: 4/16/24

COMPANY NAME :

SIGNATORY :

ID NO. :

ISSUING :
COUNTRY

ISSUE DATE :

EXPIRATION :
DATE

COUNTRY :

AGREED AND ACCEPTED THIS IMFPA BY THE APPOINTED BTC-PROVIDER / AUTHORIZED

SIGNATORY:

THE BTC-PROVIDER AUTHORIZED SIGNATORY:

SIGNATURE & Seal

..........

DATE: 4/16/24

COMPANY NAME : ..........

SIGNATORY : ..........

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BUYER or REP. with FPOA BTC
 CONTRACT REF “ASA-HSBC-GG-15.01.2021”

ID NO. : AN566751

ISSUING : GREECE
COUNTRY

ISSUE DATE : 15 MAY 2018

EXPIRATION : NO EXPIRATION
DATE

COUNTRY : GREECE

COMMISSION’S SPLIT TO BE DELIVERED TO THE FOLLOWING LIST OF BENEFICIARIES AND THEIR BANK OR WALLET
COORDINATES WHERE TO SEND THE RELEVANT SPECIFIC AMOUNTS

AMOUNT …. TO BE DELIVERED TO

Mr/Mrs …… c/o account n. ….. Bank coordinates …

or equivalent amount in BTC on the wallet ID ….

Passaport n.

Bank Name

Bank location

SWIFT Code

IBAN

Account Holder Name:

Company

Account Number:

AMOUNT …. TO BE DELIVERED TO

Mr/Mrs …… c/o account n. ….. Bank coordinates …

or equivalent amount in BTC on the wallet ID …..
Passaport n.

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BUYER or REP. with FPOA BTC
 CONTRACT REF “ASA-HSBC-GG-15.01.2021”

Bank Name

Bank location

SWIFT Code

IBAN

Account Holder Name:

Company

Account Number:

PAGE TO FOLLOW IF NEEDED

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BUYER or REP. with FPOA BTC