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Information
Requested to Initiate VAT Recovery Engagement
(Upon receipt of this Information Request, CB
VATAmerica will prepare and forward an engagement
agreement and other administrative documents
for signature.) |
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| Legal
Name of Company: |
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| Company
Address: |
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| Company
Website URL: |
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| Brief
Description of Operations: |
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| (Example: corporate flight
department, cargo charter, etc.) |
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| For EU-Based Companies: |
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| VAT
Registration Number: |
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| (If registered in more than one EU country,
please provide list of all Registrations.) Please
obtain and forward several original copies of a Certificate
of Status issued by your local VAT office. |
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| For US-Based Companies: |
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| IRS
Number (EIN): |
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| (If Company is included in a consolidated
tax return or is a single member LLC, please list
parent company name and EIN.) |
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| Business
Activity Code Number: |
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| (From Sched K of corporation tax
return,or Page 1 of partnership tax return) |
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| US
Income tax Return: |
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(Please enter the most recent tax
form filed,
such as Form 1120, 1065, 1120S, 1041)
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| For Non-EU, Non-US Companies: |
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| Please obtain and forward several original
copies of a tax registration or corporate registration
certificate issued by your local tax or corporate
administration.You may wish to consult your company's
tax department for assistance. |
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Information
Requested to Initiate VAT Recovery Engagement
VAT / MOT Recovery Engagement
Page 2 of 2
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| For ALL Companies: |
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| Name,
address and account information for wire transfers: |
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| (If blank, USD checks sent by mail
to Primary Contact) |
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| For ALL Companies: |
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| Primary Contact: |
Name: |
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| (Person that we'll contact with
announcements, updates and engagement coordination) |
Title: |
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| Address: |
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| Tel: |
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| Fax: |
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| Email: |
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| Signatory: |
Name: |
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| (Person authorized to sign administrative
documents Claims to Germany require signature by Pres,VP,CEO
or CFO.) |
Title: |
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| Address: |
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| Tel: |
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| Fax: |
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| Email: |
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| Access
to Claims Status Reports: |
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| Please list name and email address
of additional people authorized to access your Company's
Claims Status Reports at www.cbvatamerica.com |
| Please
return this completed form to CB VATAmerica LLC
344 Nassau Street, Princeton, NJ 08540, Fax +001
609 430 4961
Attn: Michele Zalma, Claims Manager, or click "Send
Information" |
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