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To Blom Bank S.A.L

APPLICATION FOR EXPORT DOCUMENTARY COLLECTION

Branch: _________________

Client’s name:

Date: _________________

Customer Instructions:

We ask your bank, at our entire risks and perils, to send for collection the enclosed documents detailed as follows, for the

amount of: _____________________________________

1- _________________________________ 7- __________________________________

2- _________________________________ 8- __________________________________

3- _________________________________ 9- __________________________________

4- _________________________________ 10- __________________________________

5- _________________________________ 11- __________________________________

6- _________________________________ 12- __________________________________

▪ Documents to be sent to the following Collecting Bank:

___________________________________________________________________________________________________________________

▪ Documents to be delivered to the following drawee:

___________________________________________________________________________________________________________________

▪ Delivery instructions of documents to drawee:

Deliver documents against payment of the amount of _____________________________________

Deliver documents against acceptance of the included bill of exchange amounting to ____________________maturing on _________

Accepted bill of exchange must be guaranteed for payment on due date by adding the collecting bank’s aval thereon under swift to the

remitting bank.

Deliver documents against subscription by the drawee of a promissory note amounting to ___________________maturing on _________

Signed promissory note must be guaranteed for payment on due date by adding the collecting bank’s aval thereon under swift to the

remitting bank.

Deliver documents against mixed payment:

1- Payment of the amount of: _____________________________________

AND

2- Drawee’s acceptance of included bill of exchange amounting to ____________________maturing on _________

Drawee’s subscription of promissory note amounting to ____________________maturing on _________

Drawee’s signature of an undertaking letter amounting to ____________________maturing on _________

Deliver documents free of payment

Deliver documents against drawee’s signature of the enclosed letter of undertaking amounting to _____________________

maturing on _________

NB: In case of delivery of documents against letter of undertaking, the text of the letter of undertaking to be signed by the drawee must be

prepared by the drawer and included in the documents to be presented for collections.

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▪ Collection conditions:

In all cases, the period of time within which documents have to be taken up or for any action to be taken by the drawee is 7 days from date of the

receipt by the collecting bank of the present collection instructions.

Payment or acceptance must be advised by the collecting bank to the remitting bank by swift.

In case of non-payment or non-acceptance within the period stated above, the collecting bank must advise the remitting bank urgently by swift.

If the collecting bank has no convenience to add its guarantee per aval on the bill of exchange or the promissory note (as applicable),

documents should not be delivered to drawee by the collecting bank who must advise the remitting bank accordingly by swift.

Whenever documents are to be delivered against acceptance of a Bill of Exchange / subscription of a promissory note / signature of an Undertaking

letter, Partial payment before maturity is allowed.

▪ Banks charges and commissions:

- Inside Lebanon are for the account of : The Drawer The Drawee

- Outside Lebanon are for the account of : The Drawer The Drawee And may not be waived (Documents must not be delivered if Collecting bank’s charges are unpaid)

▪ After collection please credit our account No.: ____________________________

▪ All documents must be sent to the collecting bank in one cover by registered mail.

Customer declarations: 1- We acknowledge that it is Blom Bank S.A.L policy to comply with all relevant laws and regulations, including anti-terrorism, anti-money laundering

and sanction laws and regulations including, without limitation, those sanctions and directives issued by the European Union, the United Nations, the

government of the United States, the US Office of Foreign Asset Control and the Central Bank of Lebanon or any other restrictive measure.

2- We acknowledge that Blom Bank S.A.L may take, and may instruct its members to take, any action which the bank in its sole discretion considers

appropriate to prevent or investigate crime or the potential breach of sanctions regimes or any other restrictive measure or to act in accordance with

relevant laws, regulations, sanctions regimes, international and national guidance, relevant Blom Bank S.A.L procedures and/or the direction of any

public, regulatory or industry body relevant to any member of Blom Bank S.A.L . This includes the interception and investigation of any payment,

communication or instruction, and the making of further enquiries as to whether a person or entity is subject to any sanctions regime. Such action may

include but is not limited to: the interception and investigation of any payment messages, instructions or other information sent in relation to the

documentary collection or making further enquiries as to whether a name which might refer to a sanctioned person or entity actually refers to that person

or entity.

3- We hereby confirm that we are fully aware of Blom Bank S.A.L role and responsibilities under this collection, referred to by article 11 of the URC 522

which clearly states that: “Banks utilizing the services of another bank for the purpose of giving effect to the instructions of the principal, do so for the

account and at the risk of such principal. Moreover, banks assume no liability or responsibility should the instructions they transmit not be carried out by

the collecting bank”. Based on the above we release Blom Bank S.A.L as from now from any responsibility or liability if the amount belonging to the

above mentioned collection was not collected or if the collecting bank did not comply with the collection’s instructions.

4- We confirm that we are aware of article 14a of the URC522 which clearly states that banks assume no liability or responsibility for the consequences

arising out of delay and/or loss in transit of any message(s), letter(s) or document(s).

5- Neither Blom Bank S.A.L nor any of its members will be liable for loss (whether direct, consequential or loss of profit, data or interest) or damage

suffered by any party arising out of any delay or failure by Blom Bank S.A.L or any of its members in performing any of its duties under these terms and

conditions or other obligations caused in whole or in part by any steps which Blom Bank S.A.L, in its sole and absolute discretion, considers appropriate

under applicable laws and regulations.

6- Whenever the collection amount is not collected within 12 months from issuance date in case of sight collection or 12 months from maturity date in case

of usance collection, we authorize Blom Bank S.A.L as from now and without our prior approval, to send a Swift message to the collecting bank, asking

them at our full responsibility to cancel the collection transaction, close their file accordingly and return back to Blom Bank S.A.L the unwithdrawn set of

documents / the unpaid draft / the unpaid promissory note / the unpaid undertaking letter. As such, Blom Bank S.A.L is authorized to close the collection

file at our full responsibility.

7- We hereby authorize Blom Bank S.A.L to send on monthly basis a swift message to the collecting bank asking them about the fate of payment / fate of

acceptance of our export documentary collection; consequently we authorize Blom Bank S.A.L to debit our account for your Swift charges.

8- For the purpose of this transaction, we hereby authorize Blom Bank S.A.L, without referring to us, to disclose any information of any kind whatsoever

pertaining to us, to any third party, in order to execute this transaction in the best business means as Blom Bank S.A.L finds appropriate.

▪ THIS DOCUMENTARY COLLECTION IS SUBJECT TO THE URC 522 OF ICC DD. 01/01/96

*We confirm our agreement to the terms and conditions under the field of “Customer declarations” numbered 1 to 8 and we acknowledge that they are irrevocably binding and enforceable upon us. *Our signature hereunder shall be considered to be made on the two pages of this of this Export Collection application, and we waive our right to claim or object the non-signature of its first page. Signature:

For Bank Use Only Branch Approval:

S.V