• Image field 1
  • PACIFIC RIM PETROLEUM COMPANY

  • COUNTERPARTY OPPORTUNITY REGISTRATION FORM

    Intermediary and Prospective Buyer / Seller Intake
  • ONE ROLE PER SUBMISSION

    USE SEPARATE SUBMISSIONS FOR EACH BUY / SELL OPPORTUNITY
  • Submission Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Opportunity type*
  • Purpose of this form

  • This form registers an intermediary and the intermediary's prospective buyer or seller for initial consideration by Pacific Rim Petroleum Company LLC (Pacific Rim). Pacific Rim is a privately owned Delaware limited liability company active in international petroleum and refined-fuel trading, commercial facilitation, counterparty qualification, documentation coordination, due diligence, logistics support, and long-term relationship development. Depending on the approved structure, Pacific Rim may purchase petroleum products for its own account, take title prior to resale, sell as titleholder, or serve as facilitator or transaction coordinator.
    Pacific Rim is founder-owned and founder-managed, with dedicated commercial and compliance leadership. Counterparties are reviewed under KYC/KYB, AML/CTF, sanctions-screening, documentation-integrity, and commercial-fit practices. Submission places the opportunity in the review queue; it does not constitute acceptance, allocation, exclusivity, a commitment to transact, or approval of any procedure or counterparty.
  • INTERMEDIARY REGISTRATION AND INTRODUCTION PROTECTION

  • Completion of the intermediary and Introduction Chain sections is required for every submitted opportunity. This information identifies all known parties participating in the specific introduction and creates a clear record of how the opportunity was presented to Pacific Rim.
    Accurate disclosure protects the prospective counterparty, intermediaries, and Pacific Rim by reducing duplicate submissions, undisclosed broker chains, conflicting claims, unauthorized representations, and potential circumvention. Registration helps preserve the intermediary's disclosed position for consideration under a later confidentiality, non- circumvention, or fee-protection agreement. Registration alone does not create or guarantee a commission, fee, exclusivity right, mandate, or entitlement to payment; any such protection requires a separate written agreement executed by authorized parties and remains subject to a completed transaction.
  • INITIAL SUBMISSION – PROVIDE WHAT IS CURRENTLY AVAILABLE

  • This registration form is intentionally comprehensive, but not every question or supporting document must be completed before an opportunity can receive an initial review. At this stage, the prospective buyer or seller should provide all information and documentation currently available and authorized and willing to be disclosed. Unless a field is specifically marked "Required," enter "Not available at this stage" where appropriate.
    The initial submission gives Pacific Rim enough information to understand the opportunity, conduct a preliminary assessment, and determine whether the proposed demand, supply, and transaction structure appear commercially viable enough to pursue. More complete and verifiable submissions can be evaluated more efficiently. Missing, unclear,
  • PAGE 1 OF 11
  • Image field 21
  • inconsistent, or unverifiable information may delay review or prevent the opportunity from advancing, and additional information may be required before any transaction proceeds.
  • CURRENT REVIEW CAPACITY AND PROCESSING TIME

  • Pacific Rim is currently managing a substantial volume of buyer, seller, and transaction submissions. Present capacity limitations relate to the time and resources required to review, verify, qualify, and coordinate opportunities—not to Pacific Rim's commercial ability to purchase, take title to, or sell petroleum products.
  • Review and processing may take several weeks or more. Submissions are prioritized by completeness, verifiability, compliance readiness, commercial fit, product availability or demand, and procedural alignment. Submission or preliminary acceptance does not guarantee an allocation, purchase, sale, transaction, priority position, exclusivity, or completion date. Do not make financial, logistical, storage, vessel, or contractual commitments in reliance on this registration unless Pacific Rim provides written authorization through definitive transaction documents.
  • HOW TO COMPLETE THIS REGISTRATION FORM

  • This registration is completed in two stages:
  • 1. Intermediary submission. The intermediary selects Buyer or Seller, completes the Intermediary Registration and Introduction Chain section, and provides one delegate email address for the prospective counterparty's authorized representative.
  • 2. Authorized representative submission. JotForm sends the designated representative a secure invitation to complete company information, role-specific transaction details, supporting-document uploads, declarations, and signature sections.
  • The delegate should be a principal, officer, authorized signatory, compliance representative, or other company representative with direct access to the requested corporate and transaction information. Do not designate another broker or intermediary unless formally authorized by the prospective buyer or seller to provide and certify company information.
  • The intermediary should not complete corporate, banking, product, authority, or compliance information on behalf of the prospective counterparty without express written authorization and direct knowledge. Only one primary delegate email should be entered. The intermediary must confirm its accuracy and the delegate's agreement to participate. The opportunity will not enter substantive review until the representative's portion and required information have been submitted.
  • CONFIDENTIAL INTAKE. Information is requested solely to identify the parties, protect introductions, evaluate commercial fit, and conduct due diligence. Pacific Rim will limit use and disclosure to personnel, advisors, service providers, financial institutions, and transaction counterparties who reasonably need the information, subject to applicable law, compliance obligations, and transaction requirements.
  • BUYER PROCESS ASSURANCE. No payment for the fuel itself is required before the buyer receives and may verify the proof-of-product documents required by the final published and mutually accepted procedure. A selected pathway may separately require verified proof of funds, bilateral escrow security, an earnest deposit after order-package approval, or another written alternative. Any such item is not payment for the fuel and will be governed only by definitive transaction documents.
  • PAGE 2 OF 11

  • Image field 39
  • SELLER PROCESS EXPECTATION. Pacific Rim will evaluate the seller's authority, product, title or allocation position, POP pathway, inspection arrangements, logistics, pricing basis, and complete written procedure. No seller procedure is accepted through this registration form. Any approved transaction must be documented in mutually accepted definitive agreements.

  • What happens after submission

  • 1) Initial completeness review 2) Intermediary / principal verification
    3) Compliance review 4) Commercial and procedural fit review
  • If the opportunity advances, Pacific Rim will request supporting documents, conduct a principal-to-principal call, and request or issue the applicable transaction documents and published procedure. Do not transmit funds, make commitments, or treat the submission as an order, allocation, purchase commitment, or authorization to contact another party outside the disclosed chain.
  • INTERMEDIARY REGISTRATION AND INTRODUCTION CHAIN

  • Complete this section for the intermediary submitting the opportunity.
    All fields in this section should be required unless PRPC designates otherwise.
  • Format: (000) 000-0000.
  • Introduction chain

  • List every known person or company involved in this specific introduction, beginning with the prospective buyer or seller and ending with the person who has direct contact with Pacific Rim. Do not omit, combine, or add parties without a genuine role. Attach additional entries if needed.
  • PAGE 3 OF 11

  • Image field 61
  • Introduction Chain — Participants
    Rows
  • Intermediary confirmations*
  • Authorized delegate

  • Format: (000) 000-0000.
  • PAGE 4 OF 11
  • Image field 75
  • AUTHORIZED REPRESENTATIVE STAGE

    The information above was submitted by the introducing intermediary and is displayed for review and identification of the disclosed introduction chain. These entries cannot be changed during this stage. If any information is inaccurate or incomplete, describe the discrepancy in the field below rather than altering the original submission.
  • PROSPECTIVE COUNTERPARTY — CORPORATE IDENTITY AND CONTACTS

  • Authorized principal and transaction contacts
    Rows
  • Compliance disclosures*
  • Disclose any sanctions exposure, politically exposed person involvement, pending or recent material litigation, regulatory action, insolvency, fraud allegation, or criminal proceeding involving the company, beneficial owners, directors, or proposed transaction.
  • PAGE 5 OF 11

  • Image field 96
  • BUYER REQUIREMENT AND TRANSACTION READINESS Requested product(s)*
    Rows
  • Financial capacity and pathway readiness options
  • PAGE 6 OF 11
  • Image field 115
  • Buyer acknowledgments*
  • SELLER SUPPLY AND TRANSACTION READINESS Available product(s)*
    Rows
  • PAGE 7 OF 11

  • Image field 140
  • Procedure and authority disclosures
  • Seller acknowledgments*
  • PAGE 8 OF 11

  • Image field 160
  • SUPPORTING DOCUMENTS AND SUBMISSION CHECKLIST

  • Attach any available documents in clear, current, legible form. Pacific Rim may request originals, certified copies, independent verification, or additional information. Do not include online-banking passwords, security codes, or unnecessary account credentials.
  • Universal Common documents
  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • Buyer Documents
  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • Seller Documents
  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • Secure handling and follow-up

  • PRIVACY PRACTICE. Sensitive identity, banking, title, and supply documents should be uploaded only through the designated secure intake method. Pacific Rim may retain the submission for due diligence, audit, legal, fraud- prevention, sanctions, and transaction-record purposes and may contact listed parties to verify authenticity. The submitter may request correction of inaccurate contact or company information, subject to legal and record-retention requirements.
  • PAGE 9 OF 11

  • Image field 172
  • CONFIDENTIALITY, NON-CIRCUMVENTION, DECLARATIONS AND SIGNATURES

  • Limited mutual confidentiality and non-circumvention undertaking

  • In consideration of the disclosure of confidential commercial information and introductions, Pacific Rim, the submitting intermediary, and the prospective counterparty intend that non-public information received through this intake be used only to evaluate, structure, document, finance, verify, or carry out the proposed transaction. Each receiving party will use reasonable care to protect that information and may disclose it only to personnel, professional advisors, financial institutions, compliance providers, insurers, logistics providers, and proposed transaction counterparties who have a reasonable need to know, or when disclosure is required by law, regulation, court order, sanctions review, fraud prevention, or lawful due diligence.
  • Confidential information does not include information that the receiving party can document was already lawfully known without restriction, becomes public without breach, is received lawfully from a third party without a duty of confidence, or is independently developed without use of the disclosure. No party shall knowingly bypass or circumvent a disclosed introducing party to avoid an otherwise valid, separately documented compensation obligation concerning the specific opportunity identified in this submission. This protection does not create a commission, exclusivity right, agency, fiduciary duty, partnership, or restriction on relationships demonstrably existing before this submission.
  • This limited undertaking begins on the last signature date and continues for twenty-four (24) months. Transaction-specific confidentiality, NCNDA, fee-protection, or dispute terms in a later signed agreement will supersede this section for that transaction. This form may be signed electronically and in counterparts. It is an intake and limited confidentiality record only; it is not an SPA, purchase order, allocation, guarantee, proof of funds, proof of product, or legal opinion. Parties should obtain independent legal advice before relying on this language for a particular jurisdiction or transaction.
  • Intermediary Declarations and consent*
  • Counterparty Declarations and consent*
  • Intermediary signature

  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • PAGE 10 OF 11

  • Image field 187
  • Prospective buyer authorized signature

  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Prospective seller authorized signature

  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  •  
  • Should be Empty: