Paymaster Client Information

Millennial Captial Management

Paymaster Client Distribution Information
This document and the answers you provide shall remain CONFIDENTIAL and PROPRIETARY and is provided ONLY to the Paymaster for the purposes of performing due diligence and use in drafting a formal agreement with the person whose information appears hereunder

Many of the form fields require responses. Payment distributions can be delayed if any lines are not fully filled in with accurate or required information.

Submitting this form is not a contract with the Paymaster or a guarantee of payment, its is simply providing information to the Paymaster to generate the agreement for your signature.

Definitions

PAYEE is the point person workign with Paymaster receiving the distribution

SUB-PAYEE(s) are individuals that receive a distribution but are not involved directly with the transaction or Paymaster

PAYOR is the person sending the funds to Paymaster to distribute
Payor Information
Corporate Name of Payor
Personal Name of Payor

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Payor Email
example@example.com
Payor Passport Number
Date of issue*

MonthDayYear
Date of Expiry*

MonthDayYear
Upload copy of Payor Passport

Browse Files

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Breifly describe the transaction in general terms, what kind of transaction is generatign the funds to distribute?
Example Sale of a commercial real estate building
What Bank will be distributing the funds to Paymaster?
Payee Personal Information
Payee Name*

PrefixFirst NameMiddle NameLast NameSuffix
Payee Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Primary Payee E-mail*
example@example.com
Payee Mobile Phone Number*

Country CodeArea CodePhone Number
Payee Home Phone Number

Country CodeArea CodePhone Number
Fax Number

Area CodePhone Number
PAYEE Passport Information
Passport Number*
Date of issue*

MonthDayYear
Date of Expiry*

MonthDayYear
Date of Birth*

MonthDayYear
Issuing Authority*
Upload copy of Passport*

Upload a File

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PAYEE Business Information
Business Name*
Business Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Business Phone Number*

Country CodeArea CodePhone Number
Business Fax Number

Country CodeArea CodePhone Number
E-mail
example@example.com
Corporate Domicile State or Country
Corporate Registration Number
EIN or taxpayer ID
Description of Business
Upload Articles of Organization or registration information

Upload a File

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Proof of Authority

Upload a File
certificate from issuing authority showing eneity is established Cancelof
Payee Banking Information
this is the bank information we will use to make your distributions.
Bank Name*
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Account Name*
Authorized Signatory 1*

PrefixFirst NameMiddle NameLast NameSuffix
Authorized Signatory 2

PrefixFirst NameMiddle NameLast NameSuffix
Bank officer Name*

First NameLast Name
Bank officer Phone*

Country CodeArea CodePhone Number
Bank officer Email
example@example.com
ABA Routing Number
Account Number
IBAN Number
Swift Code
Special Instructions for Wires
What is the total expected on the first payment from Payor?
What is the total expected of all payments from the Payor?
What is your understanding of the percentage of the distributed funds will you receive as a fee? example- if you are to receive 75% enter 75
percent
Information for Others receiving part of this distribution
YesNo
Sub Payee 1 Name

First NameLast Name
Sub Payee 1 Name Email
example@example.com
Percentage of the total distrtibution Sub Payee 1 will be receiving
from the funds received by Paymaster
Sub Payee 2 Name

First NameLast Name
Sub Payee 2 Name Email
example@example.com
Percentage of the total distrtibution Sub Payee 2 will be receiving
from the funds received by Paymaster
Sub Payee 3 Name

First NameLast Name
Sub Payee 3 Name Email
example@example.com
Percentage of the total distrtibution Sub Payee 3 will be receiving
from the funds received by Paymaster
Sub Payee 4 Name

First NameLast Name
Sub Payee 4 Name Email
example@example.com
Percentage of the total distrtibution Sub Payee 4 will be receiving
from the funds received by Paymaster
Sub Payee 5 Name

First NameLast Name
Sub Payee 5 Name Email
example@example.com
Percentage of the total distrtibution Sub Payee 5 will be receiving
from the funds received by Paymaster
Should be Empty:

Payor Information

Payee Personal Information

PAYEE Passport Information

PAYEE Business Information

Payee Banking Information

Information for Others receiving part of this distribution