enukru +38 050 147 0207 welcome@ukrainian-adventures.com
+38 050 147 0207 welcome@ukrainian-adventures.com


Ukrainian Incentives LLC (Juridical Code 40448476), represented by Director Marina Antoniuk, acting on the basis of Chapter, hereinafter – «Tour Operator», on the one hand, and

and citizen, passport _______________ issued __________________________________ living at:________________________________________ _____________________________,

hereinafter – «Tourist», who is fully operational, on the other hand, hereinafter collectively referred to as the “Parties” and each individually as the “Party”, have concluded this Tourism Services Agreement (hereinafter referred to as “the Agreement”) as follows:



1.1. «Tour» or «tour product» – tourist trip by a certain route in specific terms, provided with a complex of tourist services (booking, transportation, accommodation, meals and other).

1.2. «Tourist voucher» or «voucher» – a document specified by the Tour Operator of the form that entitles the Tourist to stay at the specified hotel with a certain type of meal plan and type of room within a specified period, and (or) to use the transfer. The tourist voucher issued within the framework of this Agreement shall not be subject to the requirements of Art. 23 of the Law of Ukraine “About Tourism”.

    1.3. «Tour Operator» – Limited Liability Company «Ukrainian Incentives» (license for tour operator activity of series No. 1921 issued by the State Agency of Ukraine for Tourism and Resorts on November 16, 2016).

Other terms not specified in the Agreement are used in the meaning given in the Law of Ukraine “About Tourism” and other normative legal.



2.1. Tour operator undertakes to provide for Tourist a complex of tourist services (tourist product) according to the order of the Tourist, and the Tourist undertakes to accept and pay for it under the Agreement.

2.2. This Agreement does not extend to the provision of services related to the departure of a natural person from the place of permanent residence for the purpose of employment, for the purpose of performing professional duties, for other business purposes or for the purpose of changing citizenship or obtaining a residence permit or right to a residence permit. work in another country or in family affairs.



3.1. The tourist trip is made up of _____________ (indicate the number of tourists and information about them; if Tourist/tourists travel with children, the date of birth of each child is required):

First and last name of Tourist

Series, № of passport of Tourist

Date of Birth of Tourist


 And also persons on behalf and in the interests of whom the Tourist acts by concluding the Agreement:

First and last name of Tourist

Series, № of passport of Tourist

Date of Birth of Tourist


3.2. Terms of tour: from ____________   till____________ including, number of nights/days_________

3.3. Destination (destinations) of travel:________________________________________________

3.4. City of travel: ______________________________________________________

3.4.1. rules of entry to the country (place) of temporary stay and stay there: ____________ ___________________________________________________________________________

3.5. Transportation conditions:______________________________________________________

3.5.1. Purchase (booking) of travel documents, number of travel documents____________________________________________________________________

3.5.2. Mean of transport: ______________________________________________________________ ____________________________________________(type of transport, category)

3.5.3. Point and date of departure / point and date of arrival:________________________________.

Departure point (start of tour) The tourist arrives independently and must arrive in advance (i.e. depending on the requirements imposed by the carrier).

3.5.4. Transfer: _____________________( Yes No; group / individual – must be specified).

3.6. Hotel/hotels: name __________________________________________________________/category___________________/location ________________________________________________

3.6.1. Room/s: _______________________________________________________________  (single, single with extra bed for child, double, double with extra bed for child, triple, apartment, suite, other, – must be specified);

3.6.2. Term and procedure for payment for hotel services: ________________________________ ___________________________________________________________________________

The check-out time at the hotel is 12.00 hours. On the last day of stay at the Hotel the Tourist is obliged to pick up his staff, to vacate the room no later than the time specified in this point;

3.6.3. Confirmation of the hotel’s service requirements: ____________ ___________________________________________________________________________

3.7. Meal plan: ______________________________ (BB, Half Board (breakfast and dinner), Full Board (breakfast, lunch and dinner), “all inclusive”, no meals, – must be specified).

3.8. Minimum number of tourists in the group (if needed): ______________________________

3.9. Tourist service program: ____________________________________________ ___________________________________________________________________________

3.10. Excursion services:______________________________________________________

3.11. Other tourist entities (their location and details) providing tourist services included in the tourism product: _________________________________________ ___________________________________________________________________________

3.12. Insurance:

а) provided by an insurance company ________________________________________________________

  1. b) Tourist has insurance policy № ___________

3.13. Visa support (must be emphasized):

а) submission of documents to the embassy (consulate) is provided by the Tour Operator; b) The tourist receives a visa independently; c) The tourist receives a visa independently at the airport upon arrival; d) The tourist has a valid visa.


4.1. Prior to the conclusion of the Contract, the Tour Operator has provided the Tourist with reliable information about the terms of rendering tourist services under the Contract in an accessible, clear, legible and understandable manner, namely:

4.1.1. place of providing tourist services, program of tourist services;

4.1.2. the characteristics of the transport vehicles, in particular their type and category;

4.1.3. a description of the hotels and other facilities intended for the provision of temporary accommodation services, including their location, category, information on confirmation of compliance of the hotel services with the set requirements, terms and procedure of payment for hotel services;

4.1.4. types and ways of providing food during a tourist trip;

4.1.5. the minimum number of Tourists in the group, as well as the fact that the Tour Operator will inform the Tourist that the tourist trip will not take place due to the shortfall of the group, not later than 3 (three) days before the start of the tourist trip;

4.1.6. the price (cost) of tourist services (tourist product);

4.1.7. basic requirements for registration and status of exit / entry documents (passport, permit (visa) for entry / exit to the country of temporary stay), including information on the terms of their registration;

4.1.8. medical warnings regarding the implementation of a tourist trip, including contraindications due to certain diseases, peculiarities of physical condition (physical disabilities) and age of tourists, as well as security conditions for tourists in the country (place of temporary stay);

4.1.9. Tour Operators, their location and postal details, contact telephones, the presence of a license to conduct tourist activities, certificates of conformity and other information in accordance with the legislation on consumer protection;

4.1.10. the group leader and the means of communication with him (in the case of travel abroad or stay abroad of a minor and / or a minor for the purpose of establishing legal representatives of the minor or a minor directly with him);

4.1.11. the time and place of intermediate stops and transport connections and the category of place that the Tourist will occupy in a particular type of vehicle;

4.1.12. types and topics of excursion service, order of meetings and conferences, support of tourists;

4.1.13. state of the environment, sanitary and epidemiological well-being;

4.1.14. the amount of financial security of the Tour Operator in the event of his insolvency or insolvency (bankruptcy) and the credit institution that provided such security.

4.2. By signing the Contract, the Tourist hereby confirms that he has received all the information specified in paragraph 4.1. of the Agreement



5.1. All costs related to transfer of funds for the services ordered by the Tourist are included in the cost of the Tour (tourist product) and are payable by the Tourist.

5.2. The cost of the specified in this Agreement Tour (tour product) is equivalent _________________________________________ (payment in UAH at the commercial rate on the day of payment).

5.3. The tourist pays the tour operator specified in clause 5.2 before the __________________________ 20___ year of the Contract value of the tour (tour product) by the bank transfer  to the current account of the Tour Operator specified in the Contract based on the account received from the Tour Operator.

5.4. Until the time of receipt by the Tour Operator of funds for tourist services under the Agreement, such relevant services shall be considered unannounced and shall not be rendered without any sanctions being applied to the Tour Operator.

5.5. Payment for services ordered by the Tourist may be made by a third party on the basis of invoices issued by the Tour Operator.

5.6. The Third party may pay for the ordered by Tourist services according to Invoices issued by Tour Operator



6.1. The tour operator has the right:

6.1.1. Make partial changes to the excursion program in case of a change in essential circumstances, or increase the cost of transportation services (in case of increase in transport tariffs, including the size of fuel collection, etc.), notifying the Tourist no later than 5 (five) days before the Tour begins. In case the specified changes do not suit the Tourist, he has the right to refuse to execute the Contract, and the Tour Operator is obliged to return to him all the funds previously paid by him under the Contract.

6.1.2. In case of objective circumstances that prevent the accommodation of the Tourist in the hotel specified in the Contract, the Tour Operator has the right to replace the Tourist in a hotel of the same or higher category without additional payment by the Tourist.

6.1.3. To terminate the Contract without material and moral damages to the Tourist in case the Tourist receives from the embassy (consulate) of the country of temporary stay a visa refusal, returning the tourist received from him for payment of the tour, less the amount actually incurred by the Tour Operator from such organization.

6.1.4. Refuse the Tourist to provide tourist services in case of incomplete and / or late payment of the Tour.

6.1.5. receiving from the TOURIST the necessary personal information in order to sell the tourist product.

6.1.6. compensation by the TOURIST the losses caused by illegal actions of the TOURIST.

6.1.7. other rights specified in the Agreement

6.2. The tourist has the right:

6.2.1. To receive the tourist services stipulated by the Contract, as well as to receive information, consultations during the tourist trip.

6.2.2. Other rights specified in the Contract.


7.1. The tour operator undertakes:

7.1.1. to provide the TOURIST with the services included in the tourist product, according to the order placed through the website www.ukrainian-adventures.com and www.ukrainian-adventures.com.ua or directly at the TOUR OPERATOR’s office;

7.1.2. Provide the tourist with the documents necessary for the receiving of tourist services

7.1.3. to provide the TOURIST with necessary and reliable information about the tourist product, formed by the TOUR OPERATOR, the obligations and rules of the TOURIST behavior, the insurance conditions, the procedure for compensation of the caused losses, the conditions of refusal of services and other necessary information;

7.1.4. comply with the requirements of the law on TOURIST security, protection of tourist resources of Ukraine and the environment;

7.1.5. to indemnify, in due course, the actual damage to the TOURIST, to other persons and to the environment, arising solely and as a result of the failure to provide or improperly provide the complex of services stipulated by the Treaty, and in the case of the fault of the TOUR OPERATOR, which is proved in accordance with the procedure established by law and confirmed guilt.

7.2. The tourist undertakes:

7.2.1. provide the TOUR OPERATOR with the information and documents necessary for the booking and sale of the tourist product; provide personal information to the extent necessary for the sale of the tourism product

7.2.2. To pay the value of the tourist product within the period stipulated in clause 5.3. Of the Treaty.

7.2.3. To comply with the requirements of the current legislation of Ukraine regarding the crossing of the State Border of Ukraine, as well as the border, customs and entry / exit rules to / from the country of temporary stay, sanitary rules; respect the customs, traditions of the local population, the political and social order of the host country; not to violate the public order and requirements of the laws in force in the territory of the country of temporary stay; not to violate the rights and legitimate interests of other citizens; abide by the rules of conduct aboard the aircraft, abide by the rules of internal arrangement and fire safety in the locations and locations. To fulfill other obligations stipulated by the current legislation of Ukraine and the legislation of the country of temporary stay.

7.2.4. Comply with customs, border, sanitary and other rules stipulated by the Treaty and / or current legislation of Ukraine. If necessary, pay the cost of an entry visa when passing passport control.

7.2.5. Do not violate the rights of other persons, the requirements of laws acting in Ukraine

7.2.6. Independently pay for additional services chosen by the Tourist at his own request: transport services (not stipulated in the terms of the Agreement), services abroad (not stipulated in the terms of the Agreement), as well as other services not stipulated in the terms of the Agreement, in places of temporary residence and stay.

7.2.7. Follow the conditions and rules, respect the social system, traditions, customs, religious beliefs of the place of residence. To preserve the environment, to treat the objects of nature and cultural heritage of Ukraine with care

7.2.8. Observe the rules of personal safety and protection of personal property when traveling on a tourist trip.

7.2.9. Pay penalties in the cases, amount and order established by the Contract.

7.2.10. In the event that a tourist has a claim for the quality of services provided, the Tourist must immediately submit a written request to the representative of the host party and notify the Tour Operator within 12 (twelve) hours from the moment of the fact of providing poor quality services in order to eliminate the problem that originated. If it is impossible to satisfy the claim on the spot, the Tourist, together with the authorized employee of the organization providing services to the Tourist, draw up an act, which is verified by their signatures and signature of the representative of the host party, with the following mark in the tourist voucher (hotel administrator, group leader, representative at the party) . Drafting the relevant act and marking it in the voucher are a prerequisite for further consideration of reimbursement of the cost of the tourist service.





8.1. The Parties are responsible for the non-performance and / or improper performance of obligations under the Agreement in accordance with the terms of this Agreement.

8.2. The TOURIST has the right to cancel the booked tourist services in whole or partly under the conditions stipulated in Clause 8.2. of this Agreement

8.3. In case of refusal of the Tourist from a tourist trip (refusal of the Embassy to issue a visa or late issuance of a visa by the Embassy of the Tourist is automatically considered a refusal of the tour) or change of the date of the trip the Tourist shall pay the Tour operator a penalty in the following amounts:

  1. a) for refusal or change in time from 3 (three) working days before the start of the trip – penalty in amount equivalent to EUR 20 at the NBU’s commercial rate for each tour participant;;
  2. b) for refusal or change in term from 3 (three) to 0 (zero) days before the start of the trip – the penalty is 100% of the total cost of the tour product;
  3. c) for refusal or change in term from 3 (three) to 0 (zero) days before the start of the trip or for non-appearance on boarding of the vehicle or to the place of starting of the trip – 100% of the total cost of the tour product, but not more than the amount actually incurred by the Tour Operator on the organization of the tour.

The rules of this clause shall apply both in case of refusal of the Tourist, and for reasons that hinder the start of the tourist trip, which are not dependent on the Tour Operator (the Tourist is subject to any restrictions on crossing the state border established by the legislation of Ukraine or the legislation of the country that is any of the points of the tourist trip).

8.4. Also, if a Tourist cancels a tour booked for the New Year / Christmas period (December 15 to January 15, inclusive), May (April 26 to May 10, inclusive), and / or other public holidays for less than 30 (thirty) days, and also in the case of religious, ethnic and / or national holidays, sports competitions, etc. at the territory of any tourist destination. (of which the Tourist was warned by the Tour Operator prior to the conclusion of the Agreement), characterized by the increased demand for tourist services at this place at the present time, the Tourist undertakes to pay in favor of the Tour Operator a penalty of 100% of the cost of the tour product, but not more than the amount actually incurred by the Tour Operator tour organization.

8.5. Changing the terms of the Tour on the initiative of the Tourist after his payment, as well as the failure to provide the Tour Operator with the necessary documents in time is equal to the cancellation of the tour and has the consequences stipulated in clause 8.2. Of the Contract

8.6. The tourist is responsible for damaging the property of third parties or committing illegal activities during the tourist trip in accordance with the current legislation of the country of temporary stay.

8.7. In case of a tourist’s violation of the program of service, rules and rules of conduct in the host country, customs and border control rules, rules of conduct on board an airplane, transportation (violation of law enforcement in the state of alcoholic or narcotic intoxication), as well as violation of other generally accepted rules of behavior , which caused the removal of the Tourist from the flight, delay by the competent authorities, delivery (stay) of the Tourist to (c) medical institutions of the host country, for the above reasons, which led to additional tourist costs, the Tour Operator is not responsible for this, and the cost of the Tour is not refundable and any other compensation is not paid.

8.8. In case of violation of the Rules of Carriage of Passengers and Baggage by the Tourist, the penalties provided for by the carrier shall apply to the Tourist.

8.9. The tourist who has signed this Agreement represents the interests of all persons for whom the order of the tourist product is made and is responsible to the Tour Operator and those persons for the choice of services, correctness of the reported data, timely payment of services and payment of penalties in case of cancellation of the trip. The risk of insufficient authority of the Tourist to conclude the Contract with respect to other persons is borne by the Tourist.

8.10. For non-fulfillment or improper fulfillment of the terms of the Agreement, the guilty Party shall pay the other Party documented losses.

8.11. The tour operator is not responsible for the refusal of the Consular Section of the Embassy to issue a visa. In this case, the cost of consular services to the Tourist is not refundable. The tourist will find out about the reasons of refusal of the Consular Section of the Embassy in the visa independently.

8.12. The tour operator is not responsible and does not pay any compensation for possible violations and actions that are not within its competence, namely:

  1. a) for change of schedule, cancellation, delay of flight, replacement of aircraft of one type for another, closure of airports for meteorological, technical and other reasons (including reasons related to the bankruptcy (liquidation) procedure of the carrier company), which led before the change of the Tour program, for the transportation of the Tourist, the storage of documents and personal belongings of the Tourist, the loss or damage of luggage during transportation. In this case, the carrier is responsible for the above. The relationship between the Tourist and the carrier is governed by the contract of carriage, the confirmation of which is the ticket issued to the Tourist;
  2. b) for the inability of the Tourist to travel, to postpone it to a later date, to suspend the trip, the damage caused by the actions of the consular, customs, migration services of Ukraine and foreign countries;
  3. c) for reimbursement of expenses in case of insured events, stipulated by the insurance contract. In case of an insured event, the Tourist is obliged to act in accordance with the instructions set out in the insurance policy;
  4. d) for the quality of hotel services.

8.13. The tour operator shall not be liable for reimbursement of the tourist’s material expenses for the tourist services purchased under the Contract, if the Tourist did not use all or part of the offered tourist services during the tourist trip, or terminated his stay in the Tour early.

8.14. The tour operator is not responsible for the loss, loss of valuables, documents, personal belongings of the Tourist during the tourist trip.

8.15. The tour operator is not responsible for the correct registration of the foreign passport of the Tourist.

8.16. The tour operator is not responsible for the decisions (actions) of the border, customs services of the countries through (to) which (s) the Tourist travels, as well as other institutions regarding the impossibility of entry of the Tourist or persons traveling with him, in accordance with the terms of the Agreement, on the territory of these countries. In this case, the Tourist pays for the expenses related to the deportation (transport costs, administrative fines, penalties and other payments).

8.17. In case of refusal to enter the territory of the country on the route of a tourist trip to one of the Tourists traveling with the group, the Contract shall not be terminated for the other Tourists in the group (such Tourists shall continue the trip according to the terms of the Agreement). In this case, claims for actions of the relevant authorities of the country along the route of travel for consideration by the Tour Operator are not accepted, no compensation is paid.

8.18. The tour operator shall not be liable if the failure or improper fulfillment of the terms of the Contract occurred as a result of:

  1. a) providing the Tour Operator with documents and information of the wrong content (incompleteness, unreliability, forgery, incorrect registration and status of documents or other);
  2. b) through the fault of third parties not related to the provision of the services specified in this Agreement, neither of the Parties knew about them and could not have known in advance;
  3. c) the occurrence of force majeure or the result of events that the Tour Operator and other tourist entities providing tourist services included in the tourism product could not have foreseen;
  4. d) Tourist’s fault.

8.19. In case the Tourist does not leave for a tourist trip due to loss of documents, delayed flight at the beginning and / or at the end of the tourist trip due to personal reasons, etc., the Tour Operator is not responsible for such actions (inactivity) of the Tourist and does not pay compensation.

8.20. The tour operator does not have information about the plans of carrying out on the territory of the hotel or the territory adjacent to the hotel in the country of temporary stay of construction and repair works carried out by the decision of the administration of the hotel or with the knowledge of the local authorities by any state or private persons accordingly and is not responsible for any what are the inconveniences that may be caused to the Tourist in this regard.

8.21. In case of refusal of the Tourist to receive tourist services due to the occurrence of situations in the territory of the country of temporary stay of the Tourist related to a possible threat to the life of the Tourist, such as: floods, epidemics, terrorist acts, natural disasters, etc., which are not officially recognized by circumstances force majeure (force majeure) and which do not interfere with the actual rendering of tourist services to the Tourist, the provisions of Clause 8.2 apply. of this Agreement, while the Tour Operator makes every effort to minimize the penalties of the partners in the organization of the tour.

8.22. The tour operator is not responsible for the violation of the estimated hours by the tourist (or persons in favor of which the legal entity has concluded the contract). The tourist independently pays for all expenses that have arisen as a result of violation of his billing hours.

8.23. Payment of a penalty under the Agreement may, at the request of the Tour Operator, be made by deducting it from the Tour Operator from the amounts to be returned to the Tourist..



9.1. All disputes that may arise during the implementation of the Agreement shall be settled by negotiation, and in case of failure to reach agreement, according to the current legislation of Ukraine.

9.2. In case of failure to provide or poorly provide the Tourist with any of the services under this Agreement and when providing the Tourist with the documents specified in paragraphs. 7.2.14. Contracts, claims related to service during the tourist trip are accepted for consideration within 10 working days after the end of the tourist trip. Within 30 (thirty) days after receipt of the claim and the above documents, the Tour Operator undertakes to provide a written response to the tourist’s claim (to decide on payment of compensation, or reasonably refuse to pay).

9.3. In case of acknowledgment of the Tourist’s claims and compensation for the damage caused by the Tour Operator, the Tourist is obliged to sign the relevant financial documents about it, as well as a written statement of refusal to submit property and other claims to the Tour Operator.


10.1. Change of the hotel or room at the request of the Tourist can only be done at an additional cost.

10.2. In case of satisfaction of the claims addressed by the Tourist in the country of temporary stay in accordance with paragraphs. 7.2.14. Of the contract, by offering the Tourist other (compensatory) services, and in case the tourist does not use such offered services, it is considered that the Tour Operator has fulfilled its obligations properly, and claims on the same issue are not considered.

10.3. Claims and statements The tour operator accepts only directly from the person who has signed this Agreement (the legal representative of such person).

10.4. Claims regarding climate, local traditions, length of flight or move, duration of passage of the customs border are not accepted in any case.

10.5. In the event of an insured event, a claim for damages in connection therewith shall be submitted by the Tourist to the insurance company specified in the insurance policy.

10.6. The hotel administration of the country of stay may periodically change the equipment of the rooms, change the food (menu), especially at the beginning and end of the season. Some advertised entertainment, including the use of sports equipment, may be provided for a fee. Equipment featured in promotional photos may not necessarily be available throughout the season.

10.7. Changing the price of a tourist product after the conclusion of the Agreement is allowed only if it is necessary to take into account the change of tariffs for transport services, introduction of new or increase of the current rates of taxes and fees and other obligatory payments, change of the hryvnia to the foreign currency, in which the value of the tourist product is expressed.

10.8. Either party may request amendments or termination of the Agreement due to significant changes in the circumstances specified in the Law of Ukraine “On Amendments to the Law of Ukraine“ On Tourism ”, from which they came out at the conclusion of the Agreement.

10.9. Changes and additions to the Contract are made with the consent of both parties, which are formalized by separate additions to the Agreement, which are signed by the TOUR OPERATOR and TOURIST.

10.10. In case of impossibility of organizing tourist services within the specified time limits, the TOUR OPERATOR informs the TOURIST about new terms of rendering tourist services, in writing (by mail, e-mail, fax) or by telephone, with obligatory registration of the text of the message.

10.11. All disputes arising from the terms of this Agreement will be settled by the parties through negotiations. In the event of a lack of agreement, the parties shall refer the dispute to the appropriate local court.

10.12. The financial liability of the TUROPERATOR is confirmed by bank guarantee № 2037 for the amount equivalent to 20,000 (twenty thousand) Euros, which was provided by the banking (credit) institution of PJSC “Commercial Bank GLOBUS” on September 16, 2016.

10.13. The Bank guarantee guarantees the liability of the TOUR OPERATOR to the TOURIST under this Agreement only in the event of circumstances of bankruptcy or insolvency of the TOUR OPERATOR, which are connected with the need to recover the value of non-rendered services provided by the Agreement, aimed at the sale of the TOUR product.



11.1. In the event of force majeure: war, flood, earthquakes, fires, strikes, epidemics, epizootics, changes in legislation and other phenomena of force majeure, the Parties shall be partially or fully exempted from their obligations under the Contract.

11.2. A Party which has failed to fulfill its obligations as a result of force majeure must notify the other Party in writing of the time of occurrence and termination of such circumstances.

11.3. The action of force majeure must be confirmed by the appropriate competent authority (Chamber of Commerce of Ukraine or other authorized body).



12.1. All disputes or disagreements that may arise out of or in connection with this Agreement will, if possible, be resolved through negotiations between the Parties.

12.2. If such a solution is impossible, the disputes and disagreements shall be submitted to the appropriate court for the jurisdiction established by law.


13.1. The Agreement shall enter into force upon signature by the Parties and shall remain in force until the fulfillment by the Parties of their obligations or until its early termination under the terms of the Treaty or the current legislation of Ukraine.

13.2. The tour operator’s obligation to fulfill the terms of this Agreement arises only after the tourist has paid in full the cost of tourist services and provided all necessary documents and information for the tourist travel.

13.3. The Agreement is concluded in 2 (two) copies in the English language having the same legal force, one copy for each Party.



Limited Liability Company

“Ukrainian Incentives”

USREOU code:40448476

Address: 02068,Kyiv, O. Koshitsya str., 1/38, of.519/1, Phone: +38 044 5703050, +380501470207

E-mail: u-in@ukrainian-incentives.com.ua  

Name of the bank: JSC CB “PRIVATBANK”,

Bank address: 1D HRUSHEVSKOHO STR., KYIV, 01001, UKRAINE


IBAN code: UA693807750000026000056146951


/Antoniuk Marina




Passport, series: _________ № _______________

Issued: ________________________________


Registered by the address:


Address for mailing:





__________________ /_____________/