THIS PORTION IS TO BE COMPLETED BY THE ACCOUNT OFFICER
Ocer’s Authorization
Primary Account Ocer____________________________________________________________________________ Primary Ocer Telephone______________________________________________________________________
Ocer ID Number_____________________________________________________________________________________ Ocer Cost Center to Book L/C_____________________________________________________________
Underwriter_______________________________________________________________________________________________ Underwriter Telephone___________________________________________________________________________
Senior Approver_________________________________________________________________________________________ Team Email_____________________________________________________________________________________________
Billing: Debit Account, Preferred (specify Account Number)_______________________________________________________________________________________________ -or- Send Invoice
Fees Charged Issuance (Minimum $300) (Select One)
________________________Basis Points P.A. (360 Days)
-or-
$
______________________ Flat
in USD
$__________ Application Processing
$__________
Courier
$
__________
Messaging
$
__________
Other, Specify____________________________________________
Collateral for L/C (select one) Secured -or- Unsecured
If Secured, Select Only One Type: Cash (Account Number)________________________________________________________________________ -or- Same Collateral as Credit Line
Other (specify)_________________________________________ -or- Multiple Assets (specify)____________________________________________________
Syndicated Transaction? Yes No If Yes, Fronting Fee May Apply _______________ Basis Points -or- $______________ Fixed
Letter of Credit Type (select one) Financial Obligation -or- Performance Obligation -or- Other (specify)_____________________________________________
Auto Extend Upon Expiration Date? Yes No Credit Facility #__________________________________________
Note: Upon Auto Extension of the Original Terms, No Notice or Document Will Be Sent to the Beneciary. Extension Requires Credit Approval, Can Be Rescinded.
Applicant Tax Identication No____________________________________________________________________ Applicant NAICS Industry_______________________________________________________________________
Instructions: Step 1 - Forward Completed Form and Attachments to Credit Underw
riting, Step 2 - F
orward Signed Form Package to Trade.Services@Capitalone.com
THIS PORTION IS TO BE COMPLETED BY THE APPLICANT
All Information Must Be Typed or Printed
APPLICANT (Obligor and Capital One Client)
Company Legal Name______________________________________________________________________________
Legal Street Address
_________________________________________________________________________________
_________________________________________________________________________________________________________________
City, State__________________________________________________________________________________________________
Postal Code__________________________ Country_______________________________________________________
FOR ACCOUNT OF (Equals Applicant, Enter Only if Dierent from Applicant)
Obligor’s Subsidiary, Aliate, or Customer
_________________________________________________________________________________________________________________
Legal Street Address
_________________________________________________________________________________
_________________________________________________________________________________________________________________
City, State
__________________________________________________________________________________________________
Postal Code
__________________________ Country_______________________________________________________
Amount in Figures $_______________________________________________________________________________ Currency: U.S. Dollars -or- Other (specify)______________________________
Amount in Words_________________________________________________________________________________________________________________________________________________________________________________________________________
Final Expiration Date _____________________________________________________________________________
Auto-Extend. If Yes, Annually on Issuance Date Anniversary -or- Other Frequency (specify)
The Purpose of this Letter of Credit is (select one) Insurance Lease Support Performance Advance Payment Bid
Other (specify)___________________________________________________________________________________ Additional Description (If Any)______________________________________________________________
Application for Irrevocable Standby Letter of Credit
TO: Capital One, N.A.
Trade Finance Services
802 Delaware Avenue
Department IZ: 18056-0500
Wilmington, Delaware 19801
continued
capital.one
DATE________________________________________
The applicant below requests Capital One, N.A. issue an irrevocable standby letter of credit with terms as set forth below by:
Document via Courier -or- Electronic via Teletransmission—(SWIFT Full Details Format)
IN FAVOR OF (Beneciary)
Beneciary Legal Name_________________________________________________________________________
Legal Street Address
_______________________________________________________________________________
_______________________________________________________________________________________________________________
City, State
________________________________________________________________________________________________
Postal Code
_________________________ Country______________________________________________________
ADVISING BANK (of Beneciary)
Name_____________________________________________________________________________________________________
Branch Address
______________________________________________________________________________________
City, State
________________________________________________________________________________________________
Postal Code
________________________ Country______________________________________________________
SWIFT BIC
_____________________________________________________________________________________________
Note: Optional, if le blank, Capital One may select
Note Upon Auto Extension of the Original Terms, No
Notice or Document Will Be Sent to the Beneciary.
Extension Requires Credit Approval, Can Be Rescinded.