JOINT-STOCK COMPANY
COMMERCIAL BANK «PRIVATBANK»
Registered address:
1D Hrushevskoho St., Kyiv, 01001, Ukraine
Contact us:
30 Naberezhna Peremohy St., Dnipro, 49094, Ukraine
Phones: 3700 (free from mobile in Ukraine)
(056) 735 32 82
www.pb.ua e-mail:
[email protected]from 22.06.2021 08:53 № QCASQTA22ICP98L2 Page 1 of 3
FURMANOV DANYLO
TIN: —, date of birth: 19.05.1995
BIRTH CERTIFICATE I-ОЛ 009704, issued by TSENTRALNYI VIDDIL REIESTRATSII AKTIV TSYVILNOHO STANU
KIROVOHADSKOHO OBLASNOHO UPRAVLINNIA IUSTYTSII date of issue 29.07.2005
Registration address: Ukraine, 26207, region Kirovohradska, district Malovyskivskyi, village Manuilivka, street Berehova, building 66
Statement of card/account 516875******8785 (UA773052990000026204750930768) of agreement SAMDNWFC00045211946 on
07.09.2018 for the period 16.03.2021 — 22.06.2021
Credit limit: 0.00 Total outflow: 340.72
Account currency: UAH Total inflow: 340.85
Opening balance: 0.51 Amount of charges: 0.00
Ending balance: 61.00 Amount of discounts: 0.69
Amount in Amount Amount Amount Balance
Transaction
Account Transaction details transaction in card of of after
date
currency currency charges discounts transaction
516875******8785 -3.94
12.06.2021 Contract No. SAMDNWFC00045211946 Purchase -3.94 0.00 0.00 0.64
from 07.09.2018
UAH
516875******8785 Transfer from PrivatBank card
Contact No. SAMDNWFC00045211946 4.00
12.06.2021 from 07.09.2018
via Privat24. Sender: 4.00 0.00 0.00 4.58
UAH
Vdovychenko Denys Olehovych
516875******8785 -15.76
12.06.2021 Contract No. SAMDNWFC00045211946 Purchase -15.76 0.00 0.00 0.58
from 07.09.2018
UAH
516875******8785 Transfer from PrivatBank card
15.00
12.06.2021 Contract No. SAMDNWFC00045211946 via Privat24. Sender: 15.00 0.00 0.00 16.34
from 07.09.2018
UAH
Vdovychenko Denys Olehovych
516875******8785 Payment for goods/services in -15.02
29.05.2021 Contract No. SAMDNWFC00045211946 -15.02 0.00 0.00 1.34
from 07.09.2018
Internet: UP *Oplati, KYIV UAH
516875******8785 15.00
29.05.2021 Contract No. SAMDNWFC00045211946 Top-up of a card 15.00 0.00 0.00 16.36
from 07.09.2018
UAH
516875******8785 Payment for goods/services in -16.10
27.05.2021 Contract No. SAMDNWFC00045211946 -16.10 0.00 0.00 1.36
from 07.09.2018
Internet: UP *Oplati, KYIV UAH
516875******8785 Transfer from PrivatBank card
15.00
27.05.2021 Contract No. SAMDNWFC00045211946 via Privat24. Sender: Skalenko 15.00 0.00 0.00 17.46
from 07.09.2018
UAH
Danylo Volodymyrovych
516875******8785 Payment for goods/services in -7.08
24.05.2021 Contract No. SAMDNWFC00045211946 -7.08 0.00 0.00 2.46
from 07.09.2018
Internet: UP *Oplati, KYIV UAH
516875******8785 Transfer from PrivatBank card
6.00
24.05.2021 Contract No. SAMDNWFC00045211946 via Privat24. Sender: 6.00 0.00 0.00 9.54
from 07.09.2018
UAH
Semenenko Tetiana Valeriivna
516875******8785 Payment for goods/services in -65.55
24.05.2021 Contract No. SAMDNWFC00045211946 -65.55 0.00 0.00 3.54
from 07.09.2018
Internet: UP *Oplati, KYIV UAH
516875******8785 Depositing the transfer to the 66.73
24.05.2021 Contract No. SAMDNWFC00045211946 66.73 0.00 0.00 69.09
from 07.09.2018
card UAH
JOINT-STOCK COMPANY
COMMERCIAL BANK «PRIVATBANK»
Registered address:
1D Hrushevskoho St., Kyiv, 01001, Ukraine
Contact us:
30 Naberezhna Peremohy St., Dnipro, 49094, Ukraine
Phones: 3700 (free from mobile in Ukraine)
(056) 735 32 82
www.pb.ua e-mail:
[email protected]from 22 06.2021 08:53 № QCASQTA22ICP98L2 Page 2 of 3
Amount in Amount Amount Amount Balance
Transaction
Account Transaction details transaction in card of of after
date
currency currency charges discounts transaction
516875******8785 Food: MAGAZYN 0981, M. -8.60
19.05.2021 Contract No. SAMDNWFC00045211946 -8.60 0.00 0.00 2.36
from 07.09.2018
KROP-TSKYJ UAH
516875******8785 Food: C Magazin Univer, -11.00
19.05.2021 Contract No. SAMDNWFC00045211946 -11.00 0.00 0.22 10.96
from 07.09.2018
Kirovohrad, Shevchenko, 6v UAH
516875******8785 Transfer from PrivatBank card
20.00
19.05.2021 Contract No. SAMDNWFC00045211946 via Privat24. Sender: 20.00 0.00 0.00 21.96
from 07.09.2018
UAH
Semenenko Tetiana Valeriivna
516875******8785 -19.43
19.05.2021 Contract No. SAMDNWFC00045211946 Purchase -19.43 0.00 0.00 1.96
from 07.09.2018
UAH
516875******8785 Transfer from DMYTRO 20.00
19.05.2021 Contract No. SAMDNWFC00045211946 20.00 0.00 0.00 21.39
from 07.09.2018
ZOBENKO UAH
516875******8785 -9.75
18.05.2021 Contract No. SAMDNWFC00045211946 Purchase -9.75 0.00 0.00 1.39
from 07.09.2018
UAH
516875******8785 Transfer from PrivatBank card
10.00
18.05.2021 Contract No. SAMDNWFC00045211946 via Privat24. Sender: 10.00 0.00 0.00 11.14
from 07.09.2018
UAH
Semenenko Tetiana Valeriivna
516875******8785 -10.14
15.05.2021 Contract No. SAMDNWFC00045211946 Purchase -10.14 0.00 0.00 1.14
from 07.09.2018
UAH
516875******8785 Transfer from PrivatBank card
11.00
15.05.2021 Contract No. SAMDNWFC00045211946 via Privat24. Sender: 11.00 0.00 0.00 11.28
from 07.09.2018
UAH
Semenenko Tetiana Valeriivna
516875******8785 -2.33
14.05.2021 Contract No. SAMDNWFC00045211946 Purchase -2.33 0.00 0.00 0.28
from 07.09.2018
UAH
516875******8785 Food: C Magazin Univer, -12.00
12.05.2021 Contract No. SAMDNWFC00045211946 -12.00 0.00 0.24 2.61
from 07.09.2018
Kirovohrad, Shevchenko, 6v UAH
516875******8785 Transfer from PrivatBank card
10.00
12.05.2021 Contract No. SAMDNWFC00045211946 via Privat24. Sender: 10.00 0.00 0.00 14.61
from 07.09.2018
UAH
Semenenko Tetiana Valeriivna
516875******8785 Food: SHOP ATB PR144, -30.30
11.05.2021 Contract No. SAMDNWFC00045211946 -30.30 0.00 0.00 4.61
from 07.09.2018
KROPYVNYTSKYI UAH
516875******8785 Food: SHOP ATB PR094, -40.80
11.05.2021 Contract No. SAMDNWFC00045211946 -40.80 0.00 0.00 34.91
from 07.09.2018
KROPYVNYTSKYI UAH
516875******8785 Payment for goods/services in -14.19
11.05.2021 Contract No. SAMDNWFC00045211946 -14.19 0.00 0.00 75.71
from 07.09.2018
Internet: UP *Oplati, KYIV UAH
516875******8785 87.12
11.05.2021 Contract No. SAMDNWFC00045211946 Top-up of a card 87.12 0.00 0.00 89.90
from 07.09.2018
UAH
516875******8785 Payment for goods/services in -15.22
27.04.2021 Contract No. SAMDNWFC00045211946 -15.22 0.00 0.00 2.78
from 07.09.2018
Internet: UP *Oplati, KYIV UAH
516875******8785 Transfer from PrivatBank card
16.00
27.04.2021 Contract No. SAMDNWFC00045211946 via Privat24. Sender: 16.00 0.00 0.00 18.00
from 07.09.2018
UAH
Semenenko Tetiana Valeriivna
JOINT-STOCK COMPANY
COMMERCIAL BANK «PRIVATBANK»
Registered address:
1D Hrushevskoho St., Kyiv, 01001, Ukraine
Contact us:
30 Naberezhna Peremohy St., Dnipro, 49094, Ukraine
Phones: 3700 (free from mobile in Ukraine)
(056) 735 32 82
www.pb.ua e-mail:
[email protected]from 22.06.2021 08:53 № QCASQTA22ICP98L2 Page 3 of 3
Amount in Amount Amount Amount Balance
Transaction
Account Transaction details transaction in card of of after
date
currency currency charges discounts transaction
516875******8785 Transfer QWB*Qiwi Koshelek, -10.20
12.04.2021 Contract No. SAMDNWFC00045211946 -3.90 0.00 0.00 2.00
from 07.09.2018
MOSKVA RUB
516875******8785 Transfer from PrivatBank card
2.00
12.04.2021 Contract No. SAMDNWFC00045211946 via Privat24. Sender: 2.00 0.00 0.00 5.90
from 07.09.2018
UAH
Semenenko Tetiana Valeriivna
516875******8785 Transfer from PrivatBank card
3.00
12.04.2021 Contract No. SAMDNWFC00045211946 via Privat24. Sender: 3.00 0.00 0.00 3.90
from 07.09.2018
UAH
Semenenko Tetiana Valeriivna
516875******8785 Entertainment: UP *UP gmx, -14.52
03.04.2021 Contract No. SAMDNWFC00045211946 -14.52 0.00 0.00 0.90
from 07.09.2018
DNIPRO UAH
516875******8785 Transfer from PrivatBank card
15.00
03.04.2021 Contract No. SAMDNWFC00045211946 via Privat24. Sender: 15.00 0.00 0.00 15.42
from 07.09.2018
UAH
Semenenko Tetiana Valeriivna
516875******8785 Entertainment: UP *UP gmx, -9.60
29.03.2021 Contract No. SAMDNWFC00045211946 -9.60 0.00 0.00 0.42
from 07.09.2018
DNIPRO UAH
516875******8785 Transfer from PrivatBank card
10.00
29.03.2021 Contract No. SAMDNWFC00045211946 via Privat24. Sender: 10.00 0.00 0.00 10.02
from 07.09.2018
UAH
Semenenko Tetiana Valeriivna
516875******8785 -1.00
22.03.2021 Contract No. SAMDNWFC00045211946 Purchase -1.00 0.00 0.00 0.02
from 07.09.2018
UAH
516875******8785 Transfer QWB*Qiwi Koshelek, -11.36
17.03.2021 Contract No. SAMDNWFC00045211946 -4.49 0.00 0.00 1.02
from 07.09.2018
MOSKVA RUB
516875******8785 Food: C Magazin Univer, -10.00
17.03.2021 Contract No. SAMDNWFC00045211946 -10.00 0.00 0.20 5.51
from 07.09.2018
Kirovohrad, Shevchenko, 6v UAH
516875******8785 Transfer from PrivatBank card
15.00
17.03.2021 Contract No. SAMDNWFC00045211946 via Privat24. Sender: 15.00 0.00 0.00 15.51
from 07.09.2018
UAH
Semenenko Tetiana Valeriivna
The certificate is issued to be provided upon request
Project Manager on Processing Head-Office Customer Documents Nikolaienko Yuliia
Formed by Privat24 self-service system
The facsimile seal and signature are used by agreement of the parties in accordance with Article 207 of the Civil Code of Ukraine
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