Author: Groucho

W.I.L. Panamanian Private Interest Foundation Application

Wealth International, Ltd.

UPS delivery location	Postal address *

c/o United Parcel Service	Aptdo 12703-1000
De Oficinas Centrales De Pizza Hut Pavas	San Jose, San Jose 1000
50 Este, En Oficentro Mediterraneo	Costa Rica
San Jose, Costa Rica
(Add note: "Please Hold at Counter for Addressee")	* No-signature-required deliveries only.

Phone/Fax (North America): 206-339-6396	E-mail: admin@trustprofessionals.com

Please fill in the client information below and then mail or send via UPS with payment to the appropriate address above. All entries except cell and fax numbers are required.
_________________________________________________________________________________________________________________________
			1st choice:	____________________________________________________________
Foundation Name:		2nd choice:	____________________________________________________________
			3rd choice:	____________________________________________________________
Is nominee council required?  Yes   No  (circle one)
		Council Member #1:  _______________________________________________________
If “No” specify:	Council Member #2:  _______________________________________________________
		Council Member #3:  _______________________________________________________
Beneficiary:	________________________________________________________________________

First Name	___________________________	Last Name	_________________________________
Delivery Address	________________________________________________________________________
		Note: Order can be shipped only to a physical address, not to a U.S. Postal Office Box.
City	__________________________ 	State	_________________________________
Postal Code	__________________________ 	Country	_________________________________
Phone	_________________          Cell  _________________          Fax   ___________________
E-mail Address	________________________________________________________________________
5-digit Referring Client #  _____________   (Please make sure you enter the number correctly.)

Total Cost $2000.00 U.S.D.

Note: If the applicant is a U.S. citizen, in some cases the company's registered agent will require a copy of the applicant's passport to be kept on file, but such will be subject to the secrecy laws of the jurisdiction.

Payment Method (check one):	
ﾐ Wire Transfer (instructions will be sent)	ﾐ Cashier's Check*	ﾐ Travelers Check*
ﾐ International Money Order*	ﾐ Alternative Digital Payment**	ﾐ Other (use comments below)

*	Prior approval required. If granted, instructions will be sent.
**	See the "Alternative Digital Currencies" category of the W.I.L. Web site "Resources" section.

If you have selected “Other” as a method of payment, please indicate your intentions here: